Department of Radiology, Thomas Jefferson University, 132 S 10th Street, Philadelphia, PA 19107.
Department of Radiology, Thomas Jefferson University, 132 S 10th Street, Philadelphia, PA 19107.
Acad Radiol. 2021 Nov;28(11):1559-1569. doi: 10.1016/j.acra.2020.02.024. Epub 2020 Mar 27.
To investigate differences in radiation dose and image quality for single-plane flat-panel-detector based interventional fluoroscopy systems from two vendors using phantom study and clinical procedures.
AlluraClarityIQ (Philips) and Artis Q (Siemens-Healthineers) interventional fluoroscopy systems were evaluated. Phantom study included comparison of system-reported air-kerma rates (AKR) for clinical protocols with simulated patient thicknesses (20-40 cm). Differences in system-reported radiation dose estimates, cumulative-air-kerma (CAK) and kerma-area-product (KAP), for different clinical procedures were investigated. Subset analysis investigated differences in CAK, KAP and other factors affecting radiation dose when the same patients underwent repeat embolization procedures performed by the same physician on the two different fluoroscopy systems. Two blinded interventional radiologists reviewed image-quality for these procedures using a five-point scale (1-5; 5-best) for five parameters.
Phantom study revealed that air-kerma rates was significantly higher for Artis Q system for 30-40cm of simulated patient thicknesses (p < 0.05). Overall data analysis from 4381 clinical cases revealed significant differences in CAK and KAP for certain procedures (p < 0.05); with significantly lower values for AlluraClarityIQ systems (median CAK lower by: 29%-58%). Subset analysis with 40 patients undergoing repeat embolization procedures on both systems revealed that median CAK and KAP were significantly lower for AlluraClarityIQ systems (p < 0.02) by 45% and 31%, respectively. Image quality scores for AlluraClarityIQ systems were significantly greater (mean difference range for five parameters: 1.3-1.6; p < 0.005).
Radiation dose and image quality differences were observed between AlluraClarityIQ and Artis Q systems. AlluraClarityIQ systems showed lower radiation utilization and an increase in subjective perception of image quality.
本研究旨在通过体模研究和临床操作，比较来自两家供应商的单平面平板探测器介入透视系统的辐射剂量和图像质量差异。
对 AlluraClarityIQ（飞利浦）和 Artis Q（西门子医疗）介入透视系统进行了评估。体模研究包括比较系统报告的空气比释动能率（AKR）与模拟患者厚度（20-40cm）的临床方案。研究了不同临床操作下系统报告的辐射剂量估算值、累积空气比释动能（CAK）和比释动能面积乘积（KAP）的差异。亚组分析调查了当同一名医生在两个不同透视系统上对同一名患者进行重复栓塞手术时，CAK、KAP 和影响辐射剂量的其他因素的差异。两名盲法介入放射科医生使用五分制（1-5；5 为最佳）对五个参数对这些程序的图像质量进行了评估。
体模研究表明，在模拟患者厚度为 30-40cm 时，Artis Q 系统的空气比释动能率显著更高（p < 0.05）。对 4381 例临床病例的总体数据分析显示，某些程序的 CAK 和 KAP 存在显著差异（p < 0.05）；AlluraClarityIQ 系统的数值显著较低（中位数 CAK 低：29%-58%）。对在两个系统上重复栓塞手术的 40 名患者进行的亚组分析显示，AlluraClarityIQ 系统的中位数 CAK 和 KAP 分别显著较低（p < 0.02），分别为 45%和 31%。AlluraClarityIQ 系统的图像质量评分显著更高（五个参数的平均差异范围：1.3-1.6；p < 0.005）。
观察到 AlluraClarityIQ 和 Artis Q 系统之间的辐射剂量和图像质量差异。AlluraClarityIQ 系统显示出较低的辐射利用率和对图像质量的主观感知增加。
