The Current State of Digital Variance Angiography: A Literature Review

Digital variance angiography (DVA), also referred to as kinetic imaging angiography, is an imaging technique that enhances vascular visualization by analyzing contrast flow motion. Although digital subtraction angiography (DSA) remains the current standard of care, DVA has demonstrated potential improvements in image quality and reductions in both radiation exposure and contrast use. This literature review aimed to evaluate currently available literature focusing on the use of DVA during angiographic procedures. The review was conducted using PubMed, EMBASE, and Web of Science, with the process being reflected in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart. Across multiple clinical applications, DVA consistently demonstrated higher objective image quality metrics including contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) as compared with DSA. Several studies reported that expert reviewers observed improved subjective image quality and substantial reductions in radiation exposure. In addition, DVA has also been shown to facilitate reduced use of contrast, potentially decreasing contrast-related complications and healthcare costs. Collectively, current evidence suggests that DVA represents a promising advancement in angiographic imaging, with the potential to deliver superior image quality with reduced radiation exposure and contrast use.