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Reduced Patient Radiation Exposure during Neurodiagnostic and Interventional X-Ray Angiography with a New Imaging Platform.
AJNR Am J Neuroradiol 2017; 38(3):442-449AA

Abstract

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 × 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.

Authors+Show Affiliations

From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.Philips Healthcare (I.M.J.v.d.B.), Best, the Netherlands.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts Matthew.Gounis@umassmed.edu.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.From the Department of Radiology (K.v.d.M., S.V., M.H., T.N., K.T., A.K., M.J.G., A.S.P., A.K.W.), New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28104643

Citation

van der Marel, K, et al. "Reduced Patient Radiation Exposure During Neurodiagnostic and Interventional X-Ray Angiography With a New Imaging Platform." AJNR. American Journal of Neuroradiology, vol. 38, no. 3, 2017, pp. 442-449.
van der Marel K, Vedantham S, van der Bom IM, et al. Reduced Patient Radiation Exposure during Neurodiagnostic and Interventional X-Ray Angiography with a New Imaging Platform. AJNR Am J Neuroradiol. 2017;38(3):442-449.
van der Marel, K., Vedantham, S., van der Bom, I. M., Howk, M., Narain, T., Ty, K., ... Wakhloo, A. K. (2017). Reduced Patient Radiation Exposure during Neurodiagnostic and Interventional X-Ray Angiography with a New Imaging Platform. AJNR. American Journal of Neuroradiology, 38(3), pp. 442-449. doi:10.3174/ajnr.A5049.
van der Marel K, et al. Reduced Patient Radiation Exposure During Neurodiagnostic and Interventional X-Ray Angiography With a New Imaging Platform. AJNR Am J Neuroradiol. 2017;38(3):442-449. PubMed PMID: 28104643.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced Patient Radiation Exposure during Neurodiagnostic and Interventional X-Ray Angiography with a New Imaging Platform. AU - van der Marel,K, AU - Vedantham,S, AU - van der Bom,I M J, AU - Howk,M, AU - Narain,T, AU - Ty,K, AU - Karellas,A, AU - Gounis,M J, AU - Puri,A S, AU - Wakhloo,A K, Y1 - 2017/01/19/ PY - 2016/07/15/received PY - 2016/10/11/accepted PY - 2017/1/21/pubmed PY - 2017/10/19/medline PY - 2017/1/21/entrez SP - 442 EP - 449 JF - AJNR. American journal of neuroradiology JO - AJNR Am J Neuroradiol VL - 38 IS - 3 N2 - 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 × 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. SN - 1936-959X UR - https://www.unboundmedicine.com/medline/citation/28104643/Reduced_Patient_Radiation_Exposure_during_Neurodiagnostic_and_Interventional_X_Ray_Angiography_with_a_New_Imaging_Platform_ L2 - http://www.ajnr.org/cgi/pmidlookup?view=long&amp;pmid=28104643 DB - PRIME DP - Unbound Medicine ER -