Abstract
Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.
Highlights
Endovascular treatment of cerebral vascular diseases has developed tremendously during the last 30 years, which has led to a change in treatment strategy and an improvement of the outcomes of treatment of these diseases
digital subtraction angiography (DSA) acquisitions of the entire field of view (FOV) for spot fluoroscopy (Spot F) and conventional collimation (CC) were performed for two reasons: 1. To create a sufficient patient skin dose map that permitted a clear visual difference in the total dose applied between the three modalities
Spot ROI shows the highest Dose area product (DAP) value in fluoroscopy mode for FOV 20 and FOV 15 because the exposed field size is significantly larger for SR (Table 1) even though the X-ray intensity is different between the Spot ROI and the surrounding area
Summary
Endovascular treatment of cerebral vascular diseases has developed tremendously during the last 30 years, which has led to a change in treatment strategy and an improvement of the outcomes of treatment of these diseases. Thanks to numerous newly developed endovascular methods of treatment, it is possible to treat some cerebral vascular diseases which were untreatable only 15 or 20 years ago. Many systems aimed at direct or indirect X-ray protection have been developed. Beam collimators of various forms and constructions were one of the first devices for reducing X-ray dose and have been used almost since the beginning of the Xray era[7,8]. Symmetric collimation is possible, which leads to an unnecessary exposure for larger anatomical areas than needed
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