Analysis of patient radiation dose and angiographic techniques during intracranial aneurysmal diagnosis: a 5-year experience of interventional neuroradiology unit in Srinagarind Hospital.
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Abstract
Background: Intracranial aneurysmal diagnosis (IAD) with an angiographic procedure is the gold standard diagnosis that provides more benefit than other techniques. Moreover, IAD has been the most common diagnostic procedure in the Interventional Neuroradiology unit (INR) in Srinagarind Hospital. However, the angiographic techniques and radiation dose from IAD had never been determined. Therefore, a review of the IAD procedure was considered.
Objectives: This study was set up to obtain a baseline data of IAD radiation dose and angiographic techniques, to compare the radiation dose and angiographic techniques during 5 years of experience and to set up the local DRLs for IAD.
Materials and methods: A retrospective study from January 2014 to December 2018 of IAD patients using bi-plane digital subtraction angiography (DSA) was conducted. Patient’s data was reviewed as follows: age, gender, cerebral angiography techniques including kV, mAs, acquisition time of 2-dimensional angiography (2DA) and 3-dimensional rotational angiography (3DRA), total number of angiographic frames, fluoroscopic time, number of 2DA exposure, number of 3DRA exposure, and radiation dose (dose area product; DAP in µGy.m2 and air kerma; Kar in mGy).
Results: A total of 795 cases (338 male and 457 female), including adult and pediatric patients at the age of 1-91 years old, were recruited into this study. The results showed significant differences in radiation dose, kV, mAs, number of 2DA exposures, 2DA acquisition time, fluoroscopic time, and angiographic frames (p<0.05) throughout 5 years. The 3rd quartile of DAP and Kar have significantly increased from 15,636.30 µGy.m2 and 939.70 mGy in 2014 to 20,006.36 µGy.m2 and 1,050.53 mGy in 2018 (p<0.001), respectively. The pediatric DAP and Kar (16,375.54 µGy.m2 and 816.70 mGy) are slightly lower than the total patient’s dose.
Conclusion: Alteration of angiographic techniques during IAD procedure over 5 years might mainly contribute to factors influencing the elevation of radiation dose. The DRLs of IAD procedure in this study is much higher than in other studies. The finding of strategies to reduce radiation dose, particularly pediatric radiation dose, must be further performed.
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