Reduction of Radiation Exposure Using Dynamic Trace Digital Angiography and Spot Fluoroscopy During Adrenal Venous Sampling

Cardiovasc Intervent Radiol. 2017 May;40(5):697-703. doi: 10.1007/s00270-017-1567-7. Epub 2017 Jan 30.

Abstract

Purpose: To compare radiation exposure of adrenal venous sampling (AVS) using dynamic trace digital angiography (DTDA) and spot fluoroscopy with that using conventional methods.

Materials and methods: AVS was performed in 11 patients using DTDA and spot fluoroscopy (Group A) and 11 patients using conventional digital subtraction angiography (DSA) with collimation (Group B). Radiation exposure and image quality of adrenal venography using a five-point scale were compared between the groups.

Results: The acquisition dose-area product (DAP) using DTDA and fluoro-DAP using spot fluoroscopy in Group A were lower than those using conventional DSA (5.3 ± 3.7 vs. 29.1 ± 20.1 Gy cm2, p < 0.001) and collimation (33.3 ± 22.9 vs. 59.1 ± 35.7 Gy cm2, p = 0.088) in Group B. The total DAP in Group A was significantly lower than that in Group B (38.6 ± 25.9 vs. 88.2 ± 53.6 Gy cm2, p = 0.006). The peak skin dose for patients and operator radiation exposure in Group A were significantly lower than those in Group B (403 ± 340 vs. 771 ± 416 mGy, p = 0.030, and 17.1 ± 14.8 vs. 36.6 ± 21.7 μSv, p = 0.013). The image quality of DTDA (4.4 ± 0.6) was significantly higher than that of digital angiography (3.8 ± 0.9, p = 0.011) and equivalent to that of DSA (4.3 ± 0.8, p = 0.651).

Conclusions: Radiation exposure during AVS can be reduced by approximately half for both patients and operators by using DTDA and spot fluoroscopy without sacrificing image quality.

Keywords: AVS; Adrenal venous sampling; Dynamic trace digital angiography; Interventional radiology; Radiation exposure; Spot fluoroscopy.

MeSH terms

  • Adrenal Glands / blood supply*
  • Adrenal Glands / diagnostic imaging*
  • Adult
  • Aged
  • Angiography, Digital Subtraction / methods*
  • Female
  • Fluoroscopy / methods
  • Humans
  • Male
  • Middle Aged
  • Radiation Dosage*
  • Radiation Exposure*
  • Retrospective Studies