 Ajay K. Wakhloo |
 Ajit Puri |
Advancements in x-ray imaging for neurointerventional procedures aim at dose reduction to patients, physicians, nurses, and x-ray technologists without compromising image quality and workflow. Beyond unknown side effects, the most important radiation-induced damages following the treatment of complex spinal and cerebrovascular disorders include erythema, epilation, and skin necrosis.
To tackle this matter, a new angiographic imaging platform (AlluraClarity, Philips Healthcare) has been developed that utilizes a dose-reduction technology, which applies to digital fluoroscopy and DSA. In short, the system uses a real-time image processing chain, which combines image noise reduction, motion correction, and contrast-dependent temporal averaging, all of which result in enhanced image quality and allow a significant reduction in the radiation dose settings.
Although dose reduction was confirmed in standard imaging phantoms and preliminary clinical studies in Europe, we sought to confirm dose-reduction benefits to patients in the United States in a real-world neurointerventional setting. In our study, we compared the performance of the dose-reduction imaging platform with that of a platform operated without dose-reduction technology and found that we could achieve doses as low as a quarter of the standard full dose with minimal impact on workflow.
Comparative angiograms and therapeutic interventions with the previous system setting also verified that significant dose reductions were achieved and improved visualization was observed in some patients. We analyzed the dose-reduction imaging platform’s effect on workflow by computing the fluoroscopy duration as well as the total administered contrast volume while using each platform. We observed a marginal increase in fluoroscopy duration and a nonsignificant increase in contrast volume used for DSA, suggesting that the workflow was unaffected by the use of the dose-reduction imaging platform.