Radiation Exposure Reduction by Digital Variance Angiography in Lower Limb Angiography: A Randomized Controlled Trial.

Autor: Sótonyi P; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary., Berczeli M; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary.; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary., Gyánó M; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary.; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary., Legeza P; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary.; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary., Mihály Z; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary.; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary., Csobay-Novák C; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary., Pataki Á; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary., Juhász V; Department of Vascular and Endovascular Surgery, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary., Góg I; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary.; Department of Vascular Surgery, Hungarian Defence Forces Medical Centre, Róbert Károly körút 44, 1134 Budapest, Hungary., Szigeti K; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary.; Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó u. 37-47, 1094 Budapest, Hungary., Osváth S; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary.; Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó u. 37-47, 1094 Budapest, Hungary., Kiss JP; Kinepict Health Ltd., Szilágyi Erzsébet Fasor 31, 1027 Budapest, Hungary.; Department of Biophysics and Radiation Biology, Semmelweis University, Tűzoltó u. 37-47, 1094 Budapest, Hungary., Nemes B; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Városmajor utca 68, 1122 Budapest, Hungary.
Jazyk: angličtina
Zdroj: Journal of cardiovascular development and disease [J Cardiovasc Dev Dis] 2023 Apr 30; Vol. 10 (5). Date of Electronic Publication: 2023 Apr 30.
DOI: 10.3390/jcdd10050198
Abstrakt: Background: digital variance angiography (DVA) provides higher image quality than digital subtraction angiography (DSA). This study investigates whether the quality reserve of DVA allows for radiation dose reduction during lower limb angiography (LLA), and compares the performance of two DVA algorithms.
Methods: this prospective block-randomized controlled study enrolled 114 peripheral arterial disease patients undergoing LLA into normal dose (ND, 1.2 µGy/frame, n = 57) or low-dose (LD, 0.36 µGy/frame, n = 57) groups. DSA images were generated in both groups, DVA1 and DVA2 images were generated in the LD group. Total and DSA-related radiation dose area product (DAP) were analyzed. Image quality was assessed on a 5-grade Likert scale by six readers.
Results: the total and DSA-related DAP were reduced by 38% and 61% in the LD group. The overall visual evaluation scores (median (IQR)) of LD-DSA (3.50 (1.17)) were significantly lower than the ND-DSA scores (3.83 (1.00), p < 0.001). There was no difference between ND-DSA and LD-DVA1 (3.83 (1.17)), but the LD-DVA2 scores were significantly higher (4.00 (0.83), p < 0.01). The difference between LD-DVA2 and LD-DVA1 was also significant ( p < 0.001).
Conclusions: DVA significantly reduced the total and DSA-related radiation dose in LLA, without affecting the image quality. LD-DVA2 images outperformed LD-DVA1, therefore DVA2 might be especially beneficial in lower limb interventions.
Databáze: MEDLINE