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Evaluation of Dose Reduction by the Clinical Implementation of a Noise Reducing Image Processing Algorithm for Neurointerventional Procedures

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A Omar

A Omar1*, M Marteinsdottir1, C Palmgren1, M Mauti2, M Soderman1, S Boon2, (1) Karolinska University Hospital, Stockholm, Sweden, (2) Philips Healthcare, Best, The Netherlands

SU-E-I-27 Sunday 3:00PM - 6:00PM Room: Exhibit Hall

Purpose: To quantify the change in registered patient and staff dose indicators, i.e., KAP and CAK, and to evaluate if any detrimental effects on the treatment response are introduced, by the clinical implementation of a noise reducing algorithm for neurointerventional procedures.

Methods: An image processing algorithm, ClarityIQ, for the AlluraClarity (Product not yet available in the US) system has been developed by Philips (Philips Healthcare Best, The Netherlands) to achieve advanced real time noise reduction in fluoroscopy and digital subtraction angiography. With the implementation of the noise reducing algorithm, an equivalent image quality can be achieved with reduced exposure by optimizing the system settings, consequently modifying the emitted photon spectrum.

A retrospective study was performed where exposure dose data with the new system settings (January-June 2012; 174 diagnostic and 138 interventional cases) was compared with data for the prior system settings (January-June 2010; 190 diagnostic and 112 interventional cases). The data was categorized according to type of diagnostic or interventional procedure. In order to evaluate the effect on the treatment response, the total number of acquisition images, duration of fluoroscopy, and total procedure time was collected.

Results: The median of the total KAP and CAK (sum of frontal and lateral plane) for diagnostic and interventional procedures for the prior settings was 124 Gycm2 and 0.78 Gy, and 328 Gycm2 and 2.71 Gy, respectively. The median for diagnostic and interventional procedures with the new settings was 47 Gycm2 and 0.27 Gy, and 109 Gycm2 and 0.89 Gy, respectively.

The difference in the total number of acquisition images, duration of fluoroscopy, and total procedure time was statistically negligible.

Conclusion: The new system settings resulted in a significantly reduced KAP and CAK (approximately 60%), indicating reduction in both patient and staff doses, with no indication of change in treatment response.

Funding Support, Disclosures, and Conflict of Interest: Two of the athors are employed by Philips Healthcare, Best, The Netherlands (S. Boon and M. Mauti). The project was partly financed by Philips Healthcare.

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