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Paper title Dose reduction and image quality in gridless Spinal Angiography: A prospective study in 53 patients
Paper code P50
Authors
  1. Amgad El Mekabaty Inselspital, Universitätsspital Bern Speaker
  2. Emanuel Orru The Johns Hopkins Hospital
  3. Diego San Millán Hôpital de Sion, CHVR
  4. Philippe Gailloud The Johns Hopkins Hospital
Form of presentation Poster
Topics
  • SSNR-Neuroradiology
Abstract text Purpose:
To test the hypothesis that removal of the anti-scatter grid (ASG) significantly lowers the dose in spinal DSA (SpDSA) while maintaining diagnostic image quality.

Materials and Methods:
53 adult patients undergoing a full or partial SpDSA were studied. SpDSAs were performed entirely with or without the ASG with an additional DSA sequence with the ASG repositioned or removed (depending on how the exam was performed) documenting the key finding of the. Data on exposure were analysed in order to determine the reduction in dose and if it was BMI-dependent. Two interventionalists were independently asked to blindly compare the sets of 2 images of the key finding in the same patient and to: 1) rate image quality; 2) categorize the image finding in a category between “normal anatomy”, “vascular tumor” or “vascular malformation”; 3) determine if the image had been obtained with or without the ASG.

Results:
Removing the ASG reduces dose of approximately 30% (p < 0.001) in a BMI-independent fashion. Both readers evaluated 100% of images as good or excellent diagnostic and correctly categorized the finding in 95% of cases, while being unable to consistently determine if the images had been obtained with or without the ASG.

Conclusion:
Removing the ASG during SpDSAs can significantly lower the dose to the patient and the operators while maintaining sufficient diagnostic quality of the images. Spinal vessels are among the smallest in the body: this dose reduction strategy could find broad application in more commonly performed abdominal interventional procedures.