Evaluation of Clinical Image Quality Following Radiation Dose Reduction in Procedures of Interventional Neuroradiology in Prasat Neurological Institute
Keywords:Interventional Neuroradiology, Digital subtraction angiography, Radiation dose reduction
Background : Treatment of patients with complex diseases by interventional neuroradiology procedures have taken long time, which causes patients to receive high radiation dose.
Objective : To compare radiation dose to patients between care dose protocol of the factory and dose reduction protocol of Prasat Neurological Institute in Thailand and also evaluate the quality of vascular images following radiation dose reduction protocol.
Method : The acquisition care dose protocol of the digital subtraction angiography was reduced from 1.8 μGy/ frame to low dose protocol 1.2 μGy/ frame. A retrospective study of 16 patients with interventional neuroradiology procedures were conducted by selecting patients who were treated with two sessions using care dose and low dose protocols. The image quality assessment from 2 tests in term of clinical diagnosis were performed by 2 radiologists.
Result : The clinical image quality between care dose and low dose protocols in arterial phase, capillary phase, venous phase and over all image were not statistically significant. While the kerma air product (KAP) dose in the same vascular examination decreased by 26.5% and reference air kerma (Ka, r) decreased by 31.2%. When combining radiation dose in a single procedure, peak skin dose decreased by 31.99%, KAP decreased by 35.3%, reference air kerma decreased by 27.5%.
Conclusion : Low dose protocol can be used both in interventional neuroradiology procedure and cerebral angiography, allow patient to receive minimal radiation, also reduce risk of radiation complication, and still maintain quality of vascular images for diagnostic and serve treatment target.
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