Abstract
Background: Three-dimensional digital subtraction angiography (3D-DSA) is a modern technique that allows for better appreciation of complex vascular lesions. This study evaluates the impact of various dose reduction strategies on 3D-DSA image quality. Methods: The standard manufacturer 5 s 0.36 μGy/frame setting was modified to create lower dose 3D-DSA protocols by varying the acquisition time (5 or 3 s) and/or dose per frame (0.36, 0.24, 0.17, and 0.10 μGy/f). All protocols were evaluated in three swine. Four raters measured a segment of the external carotid artery on two-dimensional multiplanar reconstruction images. The raters were also presented with three-dimensional volume rendered images from all protocols in a blinded manner and asked to choose the superior image. A full model analysis of variance with repeated measure factors was performed to compare mean differences in measurements between protocols. Results: Measurement differences between the standard and low dose protocols were not clinically significant (<0.5 mm). All raters demonstrated high inter-rater reliability. The 5 s protocols were considered as qualitatively superior to the 3 s protocols. Delivered system doses ranged from 43.8 to 6.5 mGy. The 5 s 0.10 μGy/frame protocols generated 65-68% less delivered dose compared with the 5 s 0.36 μ Gy/frame setting. Conclusions: Low dose 3D-DSA protocols with preserved image quality are achievable, and can help reduce unnecessary radiation exposure to both patients and operators. The 5 s low dose protocols generated clinically acceptable and superior images compared with the 3 s protocols, suggesting a more important role for acquisition time than dose per frame to maintain image quality.
Original language | English (US) |
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Pages (from-to) | 672-676 |
Number of pages | 5 |
Journal | Journal of neurointerventional surgery |
Volume | 6 |
Issue number | 9 |
DOIs | |
State | Published - Nov 1 2014 |
ASJC Scopus subject areas
- Surgery
- Clinical Neurology