Jaydev Kardam Dave PhD, MS, Presenter: Nothing to Disclose

David J. Eschelman MD, Abstract Co-Author: Consultant, Guerbet SA

Carin F. Gonsalves MD, Abstract Co-Author: Nothing to Disclose

Eric Laurence Gingold PhD, Abstract Co-Author: Nothing to Disclose

To investigate radiation dose reduction post installation of an image processing upgrade for an interventional x-ray system.

Philips Allura ClarityIQ upgrade provides automatic motion artifact reduction, temporal and spatial noise reduction, and contrast enhancement, allowing a reduction in radiation dose. Air kerma rate (AKR) measurements were made with acrylic simulating 9-27cm patient thickness for 19”-6” magnification modes and 2 dose modes, before and after ClarityIQ upgrade. Dose indicators (cumulative air kerma (CAK) and dose area product (DAP)) for two types of interventional procedures (chemo/immuno-embolization and routine catheter check/change) were analyzed for patients who were treated, before and after ClarityIQ upgrade, as part of their standard of care. Two experienced interventional radiologists (blinded to dose values) selected cases matching in complexity, number of digital acquisitions and fluoroscopy time, and provided a subjective evaluation of image quality.

For acrylic measurements, AKR was reduced by 25-77% after ClarityIQ upgrade. Thirteen chemo/immuno-embolization patients and 20 patients with routine catheter procedures were identified. There were no statistical differences in fluoroscopy time or digital acquisitions between the procedures for each patient (p>0.05). The mean reduction for the embolization procedures in CAK was 347 mGy (95% CI: 251-442 mGy; p<0.001) and in DAP was 159137 mGy.cm2 (95% CI: 126282-191992 mGy.cm2; p<0.001) when ClarityIQ was used; resulting in a 37-79% reduction in CAK and 51-84% in DAP on a per patient basis. For routine catheter procedures, the mean reduction in CAK was 33 mGy (95% CI: 17- 48 mGy; p<0.001) and in DAP was 10795 mGy.cm2 (95% CI: 6653-14937 mGy.cm2; p<0.001) when ClarityIQ was used, resulting in a reduction of 27-81% in CAK and 14-89% in DAP on a per patient basis. Subjective evaluation of patient images revealed no loss in image quality when ClarityIQ was used.  

ClarityIQ upgrade resulted in a 14-84% reduction in radiation dose indicators to patients for the procedures considered in this study, consistent with expectations based on phantom measurements, without loss in perceived image quality.

An image processing upgrade for an interventional radiology system allows reduced radiation dose in both fluoroscopy and digital acquisition modes, reducing potential risks to both patients and staff.

Dave, J, Eschelman, D, Gonsalves, C, Gingold, E, Radiation Dose Reduction in Two Common Interventional Procedures Following Allura ClarityIQ Upgrade.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014046.html