A Patient Dose-Reduction Technique for Neuroendovascular Image-Guided Interventions: Image-Quality Comparison Study

Area of Science:

• Medical Imaging
• Radiology
• Interventional Neurology

Background:

• Fluoroscopy in neurointerventions involves significant radiation exposure.
• Reducing radiation dose is crucial for patient safety and operator well-being.
• Existing techniques for dose reduction may compromise image quality.

Purpose of the Study:

• To evaluate the image quality of simulated neurointerventions using a novel ROI-dose-reduced technique.
• To compare image quality between regular and reduced radiation doses with a standard flat panel detector.
• To assess the efficacy of dose reduction without compromising diagnostic information.

Main Methods:

• Ten patient-specific intracranial aneurysm models were created.
• A 0.7-mm copper attenuator with a 10-mm ROI hole was used for dose reduction.
• Two neurointerventionalists assessed 80 images for image quality in regular-dose and ROI dose-reduced protocols.

Main Results:

• A 62% integral dose reduction per frame was achieved.
• Image quality scores were not significantly different between regular-dose and ROI dose-reduced interventions.
• Substantial intrarater agreement (Kendall τ = 0.62887) and fair interrater agreement (κ = 0.2816) were observed.

Conclusions:

• The ROI-dose-reduced intervention technique effectively reduces radiation dose by 62% during neuroendovascular procedures.
• This dose reduction does not compromise the visibility of essential features, including aneurysm and parent vessel morphology.
• The technique offers a promising approach for safer neurointerventions with maintained image quality.