Dave Jaydev K, Eschelman David J, Wasserman Jenna R, Gonsalves Carin F, Gingold Eric L
Department of Radiology, Thomas Jefferson University, Main Building, 132 S. 10th St., Suite 1092B, Philadelphia, PA, 19107, Lancaster, Pennsylvania.
Department of Radiology, Thomas Jefferson University, Main Building, 132 S. 10th St., Suite 1092B, Philadelphia, PA, 19107, Lancaster, Pennsylvania.
J Vasc Interv Radiol. 2016 Apr;27(4):593-600. doi: 10.1016/j.jvir.2016.01.131.
To investigate changes in radiation dose and image quality using phantoms and hepatic embolization procedures performed with a new image processing technology (ClarityIQ) for a single-plane flat-detector-based interventional fluoroscopy system.
Phantom study was performed using acrylic sheets simulating different patient sizes. Air kerma rates (AKRs) were compared for different fluoroscopy modes and magnification modes without and with ClarityIQ. Repeat hepatic embolization procedures performed on the same lobe of the liver in the same patient by the same interventional radiologist between January 2013 and July 2014 without and with ClarityIQ were evaluated retrospectively. This included treatment of 33 hepatic lobes in 26 patients. Cumulative air kerma (CAK), kerma-area product (KAP), and factors affecting radiation dose were extracted from study metadata and compared. Blinded randomized image quality review was performed on arteriograms using a five-point scale.
The phantom study revealed a significantly lower AKR (P < .005) with ClarityIQ. Repeated-measures analysis revealed a significant effect of ClarityIQ (P ≤ .001) on CAK and KAP, with reductions ranging between 9% and 85% (median, 67%) and between 5% and 89% (median, 75%), respectively, on a case-by-case basis. Mean reductions in CAK and KAP were 279 mGy and 134,030 mGy·cm(2), respectively. Image quality review scores were significantly lower (P ≤ .001) with ClarityIQ, effecting visualization of tumor vasculature and appearance of noise texture.
ClarityIQ resulted in radiation dose reduction in the phantom study and in the hepatic embolization procedures, but with a decrease in subjective perceptions of image quality.
使用体模以及采用一种新的图像处理技术（ClarityIQ）对基于单平面平板探测器的介入荧光透视系统进行肝脏栓塞手术，研究辐射剂量和图像质量的变化。
使用模拟不同患者体型的丙烯酸板进行体模研究。比较有无ClarityIQ时不同荧光透视模式和放大模式下的空气比释动能率（AKR）。回顾性评估2013年1月至2014年7月期间，同一位介入放射科医生在同一患者肝脏同一叶上分别在无和有ClarityIQ情况下进行的重复肝脏栓塞手术。这包括对26例患者的33个肝叶进行治疗。从研究元数据中提取累积空气比释动能（CAK）、比释动能面积乘积（KAP）以及影响辐射剂量的因素并进行比较。使用五点量表对动脉造影片进行盲法随机图像质量评估。
体模研究显示使用ClarityIQ时AKR显著降低（P <.005）。重复测量分析显示ClarityIQ对CAK和KAP有显著影响（P≤.001），逐例来看，CAK和KAP的降低幅度分别在9%至85%（中位数为67%）和5%至89%（中位数为75%）之间。CAK和KAP的平均降低量分别为279 mGy和134,030 mGy·cm²。使用ClarityIQ时图像质量评估得分显著更低（P≤.001），影响了肿瘤血管的可视化以及噪声纹理的外观。
在体模研究和肝脏栓塞手术中，ClarityIQ可降低辐射剂量，但图像质量的主观感受有所下降。
