Reduced Patient Radiation Exposure during Neurodiagnostic and Interventional X-Ray Angiography with a New Imaging Platform
Authors
van der Marel, KajoVedantham, Srinivasan
van der Bom, I. M. J.
Howk, Mary
Narain, T.
Ty, Kimberly
Karellas, Andrew
Gounis, Matthew J.
Puri, Ajit S.
Wakhloo, Ajay K.
Document Type
Journal ArticlePublication Date
2017-03-01
Metadata
Show full item recordAbstract
BACKGROUND AND PURPOSE: Advancements in medical device and imaging technology as well as accruing clinical evidence have accelerated the growth of the endovascular treatment of cerebrovascular diseases. However, the augmented role of these procedures raises concerns about the radiation dose to patients and operators. We evaluated patient doses from an x-ray imaging platform with radiation dose-reduction technology, which combined image noise reduction, motion correction, and contrast-dependent temporal averaging with optimized x-ray exposure settings. MATERIALS AND METHODS: In this single-center, retrospective study, cumulative dose-area product inclusive of fluoroscopy, angiography, and 3D acquisitions for all neurovascular procedures performed during a 2-year period on the dose-reduction platform were compared with a reference platform. Key study features were the following: The neurointerventional radiologist could select the targeted dose reduction for each patient with the dose-reduction platform, and the statistical analyses included patient characteristics and the neurointerventional radiologist as covariates. The analyzed outcome measures were cumulative dose (kerma)-area product, fluoroscopy duration, and administered contrast volume. RESULTS: A total of 1238 neurointerventional cases were included, of which 914 and 324 were performed on the reference and dose-reduction platforms, respectively. Over all diagnostic and neurointerventional procedures, the cumulative dose-area product was significantly reduced by 53.2% (mean reduction, 160.3 Gy x cm2; P < .0001), fluoroscopy duration was marginally significantly increased (mean increase, 5.2 minutes; P = .0491), and contrast volume was nonsignificantly increased (mean increase, 15.3 mL; P = .1616) with the dose-reduction platform. CONCLUSIONS: A significant reduction in patient radiation dose is achievable during neurovascular procedures by using dose-reduction technology with a minimal impact on workflow.Source
AJNR Am J Neuroradiol. 2017 Mar;38(3):442-449. Epub 2017 Jan 19. Link to article on publisher's siteDOI
10.3174/ajnr.A5049Permanent Link to this Item
http://hdl.handle.net/20.500.14038/48098PubMed ID
28104643Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.3174/ajnr.A5049