title: Radiation dose reduction during neurointerventional procedures by modification of default settings on biplane angiography equipment.
abstract: BACKGROUND
  Neurointerventional procedures represent a significant source of ionizing radiation. We sought to assess the effect during neurointerventional procedures of varying default rates of radiation dose in fluoroscopy (F) and image acquisition (IA) modes, and frame rates during cine acquisition (CINE) on total X-ray dose, acquisition exposures, fluoroscopy time, and complications.
  
  
  METHODS
  We retrospectively reviewed procedures performed with two radiation dose and CINE settings: a factory setting dose cohort (30 patients, F 45 nGy/pulse, IA 3.6 μGy/pulse, factory CINE frame rate) and a reduced dose cohort (30 patients, F 32 nGy/pulse, IA 1.2 μGy/pulse, with a decreased CINE frame rate). Total radiation dose, dose area product, number of acquisition exposures, fluoroscopy time, and complications were compared between the groups. Means comparisons (t tests) were employed to evaluate differences in the outcome variables between the two groups. p Value <0.05 was considered significant.
  
  
  RESULTS
  The reduced dose cohort had a significant reduction in mean radiation dose (factory, 3650 mGy; reduced, 1650 mGy; p=0.005) and dose area product (factory, 34 700 μGy×m(2); reduced, 15 000 μGy×m(2); p=0.02). There were no significant differences between cohorts in acquisition exposure (p=0.73), fluoroscopy time (p=0.45), or complications.
  
  
  CONCLUSIONS
  Significant reductions in radiation dose delivered by neurointerventional procedures can be achieved through simple modifications of default radiation dose in F and IA and frame rate during CINE without an increase in procedural complexity (fluoroscopy time) or rate of complications.
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Elyne N
authors.initials: EN
authors.lastname: Kahn
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Gemmete
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Chaudhary
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Byron Gregory
authors.initials: BG
authors.lastname: Thompson
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Emmanuel G
authors.initials: EG
authors.lastname: Christodoulou
authors.affiliation: Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Aditya S
authors.initials: AS
authors.lastname: Pandey
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002533:Cerebral Angiography / Q000379:methods*; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D011829:Radiation Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome; D014965:X-Rays
keywords: Angiography