Analysis of radiation doses incurred during diagnostic cerebral angiography after the implementation of dose reduction strategies

2016 ◽  
Vol 9 (4) ◽  
pp. 384-388 ◽  
Author(s):  
Tanja Schneider ◽  
Emily Wyse ◽  
Monica S Pearl
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
Cerebral Angiography ◽  
Pediatric Patients ◽  
Radiation Doses ◽  
Digital Subtraction ◽  
Air Kerma ◽  
Reduction Strategies ◽  
Technical Modifications ◽  
Area Product

BackgroundOne goal of increasing awareness of radiation dose is to encourage personal and technical modifications in order to reduce the radiation exposure of patients and staff.ObjectiveTo analyze the radiation doses incurred during diagnostic cerebral angiography and the angiographic techniques practiced over a 4-year period, in order to demonstrate the effectiveness of implementing radiation dose reduction strategies.MethodsA retrospective review of the first 50 consecutive adult and pediatric patients undergoing diagnostic cerebral angiography each year from 2010 to 2013 was performed. Angiograms and procedure examination protocols were reviewed for patient age, gender, diagnosis, angiography techniques, fluoroscopy time, reference point air kerma (Ka,r in mGy), and kerma-area product (PKA in μGym2).ResultsFrom January 2010 to June 2013, a total of 231 diagnostic cerebral angiograms were reviewed (200 adults, 31 children). Adult patients were aged from 19 to 94 years and included 77 men and 123 women. Pediatric patients were aged from 2 to 18 years and comprised 11 boys and 20 girls. Median Ka,r and PKA significantly decreased from 2010 to 2013 in adults (1867 mGy; 21 231 µGym2 vs 653 mGy; 7860 µGym2) and children (644 mGy; 6495 µGym2 vs138 mGy; 1465 µGym2), (p<0.001).ConclusionsIncreased awareness and implementation of dose reduction strategies resulted in decreased radiation doses for diagnostic cerebral angiography both in adult and pediatric patients. The use of lower and variable digital subtraction angiography frame rates and tailored examinations contributed significantly to the reduced radiation doses observed during diagnostic cerebral angiography.

Analysis of Radiation Doses and Dose Reduction Strategies During Cerebral Digital Subtraction Angiography

2017 ◽  
Vol 100 ◽  
pp. 216-223 ◽  
Author(s):  
Ho Jun Yi ◽  
Jae Hoon Sung ◽  
Dong Hoon Lee ◽  
Sang Wook Kim ◽  
Sang Won Lee
Keyword(s):  
Digital Subtraction Angiography ◽  
Dose Reduction ◽  
Radiation Doses ◽  
Digital Subtraction ◽  
Reduction Strategies

Radiation dose typical values per procedure complexity for transcatheter ventricular septal defect closure in pediatrics

2021 ◽  
Author(s):  
C. Rizk ◽  
R.N. Haddad ◽  
Z. Saliba ◽  
J. Farah
Keyword(s):  
Radiation Dose ◽  
Ventricular Septal Defect ◽  
Pediatric Patients ◽  
Septal Defect ◽  
Air Kerma ◽  
Exposure Data ◽  
Ventricular Septal Defect Closure ◽  
Exposure Levels ◽  
Area Product ◽  
Muscular Vsd

This study aims to establish radiation dose typical values (TV) for ventricular septal defect (VSD) percutaneous closures based on patient-, device- and procedure-related characteristics. Clinical and exposure data were retrospectively reviewed for 92 consecutive pediatric patients with VSD in whom transcatheter closure attempt was undertaken between March 2016 and December 2019 at a single reference center. TV were derived as the median value of total air kerma-area product (PKA,T), air kerma at the patient entrance reference point, fluoroscopy time and number of frames. Statistical analyses were conducted to investigate the exposure variability according to patient, device- and procedure-related characteristics. For (5–< 15 kg) patients, TV were 27 Gy · cm2 in term of PKA,T for venous vs. 9 Gy · cm2 for arterial approach. For (15–< 30 kg) patients, TV were 53 Gy · cm2 for muscular vs. 18 Gy · cm2 for perimembranous defects and 36 Gy · cm2 for AmplatzerTM vs. 14 Gy · cm2 for the LifetechTM device. Procedures conducted with the assistance of a fellow, venous approach, muscular VSD, AmplatzerTM devices, and procedural incidents increased the exposure levels significantly. The established TV provide benchmarks on patient exposure per procedure complexity and should help promote better patient radiation protection.

Radiation Minimisation and Outcome Maximisation in Cardiac Computed Tomograpy

2010 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
James P Earls ◽  
Jonathon A Leipsic ◽  
◽  
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
New Technologies ◽  
Cardiac Computed Tomography ◽  
Substantial Reduction ◽  
Radiation Doses ◽  
Tube Current ◽  
Prospective Triggering ◽  
Effective Radiation ◽  
Selection Of

Recent reports have raised general awareness that cardiac computed tomography (CT) has the potential for relatively high effective radiation doses. While the actual amount of risk this poses to the patient is controversial, the increasing concern has led to a great deal of research on new CT techniques capable of imaging the heart at substantially lower radiation doses than was available only a few years ago. Methods of dose reduction include optimised selection of user-defined parameters, such as tube current and voltage, as well as use of new technologies, such as prospective triggering and iterative reconstruction. These techniques have each been shown to lead to substantial reduction in radiation dose without loss of diagnostic accuracy. This article will review the most frequently used and widely available methods for radiation dose reduction in cardiac CT and give practical advice on their use and limitations.

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

scholarly journals Reducing cranial computed tomography effective radiation dose by 30% using adaptive iterative dose reduction

2016 ◽  
Vol 25 (4) ◽  
pp. 230-234
Author(s):  
Wai-Yung Yu ◽  
Thye Sin Ho ◽  
Henry Ko ◽  
Wai-Yee Chan ◽  
Serene Ong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Radiation Dose ◽  
Dose Reduction ◽  
Diagnostic Image Quality ◽  
Radiation Doses ◽  
Effective Radiation Dose ◽  
Diagnostic Image ◽  
Ct Head ◽  
Effective Radiation

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.

scholarly journals Feasibility of low-dose digital pulsed video-fluoroscopic swallow exams (VFSE): effects on radiation dose and image quality

2017 ◽  
Vol 58 (9) ◽  
pp. 1037-1044 ◽  
Author(s):  
Jakob Weiss ◽  
Mike Notohamiprodjo ◽  
Klement Neumaier ◽  
Minglun Li ◽  
Wilhelm Flatz ◽  
...  
Keyword(s):  
Image Quality ◽  
Radiation Dose ◽  
Dose Reduction ◽  
Low Dose ◽  
Research Evaluation ◽  
Diagnostic Image Quality ◽  
Organ Doses ◽  
Dose Area Product ◽  
Thermoluminescent Dosimeters ◽  
Area Product

Background Fluoroscopy is a frequently used examination in clinical routine without appropriate research evaluation latest hardware and software equipment. Purpose To evaluate the feasibility of low-dose pulsed video-fluoroscopic swallowing exams (pVFSE) to reduce dose exposure in patients with swallowing disorders compared to high-resolution radiograph examinations (hrVFSE) serving as standard of reference. Material and Methods A phantom study (Alderson-Rando Phantom, 60 thermoluminescent dosimeters [TLD]) was performed for dose measurements. Acquisition parameters were as follows: (i) pVFSE: 76.7 kV, 57 mA, 0.9 Cu mm, pulse rate/s 30; (ii) hrVFSE: 68.0 kV, 362 mA, 0.2 Cu mm, pictures 30/s. The dose area product (DAP) indicated by the detector system and the radiation dose derived from the TLD measurements were analyzed. In a patient study, image quality was assessed qualitatively (5-point Likert scale, 5 = hrVFSE; two independent readers) and quantitatively (SNR) in 35 patients who subsequently underwent contrast-enhanced pVFSE and hrVFSE. Results Phantom measurements showed a dose reduction per picture of factor 25 for pVFSE versus hrVFSE images (0.0025 mGy versus 0.062 mGy). The DAP (µGym2) was 28.0 versus 810.5 (pVFSE versus hrVFSE) for an average examination time of 30 s. Direct and scattered organ doses were significantly lower for pVFSE as compared to hrVFSE ( P < 0.05). Image quality was rated 3.9 ± 0.5 for pVFSE versus the hrVFSE standard; depiction of the contrast agent 4.8 ± 0.3; noise 3.6 ± 0.5 ( P < 0.05); SNR calculations revealed a relative decreased of 43.9% for pVFSE as compared to hrVFSE. Conclusion Pulsed VFSE is feasible, providing diagnostic image quality at a significant dose reduction as compared to hrVFSE.

Radiation dose-reduction strategies in thoracic CT

2017 ◽  
Vol 72 (5) ◽  
pp. 407-420 ◽  
Author(s):  
J.B. Moser ◽  
S.L. Sheard ◽  
S. Edyvean ◽  
I. Vlahos
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
Radiation Dose Reduction ◽  
Thoracic Ct ◽  
Reduction Strategies

Comparison of cryoablation with 3D mapping versus conventional mapping for the treatment of atrioventricular re-entrant tachycardia and right-sided paraseptal accessory pathways

2015 ◽  
Vol 26 (5) ◽  
pp. 931-940 ◽  
Author(s):  
Mario S. Russo ◽  
Fabrizio Drago ◽  
Massimo S. Silvetti ◽  
Daniela Righi ◽  
Corrado Di Mambro ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Success Rate ◽  
Three Dimensional ◽  
Accessory Pathways ◽  
Air Kerma ◽  
Three Dimensional Mapping ◽  
Conventional Mapping ◽  
Area Product ◽  
Patient Radiation Dose ◽  
Dimensional Mapping

AbstractAimTranscatheter cryoablation is a well-established technique for the treatment of atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia in children. Fluoroscopy or three-dimensional mapping systems can be used to perform the ablation procedure. The aim of this study was to compare the success rate of cryoablation procedures for the treatment of right septal accessory pathways and atrioventricular nodal re-entry circuits in children using conventional or three-dimensional mapping and to evaluate whether three-dimensional mapping was associated with reduced patient radiation dose compared with traditional mapping.MethodsIn 2013, 81 children underwent transcatheter cryoablation at our institution, using conventional mapping in 41 children – 32 atrioventricular nodal re-entry tachycardia and nine atrioventricular re-entry tachycardia – and three-dimensional mapping in 40 children – 24 atrioventricular nodal re-entry tachycardia and 16 atrioventricular re-entry tachycardia.ResultsUsing conventional mapping, the overall success rate was 78.1 and 66.7% in patients with atrioventricular nodal re-entry tachycardia or atrioventricular re-entry tachycardia, respectively. Using three-dimensional mapping, the overall success rate was 91.6 and 75%, respectively (p=ns). The use of three-dimensional mapping was associated with a reduction in cumulative air kerma and cumulative air kerma–area product of 76.4 and 67.3%, respectively (p<0.05).ConclusionsThe use of three-dimensional mapping compared with the conventional fluoroscopy-guided method for cryoablation of right septal accessory pathways and atrioventricular nodal re-entry circuits in children was associated with a significant reduction in patient radiation dose without an increase in success rate.

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