Comparative effectiveness of digital variance and subtraction angiography in lower limb angiography: A Monte Carlo modelling approach.

Autor: Elek R; Semmelweis University, Doctoral School of Theoretical and Translational Medicine, Budapest, Hungary. Electronic address: elek.richard@phd.semmelweis.hu., Herényi L; Semmelweis University, Department of Biophysics and Radiation Biology, Budapest, Hungary., Gyánó M; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary., Nemes B; Department of Interventional Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary., Osváth S; Semmelweis University, Department of Biophysics and Radiation Biology, Budapest, Hungary; Kinepict Health Ltd., Budapest, Hungary.
Jazyk: angličtina
Zdroj: Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) [Phys Med] 2024 Dec; Vol. 128, pp. 104859. Date of Electronic Publication: 2024 Nov 25.
DOI: 10.1016/j.ejmp.2024.104859
Abstrakt: Objective: By modelling patient exposures of interventional procedures, this study compares the reduction of radiation detriment between Digital Variance Angiography (DVA) and Digital Subtraction Angiography (DSA).
Methods: The paper presents a retrospective risk assessment using an in-house developed tool on 107 patient exposures from a clinical trial of DVA used to diagnose peripheral arterial disease (PAD). DICOM exposure parameters were used to initiate the PENELOPE (PENetration and Energy LOss of Positrons and Electrons) Monte Carlo simulation, radiation quality and quantity, and irradiation geometry. The effective dose and the lifetime attributable risk (LAR) for cancer incidence and mortality are calculated based on the International Commission on Radiation Protection's (ICRP) 103 recommendations and the Committee on the Biological Effects of Ionising Radiations' latest (BEIR VII) report, respectively.
Results: The study found that procedures conducted using DVA significantly reduce the radiation exposure of patients, compared to DSA. The collective effective dose for the DVA group was 58% lower than that for the DSA group. Correspondingly, the LAR of different organs showed a substantial decrease for cancer incidence (25-75%) and mortality (51-84%).
Conclusion: DVA demonstrates a considerable reduction in physical dosimetric quantities and consequently effective dose and cancer risk, suggesting its potential as a safer alternative to DSA in interventional radiology. The use of DVA supports the optimisation of patient radiation protection and aligns with the principles of ALARA (as low as reasonably achievable).
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Szabolcs Osváth is an inventor of the DVA technology, founder and CEO of Kinepict Health Ltd. developing and marketing DVA-based imaging tools. Richárd Elek is a doctoral student under the mentorship of Szabolcs Osváth.
(Copyright © 2024 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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