Difference in Dose Area Product between Analog Image Intensifier and Digital Flat Panel Detector in Peripheral Angiography and the Effect of BMI

Abstract

Purpose: Comparison of dose area products (DAP) in diagnostic angiography procedures between an image intensifier (II) and a flat panel detector (FPD) angiography system and the evaluation of DAP/body mass index (BMI) dependency.

Materials and Methods: An image intensifier system or a flat panel detector system was used to perform 571 diagnostic angiographies (n = 328 and n = 243, respectively) of 5 different types: peripheral arterial, venous, single leg, abdominal and upper extremity. The results were retrospectively analyzed. The DAP, fluoroscopy time (t) and the number of series of the respective interventions as calculated by the respective machines was compared for all interventions and for the respective subtypes and machines. The BMI dependency was calculated separately for both machines for all interventions by subdividing the patients into 6 BMI classes defined by the WHO.

Results: The average DAP for all diagnostic interventions was 1958.9 cGy×cm² (t = 384.6 s, n = 7.85 series) for the II and 2927.4 cGy×cm² (t = 267.4 s, n = 7.02 series) for the FPD. Group-dependent differences ranged between + 21 and + 252 % when using the FPD system. After time standardization, the respective increases were found to be 120 % for the FPD system. The DAPs increased considerably in patients with higher BMIs (766.7 cGy × cm² – 6892.6 cGy × cm², II machine, 950.5 cGy × cm² – 12 487.7 cGy × cm², FPD machine) with a greater DAP gain seen for the FPD. The average duration of the interventions was higher using the II machine.

Conclusion: The use of an FPD system led to higher DAP values compared to the II system in diagnostic angiographic procedures. In addition, increased BMI values led to higher DAPs, especially for the FPD machine. However, the average fluoroscopy times were shorter.

Zusammenfassung

Ziel: Dosisflächenproduktvergleich (Dose-Area-Products, DAP) bei diagnostischen Angiografien zwischen einem Bildverstärkerangiografiesystem (II) und einem Flachbilddetektorsystem (FPD) und Erhebung der DAP/Body-Mass-Index (BMI) Abhängigkeit.

Material und Methoden: Die folgenden 571 diagnostischen Angiografien wurden mit einem Bildverstärker- (n = 328) und mit einem Flachbilddetektorangiografiesystem (n = 243) retrospektiv evaluiert: arterielle Beckenbeinangiografien, venöse Beckenbeinangiografien, Feinnadelangiografien, abdominelle und obere Extremitätenangiografien. Erhoben wurde retrospektiv das Dosisflächenprodukt (DAP), die Fluoroskopiezeit (t) sowie die Serienanzahl der entsprechenden Interventionen an den entsprechenden Geräten. Die BMI-Abhängigkeit des DAPs wurde separat für beide Geräte und alle Interventionsklassen nach den 6 WHO-BMI-Klassen vorgenommen.

Ergebnisse: Das durchschnittliche DAP über alle Interventionen lag bei 1958,9 cGy×cm² (t = 384,6 s, n = 7,85 Serien) für das II und bei 2927,4 cGy×cm² (t = 267,4 s, n = 7,02 Serien) für das FPD-Gerät. Der DAP-Zuwachs nach Interventionsgruppe betrug zwischen + 21 % und + 252 % für das FPD-System. Nach Zeitnormierung betrug der DAP-Zuwachs beim FPD-Gerät 120 %. Die DAPs nahmen beim FPD-Gerät mit steigendem BMI deutlicher zu im Vergleich zum II-Gerät (766,7 cGy×cm² – 6892,6 cGy×cm² II-System, 950,5 cGy/cm² – 12 487,7 cGy/cm², FPD-System). Die durchschnittliche Durchleuchtungszeit war beim II-System höher.

Schlussfolgerung: Beim Gebrauch des FPD-Systems entstanden deutlich höhere DAP-Werte im Vergleich zum II-System bei diagnostischen Angiografien. Bei höherem BMI war der DAP-Zuwachs am FPD-Gerät höher, die Fluoroskopiezeiten jedoch deutlich geringer.

Key words

vascular - angiography - radiation safety - technical aspects

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