Radiation dose reduction during adrenal vein sampling using a new angiographic imaging technology

Area of Science:

• Radiology
• Medical Imaging
• Interventional Cardiology

Background:

• Adrenal vein sampling (AVS) is crucial for diagnosing endocrine disorders.
• Patient radiation dose is a significant concern during angiographic procedures like AVS.
• Technological advancements aim to optimize imaging while minimizing radiation exposure.

Purpose of the Study:

• To evaluate the impact of an imaging technology upgrade on patient radiation doses during selective adrenal vein sampling (AVS).
• To compare radiation metrics (cumulative air kerma, dose area product) and procedural parameters (fluoroscopy time, contrast volume) before and after the upgrade.
• To assess the effect of the upgrade on digital subtraction angiography (DSA) image quality.

Main Methods:

• Retrospective single-center study involving 70 patients undergoing AVS.
• Data collected included cumulative air kerma (AK), cumulative dose area product (DAP), fluoroscopy time, and contrast agent dosage.
• Comparison of 35 procedures before and 35 after an imaging processing technology upgrade using unpaired student's t-test and Wilcoxon signed-rank test.

Main Results:

• Significant reductions in mean AK (35%) and DAP (28%) were observed after the technology upgrade (p<0.01).
• No significant differences were found in the number of exposure frames, fluoroscopy time, or contrast medium volume used.
• Image quality remained comparable before and after the upgrade, assessed by blinded readers.

Conclusions:

• The upgraded angiographic imaging technology significantly decreases radiation dose during AVS.
• The upgrade achieves radiation dose reduction without compromising procedural efficiency (fluoroscopy time, contrast volume) or diagnostic image quality.
• This technological improvement offers a safer approach to adrenal vein sampling.