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Digital Subtraction Myelography is Associated with Less Radiation Dose than CT-based Techniques
Patrick J Nicholson1, William C Guest2, Monique van Prooijen3
1Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, University Health Network, 399 Bathurst, M5T 2S8, Toronto, ON, Canada. patrick.nicholson@uhn.ca.
Clinical Neuroradiology
|August 18, 2020
Summary
Digital-subtraction myelogram (DSM) has a significantly lower radiation dose compared to CT myelogram (CTM) for evaluating cerebrospinal fluid (CSF) leaks. This finding is crucial for patient safety in diagnosing CSF leaks.
Area of Science:
- Radiology
- Medical Imaging
- Radiation Dosimetry
Background:
- Cerebrospinal fluid (CSF) leaks can cause spontaneous intracranial hypotension (SIH).
- CT myelogram (CTM) and digital-subtraction myelogram (DSM) are diagnostic imaging techniques for CSF leaks.
- Radiation exposure is a concern in medical imaging procedures.
Purpose of the Study:
- To compare the radiation dose of digital-subtraction myelogram (DSM) with CT myelogram (CTM).
- To evaluate radiation exposure from DSM in patients with SIH.
- To establish a benchmark for DSM radiation dosimetry.
Main Methods:
- Retrospective assessment of patients undergoing DSM for SIH refractory to blood patching.
- Recording of DSM dose factors: fluoroscopy time, KAP, and air kerma.
- Calculation of effective dose for both DSM and CTM using standardized conversion factors.
Main Results:
- Median effective dose for DSM was 6.6 mSv per study.
- Median total effective dose for patients undergoing multiple DSMs was 13 mSv.
- Median effective dose for CTM was 19.7 mSv.
Conclusions:
- Digital-subtraction myelogram (DSM) involves significantly lower radiation doses than CT myelogram (CTM).
- DSM offers a potentially safer alternative for diagnosing CSF leaks regarding radiation exposure.
- Further research can validate these findings across different institutions.
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