title: Radiation dose in neuroangiography using image noise reduction technology: a population study based on 614 patients.
abstract: BACKGROUND
  The purpose of this study was to quantify the reduction in patient radiation dose by X-ray imaging technology using image noise reduction and system settings for neuroangiography and to assess its impact on the working habits of the physician.
  
  
  METHODS
  Radiation dose data from 190 neuroangiographies and 112 interventional neuroprocedures performed with state-of-the-art image processing and reference system settings were collected for the period January-June 2010. The system was then configured with extra image noise reduction algorithms and system settings, which enabled radiation dose reduction without loss of image quality. Radiation dose data from 174 neuroangiographies and 138 interventional neuroprocedures were collected for the period January-June 2012. Procedures were classified as diagnostic or interventional. Patient radiation exposure was quantified using cumulative dose area product and cumulative air kerma. Impact on working habits of the physician was quantified using fluoroscopy time and number of digital subtraction angiography (DSA) images.
  
  
  RESULTS
  The optimized system settings provided significant reduction in dose indicators versus reference system settings (p<0.001): from 124 to 47 Gy cm(2) and from 0.78 to 0.27 Gy for neuroangiography, and from 328 to 109 Gy cm(2) and from 2.71 to 0.89 Gy for interventional neuroradiology. Differences were not significant between the two systems with regard to fluoroscopy time or number of DSA images.
  
  
  CONCLUSIONS
  X-ray imaging technology using an image noise reduction algorithm and system settings provided approximately 60% radiation dose reduction in neuroangiography and interventional neuroradiology, without affecting the working habits of the physician.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute and Department of Neuroradiology, Karolinska University Hospital - Solna, Stockholm, 17176, Sweden, michael.soderman@karolinska.se.
authors.forename: Michael
authors.initials: M
authors.lastname: Söderman
authors.forename: Maria
authors.initials: M
authors.lastname: Mauti
authors.forename: Sjirk
authors.initials: S
authors.lastname: Boon
authors.forename: Artur
authors.initials: A
authors.lastname: Omar
authors.forename: María
authors.initials: M
authors.lastname: Marteinsdóttir
authors.forename: Tommy
authors.initials: T
authors.lastname: Andersson
authors.forename: Staffan
authors.initials: S
authors.lastname: Holmin
authors.forename: Bart
authors.initials: B
authors.lastname: Hoornaert
mesh_terms: D002533:Cerebral Angiography / Q000706:statistics & numerical data*; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods / Q000706:statistics & numerical data*; D015641:Radiography, Interventional / Q000379:methods / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio; D013548:Sweden / Q000453:epidemiology