Removal of Antiscatter Grids for Spinal Digital Subtraction                     Angiography: Dose Reduction without Loss of Diagnostic Value

Orrù, Emanuele; Mekabaty, Amgad El; Millán, Diego San; Pearl, Monica S.; Gailloud, Philippe

doi:10.1148/radiol.2020191786

Cited by 13 publications

(6 citation statements)

References 33 publications

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“…In the literature, radiation dose data from spinal diagnostic angiographies were commonly published from cohorts with heterogeneous pathologies [1,4,[10][11][12]14]. In contrast, we rather aimed to collect homogeneous data dedicated to a specific spinal vascular pathology.…”

Section: Resultsmentioning

confidence: 99%

“…The DRL for spinal endovascular procedures is still to be determined by the National Federal Office of Radiation Protection, and reference values in the literature are scarce and variable [1,4,[9][10][11][12]. We conducted a retrospective singlecenter study to analyze radiation dose, fluoroscopy time, and amount of contrast material in diagnostic spinal angiographies performed in a homogeneous group of patients presenting with SDAVFs in order to provide data valuable for the establishment of novel DRLs.…”

Section: Introductionmentioning

confidence: 99%

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Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

et al. 2022

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Purpose Spinal dural arteriovenous fistulas (SDAVFs) represent the most common indication for a spinal angiography. The diagnostic reference level (DRL) for this specific endovascular procedure is still to be determined. This single-center study provides detailed dosimetrics of diagnostic spinal angiography performed in patients with SDAVFs. Methods Retrospective analysis of all diagnostic spinal angiographies between December 2011 and January 2021. Only patients with an SDAVF who had baseline magnetic resonance angiography (MRA), diagnostic digital subtraction angiography (DSA), treatment and follow-up at this institution were included. Dose area product (DAP, Gy cm2) and fluoroscopy time were compared between preoperative and postoperative angiographies, according to SDAVF locations (common versus uncommon), MRA results at baseline (positive versus negative) and DSA protocols (low-dose, mixed-dose, normal-dose). The 75th percentile of the DAP distribution was used to define the local DRL. Results A total of 62 spinal angiographies were performed in 25 patients with SDAVF. Preoperative angiographies (30/62, 48%) yielded a significantly higher DAP and longer fluoroscopy time when compared to postoperative angiographies (32/62, 53%) (p < 0.01). The local DRL was 329.41 Gy cm2 for a nonspecific (n = 62), 395.59 Gy cm2 for a preoperative and 138.6 Gy cm2 for a postoperative spinal angiography. Preoperative angiography of uncommonly located SDAVFs yielded a significantly longer fluoroscopy time (p = 0.02). The MRA-based fistula detection had no significant impact on dosimetrics (p > 0.05). A low-dose protocol yielded a 61% reduction of DAP. Conclusion The results of the present study suggest novel DRLs for spinal angiography in patients with SDAVF. Dedicated low-dose protocols enable radiation dose optimization in these procedures.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

et al. 2022

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“…Many publications focus on radiation protection issues in fluoroscopy and specially in interventional procedures [1,[57][58][59][60][61][62][63][64][65][66]. The common feature of all studies is that patient dose optimization in interventional procedures occurs by a combination of equipment protocol modification and operator behaviour, and not simply by changing the protocol characteristics.…”

Section: Fluoroscopymentioning

confidence: 99%

Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives

Tsapaki

2020

Physica Medica

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The medical radiological imaging technological evolution and wide availability has resulted in the exponential increase in utilization. Evidence for a risk of cancer arising from radiation doses of lower than 100 mSv is still limited. There is a need for patient dose optimization. A literature review was conducted to identify the reasons why optimization is important and the steps to be followed for a successful optimization process in digital radiology, Computed Tomography, interventional radiology and mammography.Based on recent literature, 5 steps for a dose optimization process are proposed. These steps are: 1) establishment of a quality assurance programme; a mistake, misuse or malfunction of an X-ray machine can potentially affect the health or life of thousands of people, 2) establishment of a dose optimization team consisting of a radiologist, medical physicist and radiation technologist, 3) determination of baseline dose levels and image quality as well as comparisons with benchmarks to decide which exam protocols should be optimized, 4) modification of protocols by the medical physicist and 5) evaluation of the optimization process and its effect on patient dose and image quality.The optimization process should include joint efforts focused on 1) equipment performance 2) exam protocol customization and 3) staff behaviour. Manufacturers should provide detailed descriptions of exam protocols and training on the use of dose reduction features. The diagnostic radiology medical physicist should emerge and take a proactive lead in the everyday clinical routine in order to promote the value of optimization process.

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“…[6][7][8][9][10] Despite DSA being considered the gold standard for vascular evaluation, its inherent invasiveness and ionizing radiation limit its suitability as a preferred screening examination. [11] Among the other methods mentioned, contrast-enhanced MRA (CE-MRA) offers several advantages such as unrestricted tissue penetration depth, absence of ionizing radiation, high tissue resolution, and abundant post-processing techniques. [12][13][14] Although the non-enhanced MRA is widely utilized in clinical practice due to its ability to provide vessel images without the need for contrast agent administration, this technology still possesses several inherent limitations.…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Angiography with Hour‐Scale Duration after Single Low‐Dose Administration of Biocompatible Gadolinium Oxide Nanoprobe

Wang,

Han,

et al. 2024

Adv Healthcare Materials

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Long‐term contrast‐enhanced angiography offers significant advantages in theranostics for diverse vascular diseases, particularly in terms of real‐time dynamic monitoring during acute vascular events; However, achieving vascular imaging with a duration of hours through a single administration of low‐dose contrast agent remains challenging. Herein, a hyaluronic acid‐templated gadolinium oxide (HA@Gd2O3) nanoprobe‐enhanced magnetic resonance angiography (MRA) is proposed to address this bottleneck issue for the first time. The HA@Gd2O3 nanoprobe synthesized from a facile one‐pot biomineralization method owns ultrasmall size, good biocompatibility, optimal circulation half‐life (≈149 min), and a relatively high T1 relaxivity (r1) under both clinical 3 T (8.215 mM−1s−1) and preclinical 9.4 T (4.023 mM−1s−1) equipment. The HA@Gd2O3 nanoprobe‐enhanced MRA highlights major vessels readily with significantly improved contrast, extended imaging duration for at least 2 h, and ultrahigh resolution of 0.15 mm under 9.4 T, while only requiring half clinical dosage of Gd. This technique can enable rapid diagnosis and real‐time dynamic monitoring of vascular changes in a model of acute superior mesenteric vein thrombosis with only a single injection of nanoprobe. The HA@Gd2O3 nanoprobe‐enhanced MRA provides a sophisticated approach for long‐term (hour scale) vascular imaging with ultrahigh resolution and high contrast through single administration of low‐dose contrast agent.

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Removal of Antiscatter Grids for Spinal Digital Subtraction Angiography: Dose Reduction without Loss of Diagnostic Value

Cited by 13 publications

References 33 publications

Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives

Magnetic Resonance Angiography with Hour‐Scale Duration after Single Low‐Dose Administration of Biocompatible Gadolinium Oxide Nanoprobe

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