Skip to main content
Erschienen in: CardioVascular and Interventional Radiology 3/2008

01.05.2008 | Clinical Investigation

Comparison of Patient Dose in Two-Dimensional Carotid Arteriography and Three-Dimensional Rotational Angiography

verfasst von: Virginia Tsapaki, Eliseo Vano, Irini Μavrikou, Vassiliki Νeofotistou, Juan Jose Gallego, Jose Miguel Fernandez, Ernesto Santos, Jose Mendez

Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

Background and Purpose

It is known that interventional neuroradiology (IN) involves high radiation dose to both patients and staff even if performed by trained operators using modern fluoroscopic X-ray equipment and dose-reducing technology. Therefore, every new technology or imaging tool introduced, such as three-dimensional rotational angiography (3D RA), should be evaluated in terms of radiation dose. 3D RA requires a series with a large number of images in comparison with 2D angiography and it is sometimes considered a high-dose IN procedure. The literature is scarce on the 3D RA radiation dose and in particular there are no data on carotid arteriography (CA). The aim of this study was to investigate patient dose differences between 2D and 3D CA.

Methods

The study included 35 patients undergoing 2D CA in hospital 1 and 25 patients undergoing 3D CA in hospital 2. Patient technical data collection included information on the kerma area product (KAP), fluoroscopy time (T), total number of series (S), and total number of acquired images (F).

Results

Median KAP was 112 Gy cm2 and 41 Gy cm2 for hospitals 1 and 2, respectively, median T was 8.2 min and 5.1 min, median S was 13 and 4, and median F was 247 and 242. Entrance surface air-kerma rate, as measured in “medium” fluoroscopy mode measured in 2D acquisition using a 20 cm phantom of polymethylmethacrylate, was 17.3 mGy/min for hospital 1 and 9.2 mGy/min for hospital 2.

Conclusion

3D CA allows a substantial reduction in patient radiation dose compared with 2D CA, while providing the necessary diagnostic information.
Literatur
1.
Zurück zum Zitat Mini RL, Schmid B, Schneeberger P, et al. (1998) Dose-area product measurements during angiographic X-ray procedures. Radiat Prot Dosim 80:145–148 Mini RL, Schmid B, Schneeberger P, et al. (1998) Dose-area product measurements during angiographic X-ray procedures. Radiat Prot Dosim 80:145–148
2.
Zurück zum Zitat Steele HR, Temperton DH (1993) Technical note: Patient doses received during digital subtraction angiography. Br J Radiol 66:452–456PubMedCrossRef Steele HR, Temperton DH (1993) Technical note: Patient doses received during digital subtraction angiography. Br J Radiol 66:452–456PubMedCrossRef
3.
Zurück zum Zitat Fletcher DW, Miller DL, Balter S, et al. (2002) Comparison of dour techniques to estimate radiation dose to skin during angiographic and interventional radiology procedures. J Vasc Interv Radiol 13:391–397PubMedCrossRef Fletcher DW, Miller DL, Balter S, et al. (2002) Comparison of dour techniques to estimate radiation dose to skin during angiographic and interventional radiology procedures. J Vasc Interv Radiol 13:391–397PubMedCrossRef
4.
Zurück zum Zitat Miller DL, Balter S, Cole P, et al. (2003) Radiation doses in interventional radiology procedures: The RAD-IR study. I. Overall measures of dose. J Vasc Interv Radiol 14:711–727PubMedCrossRef Miller DL, Balter S, Cole P, et al. (2003) Radiation doses in interventional radiology procedures: The RAD-IR study. I. Overall measures of dose. J Vasc Interv Radiol 14:711–727PubMedCrossRef
5.
Zurück zum Zitat Hatakeyama Y, Kakeda S, Korogi Y, et al. (2006) Intracranial 2D and 3D DSA with flat panel detector of the direct conversion type: Initial experience. Eur Radiol 16:2594–2602PubMedCrossRef Hatakeyama Y, Kakeda S, Korogi Y, et al. (2006) Intracranial 2D and 3D DSA with flat panel detector of the direct conversion type: Initial experience. Eur Radiol 16:2594–2602PubMedCrossRef
6.
Zurück zum Zitat Bridcut, R, Murphy E, Workman A, et al. (2007) Patient dose from 3D rotational neurovascular studies. Br J Radiol [DOI: 10.1259/bjr/95349672] Bridcut, R, Murphy E, Workman A, et al. (2007) Patient dose from 3D rotational neurovascular studies. Br J Radiol [DOI: 10.1259/bjr/95349672]
7.
Zurück zum Zitat Williams JR (1997) The interdependence of staff and patient doses in interventional radiology. Br J Radiol 70:498–503PubMed Williams JR (1997) The interdependence of staff and patient doses in interventional radiology. Br J Radiol 70:498–503PubMed
8.
Zurück zum Zitat Marx MV (2003) The radiation dose in interventional radiology study: Knowledge brings responsibility. J Vasc Interv Radiol 14:947–951PubMed Marx MV (2003) The radiation dose in interventional radiology study: Knowledge brings responsibility. J Vasc Interv Radiol 14:947–951PubMed
9.
Zurück zum Zitat Behrman RB, Hijadi ZM (1999) Radiation risks to the patients and interventionalists: Risk reduction. Cathet Cardiovasc Intervent 45:455–456CrossRef Behrman RB, Hijadi ZM (1999) Radiation risks to the patients and interventionalists: Risk reduction. Cathet Cardiovasc Intervent 45:455–456CrossRef
10.
Zurück zum Zitat Wenzl T, McDonald JC (2002) Is there and elevated risk of brain cancer among physicians performing interventional radiology procedures? Radiat Prot Dosim 102:99–100 Wenzl T, McDonald JC (2002) Is there and elevated risk of brain cancer among physicians performing interventional radiology procedures? Radiat Prot Dosim 102:99–100
11.
Zurück zum Zitat Wagner L, McNeese MD, Marx V, et al. (1999) Severe skin reactions from Interventional fluoroscopy: Case report and review of the literature. Radiology 213:773–776PubMed Wagner L, McNeese MD, Marx V, et al. (1999) Severe skin reactions from Interventional fluoroscopy: Case report and review of the literature. Radiology 213:773–776PubMed
12.
Zurück zum Zitat Mooney RB, McKinstry CS, Kamel HA (2000) Absorbed dose and deterministic effects to patients in interventional neuroradiology. Br J Radiol 73:745–751PubMed Mooney RB, McKinstry CS, Kamel HA (2000) Absorbed dose and deterministic effects to patients in interventional neuroradiology. Br J Radiol 73:745–751PubMed
13.
Zurück zum Zitat Livingstone RS, Raghuram L, Korah IP, et al. (2003) Evaluation of radiation risk and work practices during cerebral interventions. J Radiol Prot 23:327–336PubMedCrossRef Livingstone RS, Raghuram L, Korah IP, et al. (2003) Evaluation of radiation risk and work practices during cerebral interventions. J Radiol Prot 23:327–336PubMedCrossRef
14.
Zurück zum Zitat Rampado O, Ropolo R (2005) Entrance skin dose distribution maps for interventional neuroradiological procedures: A preliminary study. Radiat Prot Dosim 117:256–259CrossRef Rampado O, Ropolo R (2005) Entrance skin dose distribution maps for interventional neuroradiological procedures: A preliminary study. Radiat Prot Dosim 117:256–259CrossRef
15.
Zurück zum Zitat Gkanatsios NA, Huda W, Peters KR (2002) Adult patient doses in interventional neuroradiology. Med Phys 29:717–723PubMedCrossRef Gkanatsios NA, Huda W, Peters KR (2002) Adult patient doses in interventional neuroradiology. Med Phys 29:717–723PubMedCrossRef
16.
Zurück zum Zitat Rampado O, Ropolo R (2004) A method for a real time estimation of entrance skin dose distribution in interventional neuroradiology. Med Phys 31:2356–2361PubMedCrossRef Rampado O, Ropolo R (2004) A method for a real time estimation of entrance skin dose distribution in interventional neuroradiology. Med Phys 31:2356–2361PubMedCrossRef
17.
Zurück zum Zitat Miller DL, Balter S, Cole P, et al. (2003) Radiation doses in interventional radiology procedures: The RAD-IR study. II. Skin Dose. J Vasc Interv Radiol 14:977–990PubMedCrossRef Miller DL, Balter S, Cole P, et al. (2003) Radiation doses in interventional radiology procedures: The RAD-IR study. II. Skin Dose. J Vasc Interv Radiol 14:977–990PubMedCrossRef
18.
Zurück zum Zitat Bor D, Cekirge S, Türkay T, et al. (2005) Patient and staff doses in interventional neuroradiology. Radiat Prot Dosim 117:62–68CrossRef Bor D, Cekirge S, Türkay T, et al. (2005) Patient and staff doses in interventional neuroradiology. Radiat Prot Dosim 117:62–68CrossRef
19.
Zurück zum Zitat Schueler B, Kallmes D, Cloft H (2005) 3D cerebral angiography: Radiation dose comparison with digital subtraction angiography. AJNR Am J Neuroradiol 26:1898–1901PubMed Schueler B, Kallmes D, Cloft H (2005) 3D cerebral angiography: Radiation dose comparison with digital subtraction angiography. AJNR Am J Neuroradiol 26:1898–1901PubMed
20.
Zurück zum Zitat SENTINEL. Safety and efficacy for new techniques and imaging using new equipment to support European legislation. European Coordination Action (2005–2007). http://www.sentinel.eu.com/Documents/Project+Presentation.pdf. Accessed April 7, 2007 SENTINEL. Safety and efficacy for new techniques and imaging using new equipment to support European legislation. European Coordination Action (2005–2007). http://​www.​sentinel.​eu.​com/Documents/Project+Presentation.pdf. Accessed April 7, 2007
21.
Zurück zum Zitat International Electrotechnical Commission IEC report 60601 (2000) Medical electrical equipment part 2–43: Particular requirements for the safety of X-ray equipment for interventional procedures. International Electrotechnical Commission, Geneva International Electrotechnical Commission IEC report 60601 (2000) Medical electrical equipment part 2–43: Particular requirements for the safety of X-ray equipment for interventional procedures. International Electrotechnical Commission, Geneva
22.
Zurück zum Zitat Dosimetry Working Party of the Institute of Physical Sciences (1992) National protocol for patient dose measurements in diagnostic radiology. NRPB and College of Radiographers Dosimetry Working Party of the Institute of Physical Sciences (1992) National protocol for patient dose measurements in diagnostic radiology. NRPB and College of Radiographers
23.
Zurück zum Zitat Reay J, Chapple CL, Kotre CJ (2003) Is patient size important in dose determination and optimization in cardiology? Phys Med Biol 48:3843–3850PubMedCrossRef Reay J, Chapple CL, Kotre CJ (2003) Is patient size important in dose determination and optimization in cardiology? Phys Med Biol 48:3843–3850PubMedCrossRef
24.
Zurück zum Zitat Struelens L, Vanhavere F, Bosmans, et al. (2005) Skin dose measurements on patients for diagnostic and interventional neuroradiology: A multicentre study. Radiat Prot Dosim 114:143–146 Struelens L, Vanhavere F, Bosmans, et al. (2005) Skin dose measurements on patients for diagnostic and interventional neuroradiology: A multicentre study. Radiat Prot Dosim 114:143–146
25.
Zurück zum Zitat Bashore TM, Durcham NC (2004) Radiation safety in the cardiac catheterization laboratory. Am Heart J 147:375–378PubMedCrossRef Bashore TM, Durcham NC (2004) Radiation safety in the cardiac catheterization laboratory. Am Heart J 147:375–378PubMedCrossRef
26.
Zurück zum Zitat Kuon E, Glaser C, Dahm JB (2003) Effective techniques for reduction of radiation dosage to patients undergoing invasive cardiac procedures. Br J Radiol 76:406–413PubMedCrossRef Kuon E, Glaser C, Dahm JB (2003) Effective techniques for reduction of radiation dosage to patients undergoing invasive cardiac procedures. Br J Radiol 76:406–413PubMedCrossRef
27.
Zurück zum Zitat Hirai T, Korogi Y, Suginohara K, et al. (2003) Clinical usefulness of unsubtracted 3D digital angiography compared with rotational digital angiography in the pretreatment evaluation of intracranial aneurysms. AJNR Am J Neuroradiol 24:1067–1074PubMed Hirai T, Korogi Y, Suginohara K, et al. (2003) Clinical usefulness of unsubtracted 3D digital angiography compared with rotational digital angiography in the pretreatment evaluation of intracranial aneurysms. AJNR Am J Neuroradiol 24:1067–1074PubMed
28.
Zurück zum Zitat Norbash AM, Busick D, Marks MP (1996) Techniques for reducing interventional neuroradiologic skin dose: Tube position rotation and supplemental beam filtration. AJNR Am J Neuroradiol 17:41–49PubMed Norbash AM, Busick D, Marks MP (1996) Techniques for reducing interventional neuroradiologic skin dose: Tube position rotation and supplemental beam filtration. AJNR Am J Neuroradiol 17:41–49PubMed
29.
Zurück zum Zitat Huda W, Peters KR (1994) Radiation induced temporary epilation after neuroradiologically guided embolization procedure. Radiology 193:642–644PubMed Huda W, Peters KR (1994) Radiation induced temporary epilation after neuroradiologically guided embolization procedure. Radiology 193:642–644PubMed
30.
Zurück zum Zitat Shortt CP, Fanning NF, Malone L, et al. (2007) Thyroid dose during neurointerventional procedures: Does lead shielding reduce the dose? Cardiovasc Intervent Radiol [Epub ahead of print, May 29] Shortt CP, Fanning NF, Malone L, et al. (2007) Thyroid dose during neurointerventional procedures: Does lead shielding reduce the dose? Cardiovasc Intervent Radiol [Epub ahead of print, May 29]
31.
Zurück zum Zitat Jayaraman MV, Mayo-Smith WW, Tung GA (2004) Detection of intracranialaneurysms: Multi-detector row CT angiography compared with DSA. Radiology 230:510–518PubMedCrossRef Jayaraman MV, Mayo-Smith WW, Tung GA (2004) Detection of intracranialaneurysms: Multi-detector row CT angiography compared with DSA. Radiology 230:510–518PubMedCrossRef
32.
Zurück zum Zitat Coche E, Vynckier S, Octave-Prignot M (2006) Pulmonary embolism: Radiation dose with multi-detector row CT and digital angiography for diagnosis. Radiology 240:690–697PubMedCrossRef Coche E, Vynckier S, Octave-Prignot M (2006) Pulmonary embolism: Radiation dose with multi-detector row CT and digital angiography for diagnosis. Radiology 240:690–697PubMedCrossRef
33.
Zurück zum Zitat Kuiper JW, Geleijns J, Matheijssen NA (2003) Radiation exposure of multi-row detector spiral computed tomography of the pulmonary arteries: Comparison with digital subtraction pulmonary angiography. Eur Radiol 13:1496–500 [Epub Nov 13, 2002]PubMedCrossRef Kuiper JW, Geleijns J, Matheijssen NA (2003) Radiation exposure of multi-row detector spiral computed tomography of the pulmonary arteries: Comparison with digital subtraction pulmonary angiography. Eur Radiol 13:1496–500 [Epub Nov 13, 2002]PubMedCrossRef
34.
Zurück zum Zitat Willmann JK, Baumert B, Schertler T (2005) Aortoiliac and lower extremity arteries assessed with 16-detector row CT angiography: Prospective comparison with digital subtraction angiography. Radiology 236:1083–1093 [Epub July 29, 2005]PubMedCrossRef Willmann JK, Baumert B, Schertler T (2005) Aortoiliac and lower extremity arteries assessed with 16-detector row CT angiography: Prospective comparison with digital subtraction angiography. Radiology 236:1083–1093 [Epub July 29, 2005]PubMedCrossRef
Metadaten
Titel
Comparison of Patient Dose in Two-Dimensional Carotid Arteriography and Three-Dimensional Rotational Angiography
verfasst von
Virginia Tsapaki
Eliseo Vano
Irini Μavrikou
Vassiliki Νeofotistou
Juan Jose Gallego
Jose Miguel Fernandez
Ernesto Santos
Jose Mendez
Publikationsdatum
01.05.2008
Verlag
Springer-Verlag
Erschienen in
CardioVascular and Interventional Radiology / Ausgabe 3/2008
Print ISSN: 0174-1551
Elektronische ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-007-9190-7

Weitere Artikel der Ausgabe 3/2008

CardioVascular and Interventional Radiology 3/2008 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.