Effect of Copper Filtration on Radiation Dose in Cerebral Three-dimensional Rotational Angiography During Endovascular Aneurysm Treatment.

IF 8 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Investigative Radiology Pub Date : 2025-09-04 DOI:10.1097/RLI.0000000000001235

Niclas Schmitt, Andreas Berting, Christian Herweh, Tim Hilgenfeld, Fabian Preisner, Lena Wucherpfennig, Martin Bendszus, Dominik F Vollherbst, Markus A Möhlenbruch

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引用次数: 0

Abstract

Objectives: Cerebral angiography remains the gold standard for the diagnosis and endovascular management of cerebral aneurysms. Three-dimensional rotational angiography (3D-RA) provides superior anatomic resolution compared with conventional 2D imaging; however, it is associated with relatively high radiation exposure, raising specific concerns regarding the ocular lens dose. This study aims to evaluate the potential of copper (Cu) filtration for reducing radiation dose in 3D-RA.

Materials and methods: Forty subsequent patients undergoing endovascular treatment of unruptured cerebral aneurysms were included. All received 3D-RA using the ARTIS icono angiography system (Siemens Healthineers). In 20 patients, standard hardware with a 0.8 mm aluminum (Al) filter was applied; in the subsequent 20 patients, the Al filter was replaced by a 0.1 mm Cu filter. Image quality was assessed quantitatively through contrast-to-noise ratio (CNR) and qualitatively using a 5-point scale.

Results: There were no differences in image quality between the two groups in the 3D neurovascular native/contrast images, both quantitatively (eg, mean CNR ± SD, Al: 20.72 ± 1.82 vs Cu: 20.66 ± 1.54; P = 0.93) and qualitatively (mean score ± SD, Al: 4.55 ± 0.54 vs Cu: 4.63 ± 0.46; P = 0.75), with excellent image quality achieved in both groups. Total radiation dose was lower with the Cu filter (e.g., mGy ± SD, Al: 110.63 ± 10.75 vs Cu: 68.70 ± 6.03; Gy·cm2 ± SD, Al: 6.26 ± 1.57 vs 3.35 ± 0.67, P < 0.001 respectively), corresponding to a dose reduction of 38% (entrance-skin dose) and 46% (dose-area product).

Conclusion: The use of a copper filter in cerebral 3D-RA substantially reduces radiation dose without compromising diagnostic quality, representing a practical advancement in patient safety in 3D-RA. The method integrates seamlessly into existing protocols and can be readily implemented in clinical practice.

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血管内动脉瘤治疗中脑三维旋转血管造影中铜滤过对辐射剂量的影响。

目的：脑血管造影仍然是脑动脉瘤诊断和血管内治疗的金标准。与传统的二维成像相比，三维旋转血管造影（3D-RA）提供了更好的解剖分辨率；然而，它与相对较高的辐射暴露有关，引起了对晶状体剂量的特别关注。本研究旨在评价铜（Cu）过滤在3D-RA中降低辐射剂量的潜力。材料与方法：选取40例后续行血管内治疗的未破裂脑动脉瘤患者。所有患者均使用ARTIS血管造影系统（Siemens Healthineers）接受3D-RA治疗。20例患者使用0.8 mm铝滤镜的标准硬体；在随后的20例患者中，用0.1 mm的铜过滤器代替铝过滤器。通过对比噪声比（CNR）定量评估图像质量，并使用5分制定性评估图像质量。结果：两组三维神经血管原生/对比图像的图像质量在定量上（如平均CNR±SD， Al: 20.72±1.82 vs Cu: 20.66±1.54,P = 0.93）和定性上（平均评分±SD， Al: 4.55±0.54 vs Cu: 4.63±0.46,P = 0.75）均无差异，两组图像质量均较好。铜滤器的总辐射剂量较低（例如，mGy±SD, Al: 110.63±10.75 vs Cu: 68.70±6.03;Gy·cm2±SD, Al: 6.26±1.57 vs 3.35±0.67,P < 0.001），相应的剂量减少38%（入口-皮肤剂量）和46%（剂量-面积积）。结论：在不影响诊断质量的前提下，在3D-RA脑内使用铜过滤器可显著降低辐射剂量，在3D-RA患者安全方面取得了实际进展。该方法无缝集成到现有的协议，可以很容易地在临床实践中实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Investigative Radiology 医学-核医学

CiteScore

15.10

自引率

16.40%

发文量

188

审稿时长

4-8 weeks

期刊介绍： Investigative Radiology publishes original, peer-reviewed reports on clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, and related modalities. Emphasis is on early and timely publication. Primarily research-oriented, the journal also includes a wide variety of features of interest to clinical radiologists.