Clinical Study
Evaluation of a Noise Reduction Imaging Technology in Iliac Digital Subtraction Angiography: Noninferior Clinical Image Quality with Lower Patient and Scatter Dose

https://doi.org/10.1016/j.jvir.2015.01.007Get rights and content
Under a Creative Commons license
open access

Abstract

Purpose

To determine whether equivalent-quality images can be obtained from digital subtraction angiography (DSA) of the iliac artery after implementation of a novel imaging technology that reduces patient and scatter x-ray dose.

Materials and Methods

Imaging using two randomly ordered DSA runs was performed in 51 adults scheduled for iliac artery angiography or intervention or both. One DSA run used standard acquisition chain and image processing algorithms (referred to as “ reference DSA”), and the other DSA run used dose-reduction and real-time advanced image noise reduction technology (referred to as “study DSA”). The quality of each pair of runs, consecutively performed without changes in working projection or injection parameters, was independently rated by five radiologists blinded to the imaging technology used. Patient radiation dose was evaluated using air kerma and dose area product, and scatter dose was evaluated using three dosimeters (DoseAware, Philips Healthcare, Best, The Netherlands), located at fixed positions.

Results

Comparable image pairs were available in 48 patients. There were 44 patients undergoing treatment involving the common (n = 33) or external (n = 29) iliac arteries. Study DSA images were rated as equal to or better than reference DSA images for 96% of comparisons, with an average overall agreement among raters of 0.93 (95% confidence interval, 0.65–0.96). Mean patient radiation dose (n = 48) and scatter dose rate for the three dosimeters (n = 50) was 83% ± 5 and 69% ± 10 lower, respectively, using the study technology (P < .001).

Conclusions

Iliac artery DSA performed using a dose-reduction and real-time advanced image noise reduction technology results in image quality that is noninferior to conventional DSA but with significantly lower patient and scatter radiation exposure (P < .001).

Abbreviations

BMI
body mass index
CI
confidence interval
DAP
dose area product
DSA
digital subtraction angiography

Cited by (0)

T.G. and M.M. are employees of Philips Healthcare, Best, The Netherlands. None of the other authors have identified a conflict of interest.

Videos E1–E3 and Figures E1 and E2 are available online at www.jvir.org.