Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Low-Dose Three-Dimensional Rotational Angiography for Evaluating Intracranial Aneurysms: Analysis of Image Quality and Radiation Dose

  • Hee Jong Ki (Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Bum-soo Kim (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jun-Ki Kim (Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jai Ho Choi (Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Yong Sam Shin (Department of Neurosurgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Yangsean Choi (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Na-Young Shin (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Jinhee Jang (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Kook-jin Ahn (Department of Radiology, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • Received : 2020.07.17
  • Accepted : 2021.09.30
  • Published : 2022.02.01
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Abstract

Objective: This study aimed to evaluate the image quality and dose reduction of low-dose three-dimensional (3D) rotational angiography (RA) for evaluating intracranial aneurysms. Materials and Methods: We retrospectively evaluated the clinical data and 3D RA datasets obtained from 146 prospectively registered patients (male:female, 46:100; median age, 58 years; range, 19-81 years). The subjective image quality of 79 examinations obtained from a conventional method and 67 examinations obtained from a low-dose (5-seconds and 0.10-μGy/frame) method was assessed by two neurointerventionists using a 3-point scale for four evaluation criteria. The total image quality score was then obtained as the average of the four scores. The image quality scores were compared between the two methods using a noninferiority statistical testing, with a margin of -0.2 (i.e., score of low-dose group - score of conventional group). For the evaluation of dose reduction, dose-area product (DAP) and air kerma (AK) were analyzed and compared between the two groups. Results: The mean total image quality score ± standard deviation of the 3D RA was 2.97 ± 0.17 by reader 1 and 2.95 ± 0.20 by reader 2 for conventional group and 2.92 ± 0.30 and 2.95 ± 0.22, respectively, for low-dose group. The image quality of the 3D RA in the low-dose group was not inferior to that of the conventional group according to the total image quality score as well as individual scores for the four criteria in both readers. The mean DAP and AK per rotation were 5.87 Gy-cm2 and 0.56 Gy, respectively, in the conventional group, and 1.32 Gy-cm2 (p < 0.001) and 0.17 Gy (p < 0.001), respectively, in the low-dose group. Conclusion: Low-dose 3D RA was not inferior in image quality and reduced the radiation dose by 70%-77% compared to the conventional 3D RA in evaluating intracranial aneurysms.

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References

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