Estimated radiation dose according to the craniocaudal angle in cerebral digital subtraction angiography: Patient and phantom study

Introduction The objective of this article is to evaluate the feasibility of cerebral digital subtraction angiography (DSA) using ultra-low radiation dose settings in a simplified cerebral angiography phantom. Materials and methods We created a silicone phantom capable of producing a simplified cerebral DSA. A total of 18 DSA sets were obtained with gradual six-step reduction of the detector entrance dose (DED) from 1.82 to 0.08 μGy per frame, while standard, postprocessing algorithm (PPA) and copper filter (0.3 mm) with PPA (CwP) algorithm reconstruction protocols were applied. We quantitatively compared their signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) and qualitatively analyzed the images' qualities in terms of image sharpness, contrast, and noise as investigated by five observers. Results The SNR and CNR, which decreased with lowering of the DED in the standard protocol group, were significantly compensated by using the PPA. The values were approximately double in the PPA (11.5 ± 2.9) and CwP (11.0 ± 2.5) groups compared with the standard (5.4 ± 1.1) group in the DED of 0.24 μGy per frame as well as in the other values. The total scores of the observers according to the protocols showed a tendency to decrease as the DED lowered. On average, the PPA (96.3 ± 34.6) and CwP (91.3 ± 29.9) groups yielded higher results than the standard protocol (83.7 ± 46.7). Conclusion Given that the current DED ranges from 1.82 to 3.60 μGy per frame for routine cerebral DSA, our results indicate that DED can be decreased to 15%–30% of the current dose level in vessels 2–4 mm in diameter if image-improvement algorithms are applied.

Download Full-text

Assessment of automated cone-beam CT vessel identification software during transarterial hepatic embolisation: radiation dose, contrast medium volume, processing time, and operator perspectives compared to digital subtraction angiography

Clinical Radiology ◽

10.1016/j.crad.2018.08.005 ◽

2018 ◽

Vol 73 (12) ◽

pp. 1057.e1-1057.e6 ◽

Cited By ~ 3

Author(s):

J.C. Durack ◽

K.T. Brown ◽

G. Avignon ◽

L.A. Brody ◽

C.T. Sofocleous ◽

...

Keyword(s):

Radiation Dose ◽

Contrast Medium ◽

Digital Subtraction Angiography ◽

Processing Time ◽

Cone Beam Ct ◽

Cone Beam ◽

Digital Subtraction ◽

Identification Software

Download Full-text

Abstract WMP119: 4d Digital Subtraction Angiography (4d-dsa) for Pre-treatment Evaluation of Cerebrovascular Diseases

Stroke ◽

10.1161/str.47.suppl_1.wmp119 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Ichiro Yuki ◽

Shunsuke Hataoka ◽

Toshihiro Ishibashi ◽

Chihebeddine Dahmani ◽

Yukiko Abe ◽

...

Keyword(s):

Radiation Dose ◽

Digital Subtraction Angiography ◽

Treatment Planning ◽

Vascular Malformation ◽

Vascular Malformations ◽

Cerebrovascular Diseases ◽

Acquisition Time ◽

Digital Subtraction ◽

Vascular Structures ◽

Pre Treatment

Purpose: 4D Digital Subtraction Angiography (4D-DSA) is a new imaging technology that provides both high spatial resolution and temporal resolution in one acquisition. It is a special new reconstruction algorithm that made this technology possible. Patients with various types of cerebrovascular diseases were evaluated with 4D-DSA, and its efficacy and limitations were assessed. Methods: The 4D-DSA images of patients with different types of vascular malformations were evaluated. 6 seconds acquisitions were used for the evaluation of arterial phase dynamics and 12 seconds acquisitions for assessing the entire arterial-venous phase. The amount of contrast material and radiation dose used in each acquisition was compared with the conventional rotational 3D-DSA. The unique findings observed in the 4D-DSA in each type of vascular malformation were described, and whether or not the findings are useful for the pre-treatment planning was discussed. Results: The 4D-DSA images of a total of 57 patients were evaluated. 33 aneurysm patients, 6 arteriovenous malformation (AVM) patients, 8 dural arteriovenous fistula (AVF) patients, as well as 4 spinal vascular malformation patients, and 6 others were included. The amount of contrast and radiation dose required for the 4D-DSA (6 seconds acquisition) was similar to the conventional 3D-DSA, whereas 12 seconds acquisitions required almost double the dose. Especially for the vascular malformations with arterio-venous shunting, the 4D-DSA helped understand the detailed vascular anatomy by breaking down the complex vascular structures into the different phases of contrast filling. Motion artifact due to the longer acquisition time, and metal artifact from deployed coils were observed. Conclusions: The temporal information provided by 4D-DSA helps us understand the complex vascular structures and flow dynamics. 4D-DSA can be an effective assessment tool for the pre-treatment planning of brain vascular malformations.

Download Full-text