Reduction of Radiation Exposure Using Dynamic Trace Digital Angiography and Spot Fluoroscopy During Adrenal Venous Sampling

Purpose To compare radiation exposure of adrenal venous sampling (AVS) using dynamic trace digital angiography (DTDA) and spot fluoroscopy with that using conventional methods. Materials and Methods AVS was performed in 11 patients using DTDA and spot fluoroscopy (Group A) and 11 patients using conventional digital subtraction angiography (DSA) with collimation (Group B). Radiation exposure and image quality of adrenal venography using a five-point scale were compared between the groups. Results The acquisition dose-area product (DAP) using DTDA and fluoro-DAP using spot fluoroscopy in Group A were lower than those using conventional DSA (5.3 +/- 3.7 vs. 29.1 +/- 20.1 Gy cm(2), p < 0.001) and collimation (33.3 +/- 22.9 vs. 59.1 +/- 35.7 Gy cm(2), p = 0.088) in Group B. The total DAP in Group A was significantly lower than that in Group B (38.6 +/- 25.9 vs. 88.2 +/- 53.6 Gy cm(2), p = 0.006). The peak skin dose for patients and operator radiation exposure in Group A were significantly lower than those in Group B (403 +/- 340 vs. 771 +/- 416 mGy, p = 0.030, and 17.1 +/- 14.8 vs. 36.6 +/- 21.7 mu Sv, p = 0.013). The image quality of DTDA (4.4 +/- 0.6) was significantly higher than that of digital angiography (3.8 +/- 0.9, p = 0.011) and equivalent to that of DSA (4.3 +/- 0.8, p = 0.651). Conclusions Radiation exposure during AVS can be reduced by approximately half for both patients and operators by using DTDA and spot fluoroscopy without sacrificing image quality.