Predictors of radiation dose for uterine artery embolisation are angiography system-dependent

2022 ◽  
Author(s):  
Don Johnson Nocum ◽  
John Robinson ◽  
Mark Halaki ◽  
Magnus Bath ◽  
John D. Thompson ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Uterine Artery ◽  
Predictive Accuracy ◽  
Uterine Artery Embolisation ◽  
System A ◽  
Group I ◽  
Reduce Radiation Dose ◽  
Area Product ◽  
Dose Measurements ◽  
Mlr Model

Abstract This study sought to achieve radiation dose reductions for patients receiving uterine artery embolisation (UAE) by evaluating radiation dose measurements for the preceding generation (Allura) and upgraded (Azurion) angiography system. Previous UAE regression models in the literature could not be applied to this centre’s practice due to being based on different angiography systems and radiation dose predictor variables. The aims of this study were to establish whether radiation dose is reduced with the upgraded angiography system and to develop a regression model to determine predictors of radiation dose specific to the upgraded angiography system. A comparison between Group I (Allura, n = 95) and Group II (Azurion, n = 95) demonstrated a significant reduction in KAP (kerma-area product) and Ka, r (reference air kerma) by 63% (143.2 Gy·cm2 vs 52.9 Gy·cm2; P < 0.001, d = 0.8) and 67% (0.6 Gy vs 0.2 Gy; P < 0.001, d = 0.8), respectively. The multivariable linear regression (MLR) model identified the UAE radiation dose predictors for KAP on the upgraded angiography system as total fluoroscopy dose, Ka, r, and total uterus volume. The predictive accuracy of the MLR model was assessed using a Bland-Altman plot. The mean difference was 0.39 Gy·cm2 and the limits of agreement (LoA) were +28.49 and -27.71 Gy·cm2, and thus illustrated no proportional bias. Our findings validated the upgraded angiography system and its advance capabilities to significantly reduce radiation dose for our patients. Interventional radiologist and interventional radiographer familiarisation of the system’s features and the implementation of the newly established MLR model would further facilitate dose optimisation for all centres performing UAE procedures using the upgraded angiography system.

scholarly journals The difference in dose and image quality between magnification methods used after the introduction of larger 60-inch operator screens

BJR|Open ◽  
2020 ◽  
Vol 2 (1) ◽  
pp. 20190044
Author(s):  
Hywel Mortimer-Roberts ◽  
Michael R Rees
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Communication Systems ◽  
Image Resolution ◽  
Low Contrast ◽  
Test Tool ◽  
Reduce Radiation Dose ◽  
The Difference ◽  
Picture Archiving And Communication ◽  
Area Product

Objective: To determine whether the use of display matrix magnification on larger operator screens without the use of conventional magnification can reduce radiation dose to the patient, and what effect it would have on image quality. Methods: The kerma-area product (KAP) resulting from standard projections in cardiac angiography were measured when an anthropomorphic phantom was imaged using conventional magnification method and display matrix magnification. The image quality was also evaluated by three observers using a TOR 18FG test tool for both magnification method. Results: The mean radiation KAP for the seven views with conventional magnification was 36.65 µGy m−2 whilst a reduction in KAP of 20.4% is possible using display matrix magnification (p < 0.05). The image resolution during acquisition was identical between both methods and only slightly reduced for the display matrix (1.6 LP mm−1) compared to conventional magnification (1.8 LP mm−1) when images were stored and retrieved on a Picture Archiving and Communication Systems (PACS) system. Both methods retained the same low-contrast detectability to PACS, with only a slight increase in detectability of 18 for display matrix magnification compared to 17 for conventional. Conclusion: Using display matrix magnification instead of conventional equipment magnification significantly reduces radiation does in all standard cardiac views without reducing image quality for the operator. This reduction in radiation dose is significant (p < 0.05) for the patients. The resolution did not change during acquisition, but contrast improved slightly (0.9% threshold contrast), but lost resolution of 0.2 LP mm−1 when archived to PACS. Advances in knowledge: This is a new method of reducing significant dose to the patient during cardiology examinations and may encourage further studies in other fluoroscopy lead examination to see if it could work for them.

scholarly journals Analysis of Factors Affecting Air Kerma Area Product Obtained during Uterine Artery Embolization Procedures Using Logistic Regression

2021 ◽  
Author(s):  
Khaled Soliman ◽  
Ahmed Almutairi ◽  
Murdhi AlHarbi ◽  
Khaleel Almutairi ◽  
Turky Almutairi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Radiation Dose ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Area Under The Curve ◽  
Multivariable Logistic Regression Analysis ◽  
Artery Embolization ◽  
Factors Affecting ◽  
Area Product ◽  
To Receive

Abstract Purpose Uterine artery embolization (UAE) is a common interventional radiology procedure used in medicine; the procedure is safe but there is always a concern regarding radiation dose received by the patient. The aim of this study was to use multivariable logistic regression analysis (MLRA) to study a certain number of independent prognostic variables believed to provide an estimate of the likelihood of obtaining a high kerma area product (P KA) at the end of the procedure. Method Radiation dose indices registered by the angiographic system structured dose report, the total fluoroscopy time (FT), the patient’ body mass index (BMI), the number of images taken during the procedures (IMGS), and the performing physician experience (EXPER) were used to drive a logistic regression model (LRM). Results The LRM found was: Logit (P KA) = −6.1525 + 0.0416 (FT) + 0.1028 (IMGS) + 0.1675 (BMI) – 0.1012 (EXPER). The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve; by calculating the area under the curve (AUC), we found AUC = 0.7896, with optimal ROC point of 0.3261, 0.8036. Conclusion The suggested LRM seems to indicate that patients with higher BMI, have taken longer FT, acquired higher IMGS and the procedure done by a less experienced performing physician is more susceptible to receive a higher P KA at the end. The proposed LRM is useful in predicting the occurrence of higher radiation exposure interventions and can be used in patients’ radiation dose optimization strategies during UAE procedures.

Assessment of organ radiation dose associated with uterine artery embolization

2006 ◽  
Vol 47 (2) ◽  
pp. 179-185 ◽  
Author(s):  
O. Glomset ◽  
J. Hellesnes ◽  
N. Heimland ◽  
G. Hafsahl ◽  
H. J. Smith
Keyword(s):  
Statistical Analysis ◽  
Radiation Dose ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Skin Dose ◽  
Artery Embolization ◽  
System A ◽  
Significant Difference ◽  
The Mean ◽  
Peak Skin Dose

Purpose: To evaluate the radiation dose to the skin, uterus, and ovaries during uterine artery embolization. Material and Methods: Guided uterine artery embolization for leiomyomata and two types of X-ray equipment with different dose levels were utilized during fluoroscopy in 20 women (ages ranging from 32 to 52 years, body weights from 55 to 68 kg). The first 13 women were treated using a non-pulsed system A, with 3.3 mm Al filtering and, for simplicity, a fixed peak voltage 80 kV. During treatment of the other 7 women, a pulsed system B with 5.4 mm Al filtering and an identical fixed voltage was used. The dose area product (DAP) was recorded. The vaginal dose of the first 13 patients and the peak skin dose of all patients were measured with thermoluminescent dosimeters (TLDs). TLDs were placed in the posterior vaginal fornix and on the skin at the beam entrance site. The uterine and ovarian doses were estimated based on the measured skin doses, normalized depth dose, and organ depth values. The effective dose (Deff) was estimated based on the observed DAP values. The measured vaginal doses and the corresponding estimated uterine doses were compared statistically, as were the DAP values from systems A and B. Results: For system A, the mean fluoroscopic time was 20.9 min (range 12.7–31.1), and for system B 35.9 min (range 16.4–55.4). The mean numbers of angiographic exposures for systems A and B were 82 (range 30–164) and 37 (range 20–72), respectively. The mean peak skin dose for system A was 601.5 mGy (range 279–1030) and for system B 453 mGy (range 257–875). The mean DAP for system A was 88.6 Gy·cm2 (range 41.4–161.0) and for system B 52.5 Gy·cm2 (range 20.1–107.9). Statistical analysis showed a significant difference between the DAP values, the DAP for system B being the lower one. The mean estimated effective doses from systems A and B were 32 mSv (range 15.1–58.4) and 22 mSv (range 9–46), respectively. The mean estimated maximum uterine and ovarian doses using system A were 81 mGy (range 30–247) and 85 mGy (range 24–207), respectively; when using system B, the respective doses were 101 mGy (range 45–182) and 105 mGy (range 31–246). The measured vaginal doses had a mean value of 52.5 mGy (range 12–124). Statistical analysis revealed a significant difference between the estimated uterine doses and the measured vaginal doses. Conclusion: A significant difference was found between the estimated uterine doses and the corresponding measured vaginal doses. This has to be kept in mind when using vaginal doses as a substitute for the uterine dose. There was also a significant difference between the DAP values from systems A and B. System B, with pulsed fluoroscopy and greater filtration, gave the lower exposure. The maximum skin dose indicates that skin injuries are unlikely to occur. The ovarian doses are also below the threshold for temporary or permanent sterility. The stochastic risk for radiation-induced cancer and genetic injury to the patient's future children is not considered as substantial.

Estimation of the radiation dose for dental spectral cone-beam CT

2020 ◽  
pp. 20200372
Author(s):  
Kaan Orhan ◽  
Ruben Pauwels ◽  
Yi Chen ◽  
Dandan Song ◽  
Reinhilde Jacobs
Keyword(s):  
Radiation Dose ◽  
Effective Dose ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Dose Area Product ◽  
Ion Chamber ◽  
Effective Doses ◽  
Artefact Reduction ◽  
Area Product ◽  
Dose Measurements

Objectives: The purpose of this study was to estimate the radiation dose for a dental spectral cone-beam CT (SCBCT) unit at different scanning parameters. Methods: Radiation dose measurements were performed for a commercially available dental SCBCT. Scans were obtained at different exposure times and fields of view (FOV), both for non-spectral (25 × 18 cm, 14 × 18 cm, 14 × 12 cm, 9 × 9 cm, 6 × 6 cm) and spectral modes (14 × 18 cm, 14 × 12 cm, 9 × 9 cm, 6 × 6 cm) with the tube voltage alternating between 80 and 110 kV for spectral mode, and fixed at 110 kV for non-spectral mode. An ion chamber was used for air kerma and dose area product (DAP) measurements. The effective dose was estimated based on the mAs using previously published logarithmic curves for CBCT units with a similar X-ray spectrum. Results: The adult effective dose, in non-spectral mode, was 44-269µSv for small FOVs, 131-336µSv for the medium FOV, and 163-476µSv for the large FOV. In spectral mode, the estimated adult effective doses were 96-206µSv for small, 299µSv for medium and 372µSv for large FOV protocols. Pediatric effective doses were estimated to be 75% higher than corresponding adult doses. Conclusion: SCBCT showed comparable doses with other CBCT devices, but DAP values were generally above currently published DRLs. Spectral imaging might allow for artefact reduction at comparable dose levels, which should be assessed in further image quality studies at both a technical and diagnostic level.

scholarly journals Identifying predictors of patient radiation dose during uterine artery embolisation

2020 ◽  
Author(s):  
Don J. Nocum ◽  
John Robinson ◽  
Mark Halaki ◽  
Eisen Liang ◽  
Nadine Thompson ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Uterine Artery ◽  
Uterine Artery Embolisation ◽  
Patient Radiation Dose

scholarly journals Air kerma area product in cone beam computed tomography

2015 ◽  
Vol 13 (3) ◽  
pp. 309
Author(s):  
Marcus Vinicius Linhares De Oliveira ◽  
Wilson Otto Gomes Batista ◽  
Maria Rosângela Soares ◽  
Paulo Sergio Flores Campos
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Cone Beam Computed Tomography ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Font Size ◽  
Air Kerma ◽  
Tomography Image ◽  
Reduce Radiation Dose ◽  
Area Product

<p class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;"><strong><em><span style="font-size: 12.0pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-ansi-language: EN-US;" lang="EN-US">Objective:</span></em></strong><em><span style="font-size: 12.0pt; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; mso-ansi-language: EN-US;" lang="EN-US"> to evaluate the influence of FOV in air kerma-area product (KAP) and the constancy of exposure parameters on cone beam computed tomography equipments. <strong>Methodology</strong>: Two cone beam CT (GENDEX CBX 500 and<br /> &nbsp;i-CAT Classic) were used and seven exposures with the following FOVs were performed: (A) 14cm x 8,5cm, (B) 14cm x 6cm, (C) 8,5cm x 8.5cm e (D) 8,5cm x 6cm, for CBX 500; and (E) 14cm x 6.cm, (F) 14cm x 8cm e (G) 14cm x 13cm, for the i-CAT. The technical exposure factors (kV, mA, mAs and voxel), remained constant. The dosimetric evaluation was performed with air KAP meter manufactured by IBA dosimetry, model kerma X plus TinO, positioned at the output of the X-ray beam. To evaluate the constancy of the exposure parameters a semiconductor <br /> (Radcal, Rapidose) fixed in front of the tomography image receptor was used. <strong>Result:</strong> The KAP values ​​obtained ranged between 360.1 mGy.cm&sup2; and 1031.2 mGy.cm&sup2;. The FOV height had a substantial influence on the radiation dose. Repeatability and accuracy of the tube voltage varied less than 10%. <strong>Conclusion</strong>: The radiation dose is directly related to the height and inversely related with the FOV diameter; even within the recommended limits, the percentage variation of repeatability and accuracy of kV, for the tomography equipments tested, points to the regular equipment calibration, in order to reduce radiation dose to the patient to a minimum.</span></em></p>

Impact of tube angulation on radiation dose using image noise reduction technology

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Haj Abdo ◽  
L Langenbrink ◽  
J Michaelsen ◽  
M Wirtz ◽  
E Altiok ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Noise Reduction ◽  
Image Intensifier ◽  
Image Noise ◽  
Dose Area Product ◽  
Total Radiation Dose ◽  
Image Noise Reduction ◽  
Reduce Radiation Dose ◽  
Area Product ◽  
The Impact

Abstract Objectives This study sought to evaluate the impact of tube angulation on radiation dose using image noise reduction technology in a clinical setting. Image noise reduction technology has been shown to significantly reduce radiation dose in coronary angiography in particular by reduction of radiation in cine mode. Methods In 500 coronary angiograms performed by the same operator the dose-area product (DAP) was determined. The DAP was determined for the cine mode as well as for the fluoroscopy mode. Furthermore, in the cine mode, the DAP on a per image (DAP/frame) basis was determined for the posterior-anterior projection (PA) as well as a left anterior oblique (LAO) cranial (LAO 20°/20°) and caudal (LAO 45°/−20°), right anterior oblique (RAO) cranial (RAO 20°/20°) and caudal (RAO 30°/−20°) angulations. The image intensifier area was kept constant for all angulations. Results Mean body mass index was 28.6±5.5 kg/m2. Mean total DAP was 1227±1417 cGy cm2. The mean ratio of DAP in cine mode/DAP in fluoro mode was 0.54±0.32. Mean DAP/frame in PA angulation was 5.5±3.3 (cGy cm2). Considering the cine mode, for the LAO cranial and LAO caudal angulations, the relative DAP/ frame compared to the PA angulation was 2.8±1.8 and 4.2±1.6, respectively. For the RAO cranial and RAO caudal angulations, the relative DAP/frame compared to the PA angulation was 1.7±2.2 and 1.8±1.4. Conclusions Using image noise reduction technology, radiation during fluoroscopy mode contributes more to total radiation dose than radiation during cine mode. In cine mode, the PA angulation has least radiation/ frame. The LAO caudal angulation is associated with greatest increase in radiation dose compared to the PA angulation, while LAO cranial angulation and RAO cranial and caudal angulations increase radiation dose to a lesser extent. Funding Acknowledgement Type of funding source: None

Anaesthetic implications of uterine artery embolisation in management of massive obstetric haemorrhage

Anaesthesia ◽  
2006 ◽  
Vol 61 (3) ◽  
pp. 248-252 ◽  
Author(s):  
R. Sundaram ◽  
A. G. Brown ◽  
S. K. Koteeswaran ◽  
G. Urquhart
Keyword(s):  
Uterine Artery ◽  
Uterine Artery Embolisation ◽  
Obstetric Haemorrhage
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