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Digital subtraction angiography and multislice computed tomography angiography for cervicocranial vessels: comparison of radiation doses

Year 2019, Volume: 58 Issue: 4, 363 - 369, 30.12.2019
https://doi.org/10.19161/etd.662373

Abstract

Aim: In this study our purpose was to compare the digital subtraction angiography (DSA) and computed tomography angiography (CTA) techniques in terms of the superiority of diagnosis and radiation doses. Materials and Methods: Forty-six patients (21 men, 25 women) who were subjected to both digital subtraction angiography (DSA) and computed tomography (CT) neck-brain angiographic examinations between January and December 2014 were screened retrospectively. Radiation dose records taken from the cards provided by DSA and CT devices were reviewed. The total DSA [DSA+ tri-dimension (3D) DSA], DSA, 3D-DSA and CTA dose reports were examined separately. Generated 3D images were evaluated by two radiologists who had experience in neuro radiology and interventional radiology at least for five years. Independent samples test and in dual comparisons the paired samples test, were used for statistical analyses. Results: Comparison made between DSA and CTA radiation doses has found that the total dose of total DSA (DSA+3D DSA) was three times and the DSA doses were two times higher than the CTA dose. There was no statistical difference between 3D DSA and CTA doses. CTA is less sensitive than DSA; four of 68 intracranial aneurisms could not be demonstrated with CTA. The radiation doses received by patients did not change with gender. Conclusion: CTA contains less radiation doses in the diagnosis of intracranial aneurisms, but its sensitivity, however, is lower than DSA.

References

  • Brisman JL, Song JK, Newell DW. Cerebral aneurism. N Engl J Med. 2006;355(9):928-39. 2. Schievink WI. Intracranial aneurisms. N Engl J Med. 1997; 336 (1): 28-40.
  • Kim S, Sopko D, Toncheva G, Enterline D, Keijzers B, Yoshizumi TT. Radiation dose from 3D rotational X-ray imaging: organ and effective dose with conversion factors. Radiat Prot Dosimetry. 2012; 150 (1): 50-4. 4. The 2007 Recommendations of the International Commission on Radiological Protection. Ann ICRP. 2007; 37 (2-4): 1-332.
  • Jessen KA, Shrimpton PC, Geleijns J, Panzer W, Tosi G. Dosimetry for optimisation of patient protection in computed tomography. Appl Radiat Isot. 1999; 50 (1):165-72.
  • Christner JA, Kofler JM, McCollough CH. Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol. 2010; 194 (4): 881-9. Cilt 58 Sayı 4, Aralık 2019 / Volume 58 Issue 4, December 2019 369
  • Kyriakou Y, Richter G, Dörfler A, Kalender WA. Neuroradiologic Applications with Routine C-arm Flat Panel Detector CT: Evaluation of Patient Dose Measurements. AJNR Am J Neuroradiol. 2008; 29 (10): 1930-6
  • Huda W, Mettler FA. Volume CT dose index and dose-length product displayed during CT: what good are they? Radiology. 2011; 258 (1): 236-42.
  • Zhang LJ, Wu SY, Niu JB, Zhang ZL, Wang HZ, Zhao YE, et al. Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurisms: Image Quality, Radiation Dose, and Comparison With 3D Rotational Digital Subtraction Angiography. AJR Am J Roentgenol. 2010; 194 (1): 23-30.
  • Koyama S, Aoyama T, Oda N, Yamauchi-Kawaura C. Radiation dose evaluation in tomosynthesis and C-arm cone-beam CT examination with an anthropomorphic phantom. Med Phys. 2010; 37 (8): 4298-306.
  • Sanchez RM, Vano E, Fernández JM, Moreu M, Lopez-Ibor L. Brain Radiation Doses to Patients in an Interventional Neuroradiology Laboratory. AJNR Am J Neuroradiol. 2014; 35 (7): 1276-80.
  • Bai M, Liu X, Liu B. Effective patient dose during neuroradiological C-arm CT procedures. Diagn Interv Radiol. 2013; 19 (1): 29-32. 13. ICRP Publication 105. Radiation protection in medicine. Ann ICRP. 2007; 37 (6): 1-63.
  • McCollough CH, Christner JA, Kofler JM. How effective is effective dose as a predictor of radiation risk? AJR Am J Roentgenol. 2010; 194 (4): 890-6.
  • Jessen, KA, Shrimpton, PC, J. Geleijns, J, Panzer, W, Tosi, G. Dosimetry for optimisation of patient protection in computed tomography. Applied Radiation and Isotopes. 1999; 50 (1): 165-72.
  • Bongartz G, Golding SJ, Jurik AG, Leonardi M, van Persijn van Meerten E, Rodríguez R, Schneider K, Calzado A, Geleijns J, Jessen KA, Panzer W, Shrimpton PC, Tosi G. European Guidelines for Multislice Computed Tomography. Funded by the European Commission. Contract number FIGM-CT2000-20078-CT-TIP. March 2004.
  • Shrimpton P. Assessment of patient dose in CT. In: EUR. European guidelines for multislice computed tomography funded by the European Commission 2004: contract number FIGMCT2000-20078-CT-TIP. Luxembourg, Luxembourg: European Commission, 2004:Appendix C.
  • Shrimpton PC, Hillier MC, Lewis MA, Dunn M. Doses from computed tomography (CT) examinations in the UK: 2003. Br J Radiol. 2006; 79 (948): 968-80.
  • EC 2008. Radiatıon Protection No:154. European Guidance on Estimating Population Doses from Medical X-Ray Procedures. Luxembourg, 2008.
  • AAPM Report No:96. Report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. USA, 2008.
  • Dammert S, Krings T, Moller-Hartmann W, Ueffing E, Hans FJ, Wilmes K, et al. Detection of intracranial aneurisms with multislice CT: comparison with conventional angiography. Neuroradiology. 2004; 46 (6): 427-34.
  • Kouskouras C, Charitanti A, Giavroglou C, Foroglou N, Selviaridis P, Kontopoulos V, Dimitriadis AS. Intracranial aneurisms: evaluation using CTA and MRA: correlation with DSA and intraoperative findings. Neuroradiology. 2004; 46 (10): 842-50.
  • Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurisms: a meta-analysis. Neurosurgery. 2003;52(3):624-31.
  • White PM, Wardlaw JM, Easton V. Can noninvasive imaging accurately depict intracranial aneurisms? A systematic review. Radiology. 2000; 217 (2): 361-70.
  • White PM, Teasdale EM, Wardlaw JM, Easton V. Intracranial aneurisms: CT angiography and MR angiography for detection prospective blinded comparison in a large patient cohort. Radiology. 2001; 219 (3): 739-49.
  • Okahara M, Kiyosue H, Yamashita M, Naqatomi H, Hata H, Saginova T, et al. Diagnostic accuracy of magnetic resonance angiography for cerebral aneurisms in correlation with 3D-digital subtraction angiographic images: a study of 133 aneurisms. Stroke. 2002; 33 (7): 1803-8.
  • Harrison MJ, Johnson BA, Gardner GM, Welling BG. Preliminary results on the management of unruptured intracranial aneurisms with magnetic resonance angiography and computed tomographic angiography. Neurosurgery. 1997; 40 (5): 947-55.
  • Bederson JB, Awad IA, Wiebers DO, Piepqras D, Haley EC Jr, Brot T, et al. Recommendations for the management of patients with unruptured intracranial aneurisms: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke. 2000; 31 (11): 2742-50.
  • Tipper G, U-King-Im JM, Price SJ, Trivedi RA, Cross JJ, Higgins NJ, et al. Detection and evaluation of intracranial aneurisms with 16-row multislice CT angiography. Clin Radiol. 2005; 60 (5): 565-72.
  • Manninen AL, Isokangas JM, Karttunen K, Siniluoto T, Nieminen MT. A Comparison of Radiation Exposure between Diagnostic CTA and DSA Examinations of Cerebral and Cervicocerebral Vessels. AJNR Am J Neuroradiol. 2012; 33 (11): 2038-42.

Servikokranial damarlar için dijital subtraksiyon anjiografi ve multislice bilgisayarlı tomografi anjiografi radyasyon dozlarının karşılaştırılması

Year 2019, Volume: 58 Issue: 4, 363 - 369, 30.12.2019
https://doi.org/10.19161/etd.662373

Abstract

Amaç: Bu çalışmada amacımız tanı ve radyasyon dozlarının üstünlüğü açısından dijital subtraksiyon anjiyografi (DSA) ve bilgisayarlı tomografi anjiyografi (CTA) tekniklerini karşılaştırmaktır. Gereç ve Yöntem: 2014 yılı Ocak-Aralık tarihleri arasında hem DSA hem de CTA ile boyun-beyin anjiyografik muayeneye tabi tutulan 46 hasta (21 erkek, 25 kadın) retrospektif olarak tarandı. DSA ve CT cihazları tarafından sağlanan kartlardan alınan radyasyon dozu kayıtları gözden geçirildi. Toplam DSA (DSA + 3D-DSA), DSA, 3D-DSA ve CTA dozu raporları ayrı ayrı incelendi. Oluşturulan üç boyutlu görüntüler en az beş yıl nöroloji ve girişimsel radyolojide tecrübesi olan iki radyolog tarafından değerlendirildi. İstatistiksel hesaplamalarda Independent samples testi, ikili karşılaştırmalarda ise paired samples testi kullanıldı. Bulgular: DSA ve CTA radyasyon dozları arasında yapılan karşılaştırmada, toplam TDSA dozunun [DSA + 3 boyutlu (3D) DSA], CTA dozundan 3 kat fazla olduğu ve DSA dozunun, CTA dozundan 2 kat daha fazla olduğu bulundu. 3D DSA ve CTA dozları arasında istatistiksel bir fark yoktu. CTA, DSA'dan daha az duyarlı idi; 68 intrakranial anevrizmanın dördü CTA ile kanıtlanamadı. Hastalar tarafından alınan radyasyon dozları cinsiyetle değişmedi.
Sonuç: CTA intrakranial anevrizma tanısında daha az radyasyon dozu içerir, ancak duyarlılığı DSA'dan daha düşüktür.

References

  • Brisman JL, Song JK, Newell DW. Cerebral aneurism. N Engl J Med. 2006;355(9):928-39. 2. Schievink WI. Intracranial aneurisms. N Engl J Med. 1997; 336 (1): 28-40.
  • Kim S, Sopko D, Toncheva G, Enterline D, Keijzers B, Yoshizumi TT. Radiation dose from 3D rotational X-ray imaging: organ and effective dose with conversion factors. Radiat Prot Dosimetry. 2012; 150 (1): 50-4. 4. The 2007 Recommendations of the International Commission on Radiological Protection. Ann ICRP. 2007; 37 (2-4): 1-332.
  • Jessen KA, Shrimpton PC, Geleijns J, Panzer W, Tosi G. Dosimetry for optimisation of patient protection in computed tomography. Appl Radiat Isot. 1999; 50 (1):165-72.
  • Christner JA, Kofler JM, McCollough CH. Estimating effective dose for CT using dose-length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning. AJR Am J Roentgenol. 2010; 194 (4): 881-9. Cilt 58 Sayı 4, Aralık 2019 / Volume 58 Issue 4, December 2019 369
  • Kyriakou Y, Richter G, Dörfler A, Kalender WA. Neuroradiologic Applications with Routine C-arm Flat Panel Detector CT: Evaluation of Patient Dose Measurements. AJNR Am J Neuroradiol. 2008; 29 (10): 1930-6
  • Huda W, Mettler FA. Volume CT dose index and dose-length product displayed during CT: what good are they? Radiology. 2011; 258 (1): 236-42.
  • Zhang LJ, Wu SY, Niu JB, Zhang ZL, Wang HZ, Zhao YE, et al. Dual-Energy CT Angiography in the Evaluation of Intracranial Aneurisms: Image Quality, Radiation Dose, and Comparison With 3D Rotational Digital Subtraction Angiography. AJR Am J Roentgenol. 2010; 194 (1): 23-30.
  • Koyama S, Aoyama T, Oda N, Yamauchi-Kawaura C. Radiation dose evaluation in tomosynthesis and C-arm cone-beam CT examination with an anthropomorphic phantom. Med Phys. 2010; 37 (8): 4298-306.
  • Sanchez RM, Vano E, Fernández JM, Moreu M, Lopez-Ibor L. Brain Radiation Doses to Patients in an Interventional Neuroradiology Laboratory. AJNR Am J Neuroradiol. 2014; 35 (7): 1276-80.
  • Bai M, Liu X, Liu B. Effective patient dose during neuroradiological C-arm CT procedures. Diagn Interv Radiol. 2013; 19 (1): 29-32. 13. ICRP Publication 105. Radiation protection in medicine. Ann ICRP. 2007; 37 (6): 1-63.
  • McCollough CH, Christner JA, Kofler JM. How effective is effective dose as a predictor of radiation risk? AJR Am J Roentgenol. 2010; 194 (4): 890-6.
  • Jessen, KA, Shrimpton, PC, J. Geleijns, J, Panzer, W, Tosi, G. Dosimetry for optimisation of patient protection in computed tomography. Applied Radiation and Isotopes. 1999; 50 (1): 165-72.
  • Bongartz G, Golding SJ, Jurik AG, Leonardi M, van Persijn van Meerten E, Rodríguez R, Schneider K, Calzado A, Geleijns J, Jessen KA, Panzer W, Shrimpton PC, Tosi G. European Guidelines for Multislice Computed Tomography. Funded by the European Commission. Contract number FIGM-CT2000-20078-CT-TIP. March 2004.
  • Shrimpton P. Assessment of patient dose in CT. In: EUR. European guidelines for multislice computed tomography funded by the European Commission 2004: contract number FIGMCT2000-20078-CT-TIP. Luxembourg, Luxembourg: European Commission, 2004:Appendix C.
  • Shrimpton PC, Hillier MC, Lewis MA, Dunn M. Doses from computed tomography (CT) examinations in the UK: 2003. Br J Radiol. 2006; 79 (948): 968-80.
  • EC 2008. Radiatıon Protection No:154. European Guidance on Estimating Population Doses from Medical X-Ray Procedures. Luxembourg, 2008.
  • AAPM Report No:96. Report of AAPM Task Group 23 of the Diagnostic Imaging Council CT Committee. USA, 2008.
  • Dammert S, Krings T, Moller-Hartmann W, Ueffing E, Hans FJ, Wilmes K, et al. Detection of intracranial aneurisms with multislice CT: comparison with conventional angiography. Neuroradiology. 2004; 46 (6): 427-34.
  • Kouskouras C, Charitanti A, Giavroglou C, Foroglou N, Selviaridis P, Kontopoulos V, Dimitriadis AS. Intracranial aneurisms: evaluation using CTA and MRA: correlation with DSA and intraoperative findings. Neuroradiology. 2004; 46 (10): 842-50.
  • Chappell ET, Moure FC, Good MC. Comparison of computed tomographic angiography with digital subtraction angiography in the diagnosis of cerebral aneurisms: a meta-analysis. Neurosurgery. 2003;52(3):624-31.
  • White PM, Wardlaw JM, Easton V. Can noninvasive imaging accurately depict intracranial aneurisms? A systematic review. Radiology. 2000; 217 (2): 361-70.
  • White PM, Teasdale EM, Wardlaw JM, Easton V. Intracranial aneurisms: CT angiography and MR angiography for detection prospective blinded comparison in a large patient cohort. Radiology. 2001; 219 (3): 739-49.
  • Okahara M, Kiyosue H, Yamashita M, Naqatomi H, Hata H, Saginova T, et al. Diagnostic accuracy of magnetic resonance angiography for cerebral aneurisms in correlation with 3D-digital subtraction angiographic images: a study of 133 aneurisms. Stroke. 2002; 33 (7): 1803-8.
  • Harrison MJ, Johnson BA, Gardner GM, Welling BG. Preliminary results on the management of unruptured intracranial aneurisms with magnetic resonance angiography and computed tomographic angiography. Neurosurgery. 1997; 40 (5): 947-55.
  • Bederson JB, Awad IA, Wiebers DO, Piepqras D, Haley EC Jr, Brot T, et al. Recommendations for the management of patients with unruptured intracranial aneurisms: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke. 2000; 31 (11): 2742-50.
  • Tipper G, U-King-Im JM, Price SJ, Trivedi RA, Cross JJ, Higgins NJ, et al. Detection and evaluation of intracranial aneurisms with 16-row multislice CT angiography. Clin Radiol. 2005; 60 (5): 565-72.
  • Manninen AL, Isokangas JM, Karttunen K, Siniluoto T, Nieminen MT. A Comparison of Radiation Exposure between Diagnostic CTA and DSA Examinations of Cerebral and Cervicocerebral Vessels. AJNR Am J Neuroradiol. 2012; 33 (11): 2038-42.
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles
Authors

H. İbrahim Özdemir 0000-0002-3336-6848

Celal Çınar 0000-0002-3237-9268

Halil Bozkaya 0000-0002-5012-6635

Selçuk Topal 0000-0001-7074-2569

İsmail Oran 0000-0002-3546-7773

Publication Date December 30, 2019
Submission Date July 10, 2018
Published in Issue Year 2019Volume: 58 Issue: 4

Cite

Vancouver Özdemir Hİ, Çınar C, Bozkaya H, Topal S, Oran İ. Digital subtraction angiography and multislice computed tomography angiography for cervicocranial vessels: comparison of radiation doses. EJM. 2019;58(4):363-9.