Task-based selection of three-dimensional rotational angiography imaging modes using in-house phantom

Area of Science:

• Medical Imaging
• Radiology
• Diagnostic Imaging

Background:

• Clinicians and radiographers face challenges selecting appropriate three-dimensional rotational angiography (3DRA) modes for cranial applications due to similar protocol names.
• Ambiguity in 'cerebral' and 'head limited' 3DRA modes complicates optimal use.

Purpose of the Study:

• To evaluate and recommend the optimal mode selection for cranial 3DRA procedures.
• To address clinical difficulties in choosing between 'cerebral' and 'head limited' 3DRA modes.

Main Methods:

• An in-house phantom simulating cranial vessels with varying iodinated contrast agent concentrations was utilized.
• Image quality was assessed using signal difference to noise ratio (SDNR), and radiation dose was measured via Kerma-area product (KAP).
• X-ray spectrum analysis provided quantitative evaluation.

Main Results:

• The 'head limited' mode is suggested for clinical use.
• The 'low' detail option within 'head limited' mode yields the lowest KAP and slightly superior SDNR compared to the 'normal' detail option.
• A minimum iodine concentration of 18.5 mg/ml is needed with the 'low' detail option for comparable SDNR.

Conclusions:

• The 'head limited' mode with 'low' detail settings is advisable for contrast-enhanced 3DRA procedures.
• Collaboration between clinicians, physicists, and manufacturers is crucial for standardized 3DRA mode selection.
• Objective dose and image quality metrics reduce subjectivity in 3DRA mode selection.