Reducing radiation dose while maintaining diagnostic image quality of cerebral three-dimensional digital subtraction angiography: an in vivo study in swine

Introduction: The use of computed tomography (CT) imaging as a diagnostic modality is increasing rapidly and CT is the dominant contributor to diagnostic medical radiation exposure. The aim of this project was to reduce the effective radiation dose to patients undergoing cranial CT examination, while maintaining diagnostic image quality. Methods: Data from a total of 1003, 132 and 27 patients were examined for three protocols: CT head, CT angiography (CTA), and CT perfusion (CTP), respectively. Following installation of adaptive iterative dose reduction (AIDR) 3D software, tube current was lowered in consecutive cycles, in a stepwise manner and effective radiation doses measured at each step. Results: Baseline effective radiation doses for CT head, CTA and CTP were 1.80, 3.60 and 3.96 mSv, at currents of 300, 280 and 130–150 mA, respectively. Using AIDR 3D and final reduced currents of 160, 190 and 70–100 mA for CT head, CTA and CTP gave effective doses of 1.29, 3.18 and 2.76 mSv, respectively. Conclusion: We demonstrated that satisfactory reductions in the effective radiation dose for CT head (28.3%), CTA (11.6%) and CTP (30.1%) can be achieved without sacrificing diagnostic image quality. We have also shown that iterative reconstruction techniques such as AIDR 3D can be effectively used to help reduce effective radiation dose. The dose reductions were performed within a short period and can be easily achievable, even in busy departments.

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Diagnostic image quality of mobile neonatal chest X-rays and the radiation exposure incurred.

British Journal of Radiology ◽

10.1259/bjr.72.853.10341690 ◽

1999 ◽

Vol 72 (853) ◽

pp. 55-61 ◽

Cited By ~ 13

Author(s):

A Lowe ◽

A Finch ◽

D Boniface ◽

R Chaudhuri ◽

J Shekhdar

Keyword(s):

Image Quality ◽

Radiation Exposure ◽

Diagnostic Image Quality ◽

X Rays ◽

Diagnostic Image

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Comparison of Intra- and Postoperative 3-Dimensional Digital Subtraction Angiography in Evaluation of the Surgical Result After Intracranial Aneurysm Treatment

Neurosurgery ◽

10.1093/neuros/nyz487 ◽

2019 ◽

Vol 87 (4) ◽

pp. 689-696 ◽

Cited By ~ 1

Author(s):

Serge Marbacher ◽

Jenny C Kienzler ◽

Itai Mendelowitsch ◽

Donato D’Alonzo ◽

Lukas Andereggen ◽

...

Keyword(s):

Image Quality ◽

Intracranial Aneurysm ◽

Digital Subtraction Angiography ◽

Three Dimensional ◽

Standard Of Care ◽

Digital Subtraction ◽

Factors Affecting ◽

Imaging Quality ◽

3 Dimensional ◽

Surgical Result

Abstract BACKGROUND Postoperative three-dimensional digital subtraction angiography (3D-DSA) is the gold standard in evaluating intracranial aneurysm (IA) remnants after clipping. Should intraoperative 3D-DSA image quality be equally good as postoperative 3D-DSA, it could supplant the latter as standard of care for follow-up of clipped IA. OBJECTIVE To directly compare the quality of assessment of clipped IA by intraoperative and postoperative 3D-DSA. METHODS From a prospective cohort of 221 consecutive patients who underwent craniotomy for IA treatment in a hybrid operating room, we retrospectively studied 26 patients who had both intraoperative and postoperative 3D-DSA imaging of their clipped aneurysm. Comparison of intraoperative and postoperative 3D-DSA images (blinded for review) included parameters that affected image quality and differences between the 2 periods. RESULTS In the 26 patients with 32 clipped IAs, the mean interval was 11 ± 7 mo between intraoperative and postoperative imaging 3D-DSA examinations. Reconstruction with multiple clips was used in 14 (44%) cases. Of 15 remnants, 9 (60%) were small (<2 mm). In comparing intraoperative and postoperative 3D-DSA, no discordance or discrepancy in assessment of the surgical result was noted for any clipped IA, and overall imaging quality was excellent for both modalities. Factors affecting minor differences in image quality were not identified. CONCLUSION Compared with postoperative 3D-DSA, intraoperative 3D-DSA images achieved equally high quality and effective, immediate interpretation of the surgical clipping result. With comparable imaging quality and no discordant findings, intraoperative 3D-DSA could replace postoperative 3D-DSA to become the standard of care in IA surgery.

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Diagnostic image quality of hand-held and wall-mounted X-ray devices in bitewing radiography: a non-inferiority clinical trial

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200471 ◽

2021 ◽

pp. 20200471

Author(s):

Reinier Cornelis Hoogeveen ◽

Siham Ouchene ◽

WER Berkhout

Keyword(s):

Clinical Trial ◽

Image Quality ◽

Future Research ◽

Diagnostic Image Quality ◽

Data Set ◽

Diagnostic Image ◽

X Ray ◽

The Difference ◽

Diagnostic Modalities

Objectives: The present clinical trial was intended to clarify whether subjective assessments of diagnostic X-ray image quality achieved via hand-held (HH) Nomad Pro 2 (KaVo Kerr, Brea, CA, USA) X-ray device is non-inferior that of the wall-mounted (WM) KaVo Focus (KaVo Dental, Bieberich, Germany). Methods: A prospective, cross-over, and in vivo non-inferiority clinical trial was conducted to compare these two diagnostic modalities. Based on sampling calculations, 205 patients were selected for study, generating 410 paired bitewing radiographs in randomized sequence. The films were assessed independently, engaging three observers blinded to modality for random, side-by-side-comparisons. Diagnostic image quality was rated as follows: no preference, HH preference, or WM preference. Observer judgements were combined accordingly to reach a majority. Results: Collective observer ratings indicated no preference for diagnostic image quality in 63.9% of cases, with WM preference at 16.6% and HH preference at 19.5%. The difference in HH and WM preferences (19.5%–16.6% = 2.9%) was within the expected 95% confidence interval. Majority agreement was reached in 82.7%. Conclusions: Subjectively assessed diagnostic image quality in bitewing radiographs acquired by HH and WM devices did not differ significantly. The hand-held device is thus non-inferior to the WM in this regard. Our data set of paired bitewing radiographs may subsequently aid in future research.

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Digital Luminescence Radiography Using a Chest Phantom

Acta Radiologica ◽

10.1177/028418519303400503 ◽

1993 ◽

Vol 34 (5) ◽

pp. 440-444 ◽

Cited By ~ 2

Author(s):

K. Lyttkens ◽

M. Kehler ◽

B. Andersson ◽

S. Carlsen ◽

A. Ebbesen ◽

...

Keyword(s):

Image Quality ◽

Operating Characteristic ◽

Roc Curves ◽

Diagnostic Image Quality ◽

Diagnostic Image ◽

Digital Radiographs ◽

Significant Difference ◽

Digital Luminescence Radiography ◽

Optical Discs

With the introduction of picture and archiving communicating systems an alternative image display for the wards might be a personal computer (PC). The intention with this study was to evaluate the diagnostic image quality of the monitor of a PC compared to that of a workstation. Eighty-five digital radiographs of a chest phantom with simulated tumors in the mediastinum and right lung were saved on optical discs. The examinations were reviewed by 4 radiologists on a monitor at a workstation and at a PC, and receiver operating characteristic (ROC) curves were constructed. No significant difference was found between performance of the PC and the workstation.

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