Radiological aspects of CO₂ peripheral DSA: Preliminary analysis on the dedicated protocols

Thanks to its lack of allergic reactions and renal toxicity, CO₂ represents an alternative to iodine as a contrast medium for peripheral subtraction angiography. Since CO₂ has a lower and negative contrast than iodine, postprocessing DSA and stacking are mandatory. So, it seems that higher doses than traditional iodine angiography are required. We addressed the dosimetric aspects of CO₂ angiography for two different commercial DSA-apparatus.

Two different radiological suites were analyzed by recreating the same setup on all the apparatuses: we used a PMMA slabs phantom with a MPD Barracuda dosimeter on its side to collect all radiological parameters.

Results show that the irradiation parameters were left completely unchanged between the traditional and CO₂ angiographic programs.

This leads to thinking that these CO₂ protocols do not operate on the X-ray emission, but only differ on image manipulation. The possibility of improvements by changing radiological parameters are still not explored and really promising.