Adrenal Vein Sampling: Radiation Dose Reduction on New Angiography Platform

Ali Alsafi; Florian Wernig; Jeannie Todd; Tricia Tan; F. Fausto Palazzo; Karim Meeran; James E. Jackson

doi:10.4103/AJIR.AJIR_24_20

The Arab Journal of Interventional Radiology, Table of Contents

CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2020; 4(02): 102-106
DOI: 10.4103/AJIR.AJIR_24_20

Original Article

Adrenal Vein Sampling: Radiation Dose Reduction on New Angiography Platform

Ali Alsafi

Departments of Imaging, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

,

Florian Wernig

Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

,

Jeannie Todd

Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

,

Tricia Tan

Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

,

F. Fausto Palazzo

Department of Endocrineand Thyroid Surgery, Imperial College London, Hammersmith Hospital, London, England

,

Karim Meeran

Endocrinology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

,

James E. Jackson

Departments of Imaging, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, England

› Author Affiliations

Abstract

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Objectives: Primary aldosteronism is one of the most common causes of secondary hypertension. Distinguishing unilateral from bilateral disease is essential as those with unilateral adrenal disease will benefit from adrenalectomy. This is best achieved by adrenal vein sampling (AVS) which may be a difficult procedure with significant radiation to both patient and operator. This study aims to measure the radiation dose during AVS before and after the installation of a new angiography platform. Materials and Methods: The dose area product (DAP), air kerma, and fluoroscopy time were collected retrospectively together with demographic data for the first ten patients who underwent AVS between April and September 2018 following the installation of the Philips Azurion 7 M20 interventional platform. These results were compared with those from ten patients who underwent AVS before the installation of the new machine using the Philips Allura Xper FD20 platform. Mann–Whitney test was used to compare DAP, air kerma, and fluoroscopy time. P < 0.05 was considered statistically significant. Results: Successful bilateral adrenal vein catheterization was achieved in all cases in both groups. There was no significant difference in fluoroscopy time: 5.5 (3.3–10.8) min (new) versus 5.3 (4.5–8.4) min (old) (P = 0.9502). The DAP and air kerma were both significantly lower on the new machine: 11.3 (5.2–26.7) Gy.cm² versus 45.5 (17.2–56.5) Gy.cm² (P = 0.0089) and 201.5 (88.1–464.0) mGy versus 682.5 (300.5–998.5) mGy (P = 0.0115), respectively. Conclusion: The installation of the Philips Azurion 7 M20 interventional platform has allowed a significant reduction in radiation dose during AVS.

Adrenal glands - dosimetry - hyperaldosteronism - interventional - radiation dosage - radiology - vascular surgical procedures

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References

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