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Radiation Dose from 3D Rotational vs. Conventional 2D Digital Subtraction Angiography in Intracranial Aneurysm Coiling

  • Elena Tonkopi (a1), Ahmed H. Al-Habsi (a1) and Jai J. S. Shankar (a1)

Abstract

Purpose: To compare patient effective dose resulting from two alternative imaging protocols for pre-coiling assessment of intracranial aneurysms: a series of 2D Digital Subtraction Angiography (DSA) projections, and a 3D rotational angiography (RA) acquisition. Methods: In a retrospective analysis, we investigated 44 patients who underwent endovascular coiling in our institution. Images were acquired on a biplane Image Intensifier system not equipped with dose-area product (DAP) meter. Conventional 2D DSA images were simulated with an anthropomorphic skull phantom. Entrance skin dose was measured with a 60 cc ion chamber, and the PCXMC Monte Carlo based software was used to calculate patient effective dose. For the RA protocol, a 16 cm computed tomography (CT) dosimetry phantom and a 100 mm pencil ion chamber were employed to measure the CT dose index. Patient effective dose was calculated with the ImPACT calculator. An unpaired two-tailed t-test was used to determine the significance of differences between patient doses in each group. Results: Sixteen patients underwent the 2D DSA protocol with multiple projections; their mean number of cine runs was 5.1; the mean effective dose was 2.11 millisievert (mSv) (range 1.69–3.43 mSv). Twenty eight patients were assessed using the 3D RA protocol with the effective dose of 1.29 mSv. The difference between the means of two dose distributions was statistically significant (p=0.00028). Conclusion: Our study demonstrated that the patient effective dose was significantly lower from the 3D RA protocol than that from the 2D DSA protocol used in the planning of coiling of intracranial aneurysm.

Dose de radiation émise lors de l’angiographie de soustraction digitale 3D rotationnelle versus 2D conventionnelle. Objectif: Le but de l’étude était de comparer la dose effective selon deux protocoles d’imagerie lors de l’évaluation d’anévrismes intracrâniens avant la mise en place de prothèses endovasculaires : une série de projections d’angiographie de soustraction digitale (ASD) 2D et d’angiographie 3D rotationnelle (AR). Méthode: Nous avons analysé rétrospectivement les dossiers de 44 patients chez qui des prothèses endovasculaires ont été mises en place dans notre institution. Les images ont été obtenues au moyen d’un système intensificateur d’image biplan qui n’était pas équipé d’un dispositif de mesure de produit dose-surface. Les images obtenues de l’ASD 2D conventionnelle étaient simulées à l’aide d’un crâne fantôme anthropomorphique. La dose d’entrée au niveau de la peau a été mesurée au moyen d’une chambre d’ionisation de 60 cm3 et le logiciel PCXMC Monte Carlo a été utilisé pour calculer la dose effective de chaque patient. Pour le protocole AR, une dosimétrie CT fantôme de 16 cm et une chambre d’ionisation à crayon de 100 mm ont été utilisées pour mesurer la dose CT index. La dose effective du patient a été calculée au moyen du calculateur ImPACT. Un test de t bilatéral non pairé a été utilisé pour déterminer la signification statistique des différences entre les doses des patients dans chaque groupe. Résultats: Le protocole ASD 2D a été utilisé chez 16 patients avec de multiples projections ; le nombre moyen de cine runs était de 5,1 ; la dose moyenne effective était de 2,11 millisievert (mSv) (écart de 1,69 à 3,43 mSv). Vingt-huit patients ont été évalués au moyen du protocole AR 3D avec une dose effective de 1,29 mSv. La différence entre les moyennes de deux distributions de dose était significative au point de vue statistique (p = 0,00028). Conclusion: Notre étude démontre que la dose effective du patient était significativement plus faible quand le protocole AR 3D était appliqué qu’avec le protocole ASD 2D lors de la planification de la mise en place de prothèses endovasculaires dans les anévrismes intracrâniens.

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Copyright

Corresponding author

Correspondence to: Elena Tonkopi, Department of Diagnostic Radiology, Dalhousie University, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada. Email: elena.tonkopi@cdha.nshealth.ca

References

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1. Missler, U, Hundt, C, Wiesmann, M, Mayer, T, Brückmann, H. Three-dimensional reconstructed rotational digital subtraction angiography in planning treatment of intracranial aneurysms. Eur Radiol. 2000;10:564-568.
2. Bridcut, RR, Murphy, E, Workman, A, Flynn, P, Winder RJ. Patient dose from 3D neurovascular studies. Brit J Radiol. 2007;80:362-366.
3. Anxionnat, R, Bracard, S, Ducrocq, X, et al. Intracranial aneurysms: clinical value of 3D digital subtraction angiography in the therapeutic decision and endovascular treatment. Radiology. 2001;218:799-808.
4. Heran, NS, Song, JK, Namba, K, Smith, W, Niimi, Y, Berenstein, A. The utility of DynaCT in neuroendovascular procedures. AJNR Am J Neuroradiol. 2006;27:330-332.
5. Wong, SC, Nawawi, O, Ramli, N, Abd Kadir, KA. Benefits of 3D rotational DSA compared with 2D DSA in the evaluation of intracranial aneurysm. Acad Radiol. 2012;19:701-707.
6. Sugahara, T, Korogi, Y, Nakashima, K, Hamatake, S, Honda, S, Takahashi, M. Comparison of 2D and 3D digital subtraction angiography in evaluation of intracranial aneurysms. AJNR Am J Neuroradiol. 2002;23:1545-1552.
7. Gkanatsios, NA, Huda, W, Peters, KR. Adult patient doses in interventional neuroradiology. Med Phys. 2002;29:717-723.
8. Balter, S, Hopewell, JW, Miller, DL, Wagner, LK, Zelefsky, MJ. Fluoroscopy guided interventional procedures: a review of radiation effects on patients’ skin and hair. Radiology. 2010;254:326-341.
9. Raelson, CA, Kanal, KM, Vavilala, MS, et al. Radiation dose and excess risk of cancer in children undergoing neuroangiography. AJR. 2009;193:1621-1628.
10. Schueler, BA, Kallmes, DF, Cloft, HJ. 3D cerebral angiography: radiation dose comparison with digital subtraction angiography. AJNR Am J Neuroradiol. 2005;26:1898-1901.
11. Tsapaki, V, Vano, E, Muavrikou, I, et al. Comparison of patient dose in two-dimensional carotid arteriography and three-dimensional rotational angiography. Cardiovasc Intervent Radiol. 2008;31:477-482.
12. Kothary, N, Abdelmaksoud, MHK, Tognolini, A, et al. Imaging guidance with C-arm: prospective evaluation of its impact on patient radiation exposure during transhepatic arterial chemoebilization. J Vasc Interv Radiol. 2011;22:1535-1543.
13. Wagner, LK, Archer, BR, Cohen, AM. Management of patient skin dose in fluoroscopically guided interventional procedures. J Vasc Interv Radiol. 2000;11:25-33.
14. Servomaa, A, Tapiovaara, M. Organ dose calculation in medical X ray examinations by the program PCXMC. Rad Prot Dosimetry. 1998;80:213-219.
15. The 2007 recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37:1-332.
16. ImPACT Group (www.impactscan.org/ctdosimetry ), London, UK, St.George’s Hospital (updated May 27, 2011).
17. Pedicelli, A, Rollo, M, Di Lella, GM, Tartaglione, T, Colosimo, C, Bonomo, L. 3D rotational angiographyfor the diagnosis and preoperative assessment of intracranial aneurysm: preliminary experience. Radiol Med. 2007;112:895-905.
18. Hochmuth, A, Spetzger, U, Schumacher, M. Comparison of three-dimensional rotational angiography with digital subtraction angiography in the assessment of ruptured cerebral aneurysms. AJNR Am J Neuroradiol. 2002;23:1199-1205.
19. Wielandts, JY, Smans, K, Ector, J, De Buck, S, et al. Effective dose analysis of three-dimentional rotational angiography during catheter ablation procedures. Phys Med Biol. 2010;55:563-579.
20. Kyriakou, Y, Richter, G, Dorfler, A, Kalender, WA. Neuroradiological applications with routine C-arm flat panel detector CT: evaluation of patient dose measurements. AJNR Am J Neuroradiol. 2008;29:1930-1936.
21. Fahrig, R, Dixon, R, Pane, T, Morin, RL, Ganguly, A, Strobel, N. Dose and image quality for a cone-beam C-arm CT system. Med Phys. 2006;33:4541-4550.
22. Dixon, RL, Boon, JM. Cone beam CT dosimetry: a unified and self-consistent approach including all scan modalities – with or without phantom motion. Med Phys. 2010;37:2703-2718.
23. Sawyer, LJ, Whittle, SA, Matthews, ES, Starritt, HC, Jupp, TP. Estimation of organ and effective doses resulting from cone beam CT imaging for radiotherapy treatment planning. Brit J Radiol. 2009;82:577-584.
24. Amer, A, Marchant, T, Sykes, J, Czajka, J, Moore, C. Imaging doses from the Elekta Synergy X-ray cone beam CT system. Brit J Radiol. 2007;80:476-482.

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Radiation Dose from 3D Rotational vs. Conventional 2D Digital Subtraction Angiography in Intracranial Aneurysm Coiling

  • Elena Tonkopi (a1), Ahmed H. Al-Habsi (a1) and Jai J. S. Shankar (a1)

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