title: Dose comparison of classical 2-plane DSA and 3D rotational angiography for the assessment of intracranial aneurysms.
abstract: BACKGROUND
  The purpose of this experimental phantom study was to compare radiation doses imparted to patients undergoing classical two-plane digital subtraction angiography (2-plane DSA) and 3D rotational angiography in interventional neuroradiology.
  
  
  METHODS
  Thermoluminescence dosimeter (TLD) measurements were performed at an anthropomorphic phantom using a digital interventional angiography system. Two-plane DSA included posterior/anterior (PA) and lateral (LAT) projections (frame-rate, 7.6 frames (PA) and 9.8 frames (LAT) for a scan time of approximately 8 s; image intensifier 27 cm (PA) and 25 cm (LAT)). For 3D rotational angiography, 122 images were acquired from one single image run with the imaging system rotating 240° around the phantom's head (image intensifier 37 cm).
  
  
  RESULTS
  Effective dose was 0.4 mSv for 2-plane DSA compared to 0.1 mSv for 3D rotational angiography. Organ doses were approximately two to five times higher for classical 2-plane technique compared to the 3D rotational angiography, respectively: brain (11.4 vs. 2.4 mSv), eye lens (4.5 vs.1 mSv), salivary glands (7 vs. 1,7 mSv), oral mucosa (2.7 vs.0.9 mSv), thyroid (0.5 vs. 0.2 mSv), thymus (0.2 vs. 0.05 mSv), bone marrow within imaged region (1 vs. 0.2 mSv), oesophagus (0.07 vs. 0.03 mSv), endotracheal system (2.6 vs. 0.7 mSv) and skeletal components in the imaged region (0.7 vs. 0.2 mSv).
  
  
  CONCLUSIONS
  Three-dimensional rotational angiography clearly reduces radiation doses compared to the classical 2-plane technique. Replacement of additional 2-plane DSA projections with 3D rotational angiography will lead to a remarkable decrease in patient radiation dose, without loss of image quality. Thus, we recommend routine application of 3D rotational angiography, in particular for diagnostic assessment of aneurysm morphology.
authors.affiliation: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany. nika.guberina@uk-essen.de.
authors.forename: N
authors.initials: N
authors.lastname: Guberina
authors.affiliation: Department of Medical and Occupational Radiation Protection, Federal Office for Radiation Protection, Neuherberg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Lechel
authors.affiliation: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Forsting
authors.affiliation: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Mönninghoff
authors.affiliation: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Dietrich
authors.affiliation: Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Ringelstein
mesh_terms: D015901:Angiography, Digital Subtraction / Q000295:instrumentation / Q000379:methods*; D002533:Cerebral Angiography / Q000295:instrumentation / Q000379:methods*; D000072226:Computed Tomography Angiography / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008297:Male; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013819:Thermoluminescent Dosimetry
keywords: 2-plane DSA; 3D rotational angiography; Dose measurement; Effective dose; Experimental phantom study