Hayakawa Takaoki, Horibe Masayasu, Iwasaki Eisuke, Bazerbachi Fateh, Suno Yuki, Sato Tsubasa, Okada Haruka, Nakajima Yuki, Mizukami Yosuke, Kayashima Atsuto, Seino Takashi, Kawasaki Shintaro, Kanai Takanori
Department of Internal Medicine Division of Gastroenterology and Hepatology School of Medicine, Keio University Tokyo Japan.
CentraCare, Interventional Endoscopy Program, St. Cloud Hospital St. Cloud USA.
DEN Open. 2025 Feb 23;5(1):e70087. doi: 10.1002/deo2.70087. eCollection 2025 Apr.
This study evaluated a novel contrast-enhanced (CE) fluoroscopy protocol for endoscopic retrograde cholangiopancreatography, which optimizes image processing to enhance contrast of devices and contrast media. We compared the CE protocol with the conventional standard protocol to assess its potential for reducing radiation exposure while improving image visibility.
The study utilized a multidirectional fluoroscopy unit and phantoms to evaluate the new CE protocol against the conventional protocol. Comparisons included radiation dose rates, spatial resolution, and concentration resolution under various fluoroscopic conditions. The investigation aimed to determine if the CE protocol offered improved visibility while potentially reducing radiation exposure.
Three CE protocol modes (LOW-7.5 fps, MID-3.75 fps, and LOW-3.75 fps) achieved lower dose rates than the standard MID-7.5 fps mode commonly used in clinical practice. Dynamic spatial resolution was significantly superior in all three CE modes compared to the standard protocol ( < 0.0167). Static spatial resolution did not differ significantly between protocols. Only the CE MID-3.75 fps mode showed superior concentration resolution compared to the standard protocol ( < 0.00833).
The novel CE fluoroscopy protocol provides superior dynamic spatial resolution in endoscopic retrograde cholangiopancreatopgraphy while reducing radiation exposure, potentially enhancing procedure guidance and safety for both patients and clinicians.
本研究评估了一种用于内镜逆行胰胆管造影的新型对比增强（CE）荧光透视方案，该方案优化了图像处理以增强设备和造影剂的对比度。我们将CE方案与传统标准方案进行比较，以评估其在提高图像可视性的同时减少辐射暴露的潜力。
本研究使用多向荧光透视设备和体模，根据传统方案评估新的CE方案。比较内容包括各种荧光透视条件下的辐射剂量率、空间分辨率和浓度分辨率。该研究旨在确定CE方案在潜在减少辐射暴露的同时是否能提供更好的可视性。
三种CE方案模式（低帧率-7.5帧/秒、中帧率-3.75帧/秒和低帧率-3.75帧/秒）的剂量率低于临床实践中常用的标准中帧率-7.5帧/秒模式。与标准方案相比，所有三种CE模式的动态空间分辨率均显著更高（P<0.0167）。各方案之间的静态空间分辨率无显著差异。与标准方案相比，只有CE中帧率-3.75帧/秒模式显示出更高的浓度分辨率（P<0.00833）。
新型CE荧光透视方案在内镜逆行胰胆管造影中提供了卓越的动态空间分辨率，同时减少了辐射暴露，可能增强了对患者和临床医生的操作指导及安全性。
