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

Background One 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. Objective To 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. Methods A 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 (K a,r in mGy), and kerma-area product (PKA in μGym 2). Results From 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 K a,r and PKA significantly decreased from 2010 to 2013 in adults (1867 mGy; 21 231 μGym 2 vs 653 mGy; 7860 μGym 2) and children (644 mGy; 6495 μGym 2 vs138 mGy; 1465 μGym 2), (p<0.001). Conclusions Increased 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.