Image Quality of Low-Dose Cerebral Angiography and Effectiveness of Clinical Implementation on Diagnostic and Neurointerventional Procedures for Intracranial Aneurysms
- 4 April 2019
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal Of Neuroradiology
- Vol. 40 (5), 827-833
- https://doi.org/10.3174/ajnr.a6029
Abstract
BACKGROUND AND PURPOSE: Awareness of the potential for exposure to high doses of radiation from interventional radiologic procedures has increased. The purpose of this study was to evaluate image quality and dose reduction of low-dose cerebral angiography during diagnostic and therapeutic procedures for intracranial aneurysms. MATERIALS AND METHODS: A retrospective review of 1137 prospectively collected patients between January 2012 and June 2014 was performed. Beginning in April 2013, a dose-reduction strategy was implemented. Subjective image-quality assessment of 506 standard and 540 low-dose cerebral angiography images was performed by 2 neuroradiologists using a 5-point scale and was tested using noninferiority statistics. Radiation dose-area product and air kerma of 1046 diagnostic and 317 therapeutic procedures for intracranial aneurysms were analyzed and compared between groups before (group 1) and after (group 2) clinical implementation of a dose-reduction strategy. RESULTS: The image quality of the low-dose cerebral angiography was not inferior on the basis of results from the 2 readers. For diagnostic cerebral angiography, the mean dose-area product and air kerma were 140.8 Gy×cm2 and 1.0 Gy, respectively, in group 1 and 82.0 Gy×cm2 and 0.6 Gy in group 2 (P < .001, P < .001). For the neurointerventional procedure, the mean dose-area product and air kerma were 246.0 Gy×cm2 and 3.7 Gy, respectively, in group 1 and 169.8 Gy×cm2 and 3.3 Gy in group 2 (P < .001, P = .291). CONCLUSIONS: With low-dose cerebral angiography, image quality was maintained, and implementation of dose-reduction strategies reduced radiation doses in patients undergoing diagnostic and neurointerventional procedures for intracranial aneurysms.Keywords
This publication has 22 references indexed in Scilit:
- Radiation exposure, and procedure and fluoroscopy times in endovascular treatment of intracranial aneurysms: a methodological comparisonJournal of NeuroInterventional Surgery, 2018
- Analysis of radiation doses incurred during diagnostic cerebral angiography after the implementation of dose reduction strategiesJournal of NeuroInterventional Surgery, 2016
- Patient Radiation Exposure During Diagnostic and Therapeutic Procedures for Intracranial Aneurysms: A Multicenter StudyNeurointervention, 2016
- Radiation dose reduction during neurointerventional procedures by modification of default settings on biplane angiography equipmentJournal of NeuroInterventional Surgery, 2015
- Diagnostic quality and accuracy of low dose 3D-DSA protocols in the evaluation of intracranial aneurysmsJournal of NeuroInterventional Surgery, 2014
- Image Noise Reduction Algorithm for Digital Subtraction Angiography: Clinical ResultsRadiology, 2013
- Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in NeuroradiologyAmerican Journal Of Neuroradiology, 2012
- Proposed local diagnostic reference levels in angiography and interventional neuroradiology and a preliminary analysis according to the complexity of the proceduresPhysica Medica-European Journal Of Medical Physics, 2012
- How to set up and apply reference levels in fluoroscopy at a national levelEuropean Radiology, 2006
- Patient radiation doses and references levels in interventional radiology.2004