Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

Gao, Zhimei; Zeng, Yongming; Sun, Jie; Yang, Jingjie; Zhou, Yang; Zhou, Mi; Song, Ting

doi:10.1177/1591019916631980

Cited by 4 publications

(5 citation statements)

References 18 publications

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“…The contrast enhancement in the A2 and M2 segments also tended to increase in response to an increased injection rate, but the R 2 values were very low. The results of this study are consistent with those previously reported when the contrast medium is injected from the internal carotid artery [ 12 ]. Therefore, the relationship between the injection rate and contrast enhancement could be considered to be the same whether the injection position was the internal carotid artery or the common carotid artery.…”

Section: Discussionsupporting

confidence: 93%

“…Further, although there are reports of different injection parameters being used for different patients [ 3 10 11 ], the criterion used for determination of these injection parameters has not been clearly described. There has been a report on the relationship between the injection rate and image quality on 3D DSA when the contrast medium was injected from the internal carotid artery [ 12 ]. However, in that study, only relatively thick blood vessels (internal carotid artery, proximal A1 segment, and proximal M1 segment) were evaluated, and the distal relatively thin blood vessels were only assessed by eye.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Injection Rate and Contrast Enhancement on Three-dimensional Digital Subtraction Angiography of the Cerebral Arteries

Takagi

Hanasaki

2018

Journal of the Belgian Society of Radiology

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Objective:Three-dimensional (3D) digital subtraction angiography (DSA) is becoming a common technique for the assessment of the cerebral arteries. Nevertheless, the injection parameters for each artery are not standardized among institutions. The objective of this study was to analyze the relationship between injection rate and contrast enhancement on 3D DSA of the common carotid artery.Materials and methods:Twenty-four patients who underwent 3D DSA of the common carotid artery from June 2013 to March 2015 were included in this retrospective study. Contrast enhancement of each patient was analyzed for four cerebral arteries segments (A1, A2, M1 and M2) by measuring the average pixel value on the source rotational two-dimensional DSA images. Linear regression analysis was used to investigate the correlation between injection rate and contrast enhancement.Results:All four regression lines showed that a higher injection rate led to higher contrast enhancement. There was a significant relationship for the A1, A2 and M1 segments (P = 0.008, 0.03 and < 0.001) but not for the M2 segment (P = 0.13). The goodness-of-fit of the regression lines was high for the M1 segment (R2 = 0.63). However, as the size of the vascular lumen became narrower, the value for the A1 (R2 = 0.28) and A2 (R2 = 0.19) segments became lower.Conclusion:In 3D DSA of the common carotid artery, contrast enhancement of a relatively wide lumen could be optimized by adjusting the injection rate. However, it is difficult to optimize the contrast enhancement of a relatively narrow lumen only by adjusting the injection rate.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Relationship between Injection Rate and Contrast Enhancement on Three-dimensional Digital Subtraction Angiography of the Cerebral Arteries

Takagi

Hanasaki

2018

Journal of the Belgian Society of Radiology

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“…Variability in DSA acquisition parameters, such as catheter position, injection rate, and mix ratio, can significantly influence the quality of imaging and subsequently affect the extraction and interpretation of radiomic features ( 28 ). As we described in method, we standardized the acquisition parameters for most DSA runs, however, we employed a multi-center approach, incorporating imaging data obtained from different machines and vendors.…”

Section: Discussionmentioning

confidence: 99%

Predicting postinterventional rupture of intracranial aneurysms using arteriography-derived radiomic features after pipeline embolization

Ma,

Liang,

Liang

et al. 2024

Front. Neurol.

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Background and purposePostinterventional rupture of intracranial aneurysms (IAs) remains a severe complication after flow diverter treatment. However, potential hemodynamic mechanisms underlying independent predictors for postinterventional rupture of IAs remain unclear. In this study, we employed arteriography-derived radiomic features to predict this complication.MethodsWe included 64 patients who underwent pipeline flow diversion for intracranial aneurysms, distinguishing between 16 patients who experienced postinterventional rupture and 48 who did not. We performed propensity score matching based on clinical and morphological factors to match these patients with 48 patients with postinterventional unruptured IAs at a 1:3 ratio. Postinterventional digital subtraction angiography were used to create five arteriography-derived perfusion parameter maps and then radiomics features were obtained from each map. Informative features were selected through the least absolute shrinkage and selection operator method with five-fold cross-validation. Subsequently, radiomics scores were formulated to predict the occurrence of postinterventional IA ruptures. Prediction performance was evaluated with the training and test datasets using area under the curve (AUC) and confusion matrix-derived metrics.ResultsOverall, 1,459 radiomics features were obtained, and six were selected. The resulting radiomics scores had high efficacy in distinguishing the postinterventional rupture group. The AUC and Youden index were 0.912 (95% confidence interval: 0.767–1.000) and 0.847 for the training dataset, respectively, and 0.938 (95% confidence interval, 0.806–1.000) and 0.800 for the testing dataset, respectively.ConclusionRadiomics scores generated using arteriography-derived radiomic features effectively predicted postinterventional IA ruptures and may aid in differentiating IAs at high risk of postinterventional rupture.

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“…Injection parameter recommendations in the literature seem to have been derived empirically, and little work has been devoted to quantify the effects of contrast medium concentration on the quality of CBCT for neurological applications. 23,24 The purpose of this study was to study the effects of various concentrations of iodinated contrast medium that facilitates optimal visualization of structures of interest. We assessed the grayscale value differences between the pathological tissue, devices, and brain parenchyma at various concentrations of contrast medium, and present our preliminary clinical experience with these parameters in a variety of neurovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Optimizing contrast-enhanced cone-beam CT protocol to facilitate simultaneous visualization of neurovascular pathologies and surrounding structures of interest

et al. 2018

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Objective Contrast-enhanced cone-beam computed tomography (CBCT) imaging is commonly used for evaluating neurovascular stents and their relationship to the parent artery or vascular pathologies such as arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs) in the context of surrounding anatomical structures. The purpose of this study was to understand the effects of varying concentrations of contrast medium used in CBCT imaging for optimal visualization of various endovascular devices and anatomical pathologies. Methods Thirty-five patients with various neurovascular pathologies were included in the study. Contrast-enhanced CBCT images (20 s DR, Siemens syngo DynaCT, Siemens AG, Forchheim, Germany) were acquired in all cases, with varying dilutions of contrast medium, from 1% to 30%. The injection rate was kept constant at 3 cc/sec with an X-ray delay of two sec, and a total volume of 66 cc of diluted contrast was administered. Results from visual and quantitative analysis were reported. Results Ten percent dilution of contrast medium resulted in the best image differentiation between flow-diverter devices and the parent artery. Concentrations as low as 2.5% contrast medium also resulted in identifying AVMs in the context of the surrounding brain parenchyma, whereas 20% to 30% dilution provided the best visualization of residual AVMs with prior Onyx embolization and dAVFs in the presence of bony structures. Conclusions Simultaneous visualization of brain parenchyma, bony structures, devices, and pathological anatomy using contrast-enhanced CBCT imaging is feasible with appropriate doses of iodinated contrast, and should be tailored to the individual case based on the goals of CBCT.

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Application of low injection rate and low contrast agent dose in three-dimensional rotational digital subtraction angiography of the intracranial aneurysm

Cited by 4 publications

References 18 publications

Relationship between Injection Rate and Contrast Enhancement on Three-dimensional Digital Subtraction Angiography of the Cerebral Arteries

Relationship between Injection Rate and Contrast Enhancement on Three-dimensional Digital Subtraction Angiography of the Cerebral Arteries

Predicting postinterventional rupture of intracranial aneurysms using arteriography-derived radiomic features after pipeline embolization

Optimizing contrast-enhanced cone-beam CT protocol to facilitate simultaneous visualization of neurovascular pathologies and surrounding structures of interest

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