Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography

Abstract Digital variance angiography (DVA) exhibits promising prospects with respect to radiation exposure in digital subtraction angiography (DSA). This study aimed to determine the reduction of radiation dose in endovascular peripheral interventions (EPI) using DVA. The DVA imaging tool v6.0 (Kin...

Full description

Saved in:
Bibliographic Details
Main Authors: Till Schürmann, Ulrich Beschorner, Dirk Westermann, Thomas Zeller, Fabian Bamberg, Christopher L. Schlett, Thomas Stein, Elias Noory
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
Subjects:
Online Access:https://doi.org/10.1038/s41598-025-06361-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849234450354798592
author Till Schürmann
Ulrich Beschorner
Dirk Westermann
Thomas Zeller
Fabian Bamberg
Christopher L. Schlett
Thomas Stein
Elias Noory
author_facet Till Schürmann
Ulrich Beschorner
Dirk Westermann
Thomas Zeller
Fabian Bamberg
Christopher L. Schlett
Thomas Stein
Elias Noory
author_sort Till Schürmann
collection DOAJ
description Abstract Digital variance angiography (DVA) exhibits promising prospects with respect to radiation exposure in digital subtraction angiography (DSA). This study aimed to determine the reduction of radiation dose in endovascular peripheral interventions (EPI) using DVA. The DVA imaging tool v6.0 (Kinepict Medical Imaging Tool, version 6.0.4, Kinepict Health Ltd., Budapest, Hungary) was utilized for patients undergoing EPI using digital angiography. EPI normal dose (EPI-ND) protocols were adapted from 1.20 to 0.81 µGy/frame to EPI low dose (EPI-LD) protocols using DVA-LD acquisitions with 0.36 µGy/frame and occasionally 0.24 µGy/frame based on specific examination requirements. The dose area product (DAP) was evaluated and contrast-to-noise ratio (CNR) was measured for each DSA acquisition. Evaluation included 370 EPI-ND and 62 EPI-LD using DVA-LD of three lower extremity regions (mean age: 73 ± 11 years, 67% male). LD protocols decreased median DAP of ND protocols significantly by 62.0% in pelvic, 53.8% in femoral and popliteal, and 59.4% in cruro-pedal regions, respectively (p < .005). DVA-LD increased median CNR significantly compared to DSA-LD (p < .001), and was equal to DSA-ND (p > .15). Image quality was enhanced by CNRDVA−LD/CNRDSA−ND ratio of 1.9 in pelvic, 2.4 in femoral and popliteal and in cruro-pedal regions. DVA reveals significant radiation dose reduction in lower extremity EPIs and enhances image contrast while decreasing noise.
format Article
id doaj-art-78e5d8dfd53640a7b0f8fc0f336db5ba
institution Kabale University
issn 2045-2322
language English
publishDate 2025-07-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj-art-78e5d8dfd53640a7b0f8fc0f336db5ba2025-08-20T04:03:07ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-06361-7Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiographyTill Schürmann0Ulrich Beschorner1Dirk Westermann2Thomas Zeller3Fabian Bamberg4Christopher L. Schlett5Thomas Stein6Elias Noory7Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Cardiology and Angiology, University Heart Center, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Cardiology and Angiology, University Heart Center, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Cardiology and Angiology, University Heart Center, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgDepartment of Cardiology and Angiology, University Heart Center, University Medical Center Freiburg, Faculty of Medicine, University of FreiburgAbstract Digital variance angiography (DVA) exhibits promising prospects with respect to radiation exposure in digital subtraction angiography (DSA). This study aimed to determine the reduction of radiation dose in endovascular peripheral interventions (EPI) using DVA. The DVA imaging tool v6.0 (Kinepict Medical Imaging Tool, version 6.0.4, Kinepict Health Ltd., Budapest, Hungary) was utilized for patients undergoing EPI using digital angiography. EPI normal dose (EPI-ND) protocols were adapted from 1.20 to 0.81 µGy/frame to EPI low dose (EPI-LD) protocols using DVA-LD acquisitions with 0.36 µGy/frame and occasionally 0.24 µGy/frame based on specific examination requirements. The dose area product (DAP) was evaluated and contrast-to-noise ratio (CNR) was measured for each DSA acquisition. Evaluation included 370 EPI-ND and 62 EPI-LD using DVA-LD of three lower extremity regions (mean age: 73 ± 11 years, 67% male). LD protocols decreased median DAP of ND protocols significantly by 62.0% in pelvic, 53.8% in femoral and popliteal, and 59.4% in cruro-pedal regions, respectively (p < .005). DVA-LD increased median CNR significantly compared to DSA-LD (p < .001), and was equal to DSA-ND (p > .15). Image quality was enhanced by CNRDVA−LD/CNRDSA−ND ratio of 1.9 in pelvic, 2.4 in femoral and popliteal and in cruro-pedal regions. DVA reveals significant radiation dose reduction in lower extremity EPIs and enhances image contrast while decreasing noise.https://doi.org/10.1038/s41598-025-06361-7Digital variance angiographyDigital subtraction angiographyEndovascular peripheral interventionsX-rayRadiation dose
spellingShingle Till Schürmann
Ulrich Beschorner
Dirk Westermann
Thomas Zeller
Fabian Bamberg
Christopher L. Schlett
Thomas Stein
Elias Noory
Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
Scientific Reports
Digital variance angiography
Digital subtraction angiography
Endovascular peripheral interventions
X-ray
Radiation dose
title Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
title_full Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
title_fullStr Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
title_full_unstemmed Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
title_short Radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
title_sort radiation exposure reduction in peripheral interventions using digital variance angiography versus conventional angiography
topic Digital variance angiography
Digital subtraction angiography
Endovascular peripheral interventions
X-ray
Radiation dose
url https://doi.org/10.1038/s41598-025-06361-7
work_keys_str_mv AT tillschurmann radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT ulrichbeschorner radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT dirkwestermann radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT thomaszeller radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT fabianbamberg radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT christopherlschlett radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT thomasstein radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography
AT eliasnoory radiationexposurereductioninperipheralinterventionsusingdigitalvarianceangiographyversusconventionalangiography