title: Difference in dose area product between analog image intensifier and digital flat panel detector in peripheral angiography and the effect of BMI.
abstract: OBJECTIVE
  Comparison of dose area products (DAP) in diagnostic angiography procedures between an image intensifier (II) and a flat panel detector (FPD) angiography system and the evaluation of DAP/body mass index (BMI) dependency.
  
  
  METHODS
  An image intensifier system or a flat panel detector system was used to perform 571 diagnostic angiographies (n = 328 and n = 243, respectively) of 5 different types: peripheral arterial, venous, single leg, abdominal and upper extremity. The results were retrospectively analyzed. The DAP, fluoroscopy time (t) and the number of series of the respective interventions as calculated by the respective machines was compared for all interventions and for the respective subtypes and machines. The BMI dependency was calculated separately for both machines for all interventions by subdividing the patients into 6 BMI classes defined by the WHO.
  
  
  RESULTS
  The average DAP for all diagnostic interventions was 1958.9 cGy×cm2 (t = 384.6 s, n = 7.85 series) for the II and 2927.4 cGy×cm2 (t = 267.4 s, n = 7.02 series) for the FPD. Group-dependent differences ranged between + 21 and + 252 % when using the FPD system. After time standardization, the respective increases were found to be 120 % for the FPD system. The DAPs increased considerably in patients with higher BMIs (766.7 cGy × cm2 - 6892.6 cGy × cm2, II machine, 950.5 cGy × cm2 - 12 487.7 cGy × cm2, FPD machine) with a greater DAP gain seen for the FPD. The average duration of the interventions was higher using the II machine.
  
  
  CONCLUSIONS
  The use of an FPD system led to higher DAP values compared to the II system in diagnostic angiographic procedures. In addition, increased BMI values led to higher DAPs, especially for the FPD machine. However, the average fluoroscopy times were shorter.
authors.affiliation: Diagnostische und Interventionelle Radiologie, Eberhard-Karls-Universitätsklinikum Tübingen. benjamin.wiesinger@med.unituebingen.de
authors.forename: B
authors.initials: B
authors.lastname: Wiesinger
authors.forename: S
authors.initials: S
authors.lastname: Kirchner
authors.forename: G
authors.initials: G
authors.lastname: Blumenstock
authors.forename: K
authors.initials: K
authors.lastname: Herz
authors.forename: J
authors.initials: J
authors.lastname: Schmehl
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
authors.forename: J
authors.initials: J
authors.lastname: Wiskirchen
mesh_terms: D000792:Angiography / Q000295:instrumentation* / Q000706:statistics & numerical data*; D015992:Body Mass Index; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000295:instrumentation* / Q000706:statistics & numerical data; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014963:X-Ray Intensifying Screens / Q000706:statistics & numerical data*