Radiation Dose Reduction During Adrenal Vein Sampling Using a New Angiographic Noise Reduction Imaging Technology

Purpose: To compare the patient radiation doses during angiographic selective adrenal vein sampling (AVS) before and after a noise reduction imaging technology upgrade.Methods: In this retrospective single-center-study, cumulative air kerma (AK), cumulative dose area product (DAP), fluoroscopy time and contrast agent dosage were recorded from 70 patients during AVS. 35 procedures were performed before and 35 after a noise reduction imaging processing technology upgrade. Mean values were calculated and compared using an unpaired student’s t-test. DSA image quality was assessed independently by two blinded readers using a four-point Likert scale (1=poor; 4=excellent) and compared using Wilcoxon signed-rank test.Results: After the technology upgrade we observed a significant reduction of 35% in AK (1.7±0.7 vs. 1.1±0.7 Gy, p=0.01) and a significant reduction of 28% in DAP (235.1±113 vs. 170.1±94 Gy*cm2, p=0.01) in comparison to procedures before the upgrade. There were no significant differences between the number of exposure frames (143±86 vs. 132±61frames, p=0.53), fluoroscopy time (42±23 vs. 36±18 min, p=0.22), or the amount of contrast medium used (179.5±84 vs. 198.1±109 ml, p=0.41). There was also no significant difference regarding image quality (3 (2-4) vs. 3 (2-4), p=0.67). ​Conclusion: The angiographic noise reduction imaging technology upgrade significantly decreases the radiation dose during adrenal vein sampling without increasing time of fluoroscopy or contrast volume and without compromising image quality.