Subjective and objective evaluation of image quality in biplane cerebral digital subtraction angiography following significant acquisition dose reduction in a clinical setting

Amir R. Honarmand, Ali Shaibani, Tamila Pashaee, Furqan H. Syed, Michael C Hurley, Christina Louise Sammet, Matthew Bryan Potts, Babak S Jahromi, Sameer Ahmad Ansari*

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective Different technical and procedural methods have been introduced to develop low radiation dose protocols in neurointerventional examinations. We investigated the feasibility of minimizing radiation exposure dose by simply decreasing the detector dose during cerebral DSA and evaluated the comparative level of image quality using both subjective and objective methods. Methods In a prospective study of patients undergoing diagnostic cerebral DSA, randomly selected vertebral arteries (VA) and/or internal carotid arteries and their contralateral equivalent arteries were injected. Detector dose of 3.6 and 1.2â €..μGy/frame were selected to acquire standard dose (SD) and low dose (LD) images, respectively. Subjective image quality assessment was performed by two neurointerventionalists using a 5 point scale. For objective image quality evaluation, circle of Willis vessels were categorized into conducting, primary, secondary, and side branch vessels. Two blinded observers performed arterial diameter measurements in each category. Only image series obtained from VA injections opacifying the identical posterior intracranial circulation were utilized for objective assessment. Results No significant difference between SD and LD images was observed in subjective and objective image quality assessment in 22 image series obtained from 10 patients. Mean reference air kerma and kerma area product were significantly reduced by 61.28% and 61.24% in the LD protocol, respectively. Conclusions Our study highlights the necessity for reconsidering radiation dose protocols in neurointerventional procedures, especially at the level of baseline factory settings.

Original languageEnglish (US)
Pages (from-to)297-301
Number of pages5
JournalJournal of neurointerventional surgery
Volume9
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Cerebral Angiography
Digital Subtraction Angiography
Vertebral Artery
Radiation
Circle of Willis
Internal Carotid Artery
Arteries
Air
Prospective Studies
Injections

Keywords

  • Angiography

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{2bcd7af91ab14ff6855ccdbb9ba5fcc5,
title = "Subjective and objective evaluation of image quality in biplane cerebral digital subtraction angiography following significant acquisition dose reduction in a clinical setting",
abstract = "Objective Different technical and procedural methods have been introduced to develop low radiation dose protocols in neurointerventional examinations. We investigated the feasibility of minimizing radiation exposure dose by simply decreasing the detector dose during cerebral DSA and evaluated the comparative level of image quality using both subjective and objective methods. Methods In a prospective study of patients undergoing diagnostic cerebral DSA, randomly selected vertebral arteries (VA) and/or internal carotid arteries and their contralateral equivalent arteries were injected. Detector dose of 3.6 and 1.2{\^a} €..μGy/frame were selected to acquire standard dose (SD) and low dose (LD) images, respectively. Subjective image quality assessment was performed by two neurointerventionalists using a 5 point scale. For objective image quality evaluation, circle of Willis vessels were categorized into conducting, primary, secondary, and side branch vessels. Two blinded observers performed arterial diameter measurements in each category. Only image series obtained from VA injections opacifying the identical posterior intracranial circulation were utilized for objective assessment. Results No significant difference between SD and LD images was observed in subjective and objective image quality assessment in 22 image series obtained from 10 patients. Mean reference air kerma and kerma area product were significantly reduced by 61.28{\%} and 61.24{\%} in the LD protocol, respectively. Conclusions Our study highlights the necessity for reconsidering radiation dose protocols in neurointerventional procedures, especially at the level of baseline factory settings.",
keywords = "Angiography",
author = "Honarmand, {Amir R.} and Ali Shaibani and Tamila Pashaee and Syed, {Furqan H.} and Hurley, {Michael C} and Sammet, {Christina Louise} and Potts, {Matthew Bryan} and Jahromi, {Babak S} and Ansari, {Sameer Ahmad}",
year = "2017",
month = "3",
day = "1",
doi = "10.1136/neurintsurg-2016-012296",
language = "English (US)",
volume = "9",
pages = "297--301",
journal = "Journal of NeuroInterventional Surgery",
issn = "1759-8478",
publisher = "BMJ Publishing Group",
number = "3",

}

TY - JOUR

T1 - Subjective and objective evaluation of image quality in biplane cerebral digital subtraction angiography following significant acquisition dose reduction in a clinical setting

AU - Honarmand, Amir R.

AU - Shaibani, Ali

AU - Pashaee, Tamila

AU - Syed, Furqan H.

AU - Hurley, Michael C

AU - Sammet, Christina Louise

AU - Potts, Matthew Bryan

AU - Jahromi, Babak S

AU - Ansari, Sameer Ahmad

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objective Different technical and procedural methods have been introduced to develop low radiation dose protocols in neurointerventional examinations. We investigated the feasibility of minimizing radiation exposure dose by simply decreasing the detector dose during cerebral DSA and evaluated the comparative level of image quality using both subjective and objective methods. Methods In a prospective study of patients undergoing diagnostic cerebral DSA, randomly selected vertebral arteries (VA) and/or internal carotid arteries and their contralateral equivalent arteries were injected. Detector dose of 3.6 and 1.2â €..μGy/frame were selected to acquire standard dose (SD) and low dose (LD) images, respectively. Subjective image quality assessment was performed by two neurointerventionalists using a 5 point scale. For objective image quality evaluation, circle of Willis vessels were categorized into conducting, primary, secondary, and side branch vessels. Two blinded observers performed arterial diameter measurements in each category. Only image series obtained from VA injections opacifying the identical posterior intracranial circulation were utilized for objective assessment. Results No significant difference between SD and LD images was observed in subjective and objective image quality assessment in 22 image series obtained from 10 patients. Mean reference air kerma and kerma area product were significantly reduced by 61.28% and 61.24% in the LD protocol, respectively. Conclusions Our study highlights the necessity for reconsidering radiation dose protocols in neurointerventional procedures, especially at the level of baseline factory settings.

AB - Objective Different technical and procedural methods have been introduced to develop low radiation dose protocols in neurointerventional examinations. We investigated the feasibility of minimizing radiation exposure dose by simply decreasing the detector dose during cerebral DSA and evaluated the comparative level of image quality using both subjective and objective methods. Methods In a prospective study of patients undergoing diagnostic cerebral DSA, randomly selected vertebral arteries (VA) and/or internal carotid arteries and their contralateral equivalent arteries were injected. Detector dose of 3.6 and 1.2â €..μGy/frame were selected to acquire standard dose (SD) and low dose (LD) images, respectively. Subjective image quality assessment was performed by two neurointerventionalists using a 5 point scale. For objective image quality evaluation, circle of Willis vessels were categorized into conducting, primary, secondary, and side branch vessels. Two blinded observers performed arterial diameter measurements in each category. Only image series obtained from VA injections opacifying the identical posterior intracranial circulation were utilized for objective assessment. Results No significant difference between SD and LD images was observed in subjective and objective image quality assessment in 22 image series obtained from 10 patients. Mean reference air kerma and kerma area product were significantly reduced by 61.28% and 61.24% in the LD protocol, respectively. Conclusions Our study highlights the necessity for reconsidering radiation dose protocols in neurointerventional procedures, especially at the level of baseline factory settings.

KW - Angiography

UR - http://www.scopus.com/inward/record.url?scp=85014572127&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014572127&partnerID=8YFLogxK

U2 - 10.1136/neurintsurg-2016-012296

DO - 10.1136/neurintsurg-2016-012296

M3 - Article

C2 - 27053704

AN - SCOPUS:85014572127

VL - 9

SP - 297

EP - 301

JO - Journal of NeuroInterventional Surgery

JF - Journal of NeuroInterventional Surgery

SN - 1759-8478

IS - 3

ER -