Low-Dose Fluoroscopy Protocol for Diagnostic Cerebral Angiography

Song, Yunsun; Han, Seongsik; Kim, Byung Jun; Oh, Seong Heum; Kim, Jin Su; Kim, Tae Il; Lee, Deok Hee

doi:10.5469/neuroint.2020.00129

Cited by 5 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on a basic knowledge, there are several factors that affect patient radiation dose during the cerebral angiographic procedure, such as the number of exposures, frame rate, additional filter thickness, focal spot size, number of images, fluoroscopic time, and pulse. Several lines of evidence have demonstrated that optimization through the modification of these factors significantly reduces radiation dose during cerebral angiography [8,10,11,15,16]. Since some factors (number of image and acquisition time) could not be controlled in this study, a statistical analysis of radiation doses from the conventional and high kV techniques using analysis of covariances (ANCOVAs) was necessary.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing Radiation Dose of Cerebral Angiography Using Conventional and High kV Techniques: A Retrospective Study on Intracranial Aneurysm Patients and a Phantom Study

et al. 2023

View full text Add to dashboard Cite

Evaluation of patient radiation dose after the implementation of a high kV technique during a cerebral angiographic procedure is an important issue. This study aimed to determine and compare the patient radiation dose of intracranial aneurysm patients undergoing cerebral angiography using the conventional and high kV techniques in a retrospective study and a phantom study. A total of 122 cases (61 cases with conventional technique and 61 cases with high kV technique) of intracranial aneurysm patients, who underwent cerebral angiographic procedure and met the inclusion criteria, were recruited. The radiation dose and the angiographic exposure parameters were reviewed retrospectively. The radiation dose in the phantom study was conducted using nanoDotTM optically stimulating luminescence (OSLD), which were placed on the scalp of the head phantom, the back of the neck, and the phantom skin at the position of the eyes. The standard cerebral angiographic procedure using the conventional and high kV techniques was performed following the standard protocol. The results showed that the high kV technique significantly reduced patient radiation dose and phantom skin dose. This study confirms that the implementation of a high kV technique in routine cerebral angiography for aneurysm diagnosis provides an effective reduction in radiation dose. Further investigation of radiation dose in other interventional neuroradiology procedures, particularly embolization procedure, should be performed.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The high kV technique reduced the 2DA DAP by up to 50.12%. In addition, the median total DAP in the high kV technique group (10,967.55 µGy•m 2 ) decreased from the conventional technique group (16,198.53 µGy•m 2 ) by 32.29%.…”

Section: Effects Of the High Kv Technique On Patient Radiation Dosementioning

confidence: 92%

Comparing Radiation Dose of Cerebral Angiography Using Conventional and High kV Techniques: A Retrospective Study on Intracranial Aneurysm Patients and a Phantom Study

et al. 2023

View full text Add to dashboard Cite

show abstract

“…However, as most aneurysms occur in the circle of Willis, the lens is inevitably exposed to radiation in 3D-RA. While many studies in the neurointerventional field have investigated different protocols for reducing radiation doses [ 7 8 9 10 11 12 13 14 15 ], few papers focused on dose reduction in 3D-RA, and none specifically focused on reducing the dose to the lens.…”

Section: Introductionmentioning

confidence: 99%

Reduction of Radiation Dose to Eye Lens in Cerebral 3D Rotational Angiography Using Head Off-Centering by Table Height Adjustment: A Prospective Study

Ryu

Yoon

Kim³

et al. 2023

Korean J Radiol

Self Cite

View full text Add to dashboard Cite

Objective Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. Materials and Methods The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients’ 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. Results The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy ( P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm 2 , P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. Conclusion The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.

show abstract

“…Recent studies have demonstrated that the application of low-dose protocols is effective and safe for diagnostic angiography. Song et al [ 4 ] created a low-dose protocol by gradually decreasing the detector entrance dose from 23 to 8 nGy, which lowered the fluoroscopy dose area product (DAP) and air kerma (AK) by 52% in diagnostic cerebral angiography, as compared to default settings. Also, van der Marel et al [ 5 ] created a dose-reduction platform, and its application reduced cumulative DAP in both diagnostic and neurointervention procedures by 53.2%.…”

mentioning

confidence: 99%

Recent Radiation Reduction Strategies for Neurointerventionists

Shin¹

2020

Neurointervention

View full text Add to dashboard Cite

Low-Dose Fluoroscopy Protocol for Diagnostic Cerebral Angiography

Cited by 5 publications

References 17 publications

Comparing Radiation Dose of Cerebral Angiography Using Conventional and High kV Techniques: A Retrospective Study on Intracranial Aneurysm Patients and a Phantom Study

Comparing Radiation Dose of Cerebral Angiography Using Conventional and High kV Techniques: A Retrospective Study on Intracranial Aneurysm Patients and a Phantom Study

Reduction of Radiation Dose to Eye Lens in Cerebral 3D Rotational Angiography Using Head Off-Centering by Table Height Adjustment: A Prospective Study

Recent Radiation Reduction Strategies for Neurointerventionists

Contact Info

Product

Resources

About