Artikel
Dose Management Capabilities of Digital Variance Angiography: 70% Decrease of DSA-related Radiation Exposure in Lower Limb X-ray Angiography
Suche in Medline nach
Autoren
Veröffentlicht: | 22. Dezember 2021 |
---|
Gliederung
Text
Background: Our aim was to investigate whether the previously observed higher contrast-to-noise ratio (CNR) and better image quality of Digital Variance Angiography (DVA) [1], [2] – compared to Digital Subtraction Angiography (DSA) – can be used to reduce radiation exposure in lower limb X-ray angiography.
Methods: This prospective study enrolled 30 peripheral artery disease patients (Fontaine IIb-IV, mean±SD age 70±8 years) undergoing diagnostic lower limb X-ray angiography between April and July 2019. In all enrolled patients, both normal (1.2 µGy/frame) and low-dose (0.36 µGy/frame) protocols were used for the acquisition of images in three anatomical regions (abdominal, femoral, crural). The CNR of DSA and DVA images were calculated, and the visual quality was evaluated by seven specialists using a 5-grade Likert scale. For investigating non-inferiority, the difference of low-dose DVA and normal dose DSA scores (DVA30-DSA100) was analyzed.
Results: DVA produced consistently higher (two to threefold) CNR and significantly higher visual score than DSA. DVA30 proved to be superior to DSA100 in the crural region (difference 0.25±0.07, p<0.001). There was no significant difference in the femoral region (-0.08±0.06, p=0.435), but DSA100 was superior to DVA30 in the abdominal region (-0.26±0.12, p=0.036). However, after exclusion of patients with excessive intestinal gases (3/30, 10% of patients), the difference in the abdominal region decreased to -0.10±0.09 and was no longer significant (p=0.350).
Conclusion: Our data show that DVA allows a very substantial (70%) reduction of DSA-related radiation exposure in lower limb X-ray angiography, therefore this technology might increase the safety of these endovascular procedures.
References
- 1.
- Gyano M, Gog I, Orias VI, Ruzsa Z, Nemes B, Csobay-Novak C, Olah Z, Nagy Z, Merkely B, Szigeti K, Osvath S, Sotonyi P. Kinetic Imaging in Lower Extremity Arteriography: Comparison to Digital Subtraction Angiography. Radiology. 2019;291:246-53.
- 2.
- Orias VI, Gyano M, Gog I, Szollosi D, Veres DS, Csobay-Novak C, Olah Z, Kiss JP, Nagy Z, Szigeti K, Osvath S, Ruzsa Z, Sotonyi P. Digital Variance Angiography as a Paradigm Shift in Carbon-dioxide Angiography. Invest Radiol. 2019;54:428-436.