Arterial endofibrosis in endurance athletes: Prospective comparison of the diagnostic accuracy of intra-arterial digital subtraction angiography and computed tomography angiography

Perrier, Lionel; Feugier, Patrick; Goutain-Majorel, C.; Girouin, N.; Boutier, R.; Papillard, M.; Bedel, M.; Rabilloud, Muriel; Rouvière, Olivier

doi:10.1016/j.diii.2020.03.003

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…Digital-subtraction angiography (DSA), which was developed in the late 1970s, 3 remains the reference standard for imaging near-stationary vasculature, such as arteries in the arms, legs, head, and neck. 4,5 DSA subtracts images acquired before injection of an iodine contrast agent from those acquired after injection, enabling the removal of non-iodinated structures from the resulting images. 6,7 Due to the pre-injection and post-injection images being acquired several seconds apart, motion artifacts may compromise DSA studies.…”

Section: Introductionmentioning

confidence: 99%

Theoretical comparison of energy‐resolved and digital‐subtraction angiography

2022

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Background X‐ray coronary angiography is a sub‐optimal vascular imaging technique because it cannot suppress un‐enhanced anatomy that may obscure the visualization of coronary artery disease. Purpose The purpose of this paper is to evaluate the theoretical image quality of energy‐resolved x‐ray angiography (ERA) implemented with spectroscopic x‐ray detectors (SXDs), which may overcome limitations of x‐ray coronary angiography. Methods We modeled the large‐area signal‐difference‐to‐noise (SDNR) of contrast‐enhanced vasculature in ERA images and compared with that of digital‐subtraction angiography (DSA), which served as a gold standard vascular imaging technique. To this end, we used calibrated numerical models of the response of cadmium telluride SXDs including the effects of charge sharing, electronic noise, and energy thresholding. Our models assumed zero scatter, no pulse pile up and small signals such that image contrast is approximately linear in the area density of contrast agents. For DSA, we similarly modeled x‐ray detection by cesium iodide energy‐integrating detectors using validated numerical models. For ERA, we investigated iodine and gadolinium (Gd) contrast agents, two‐material and three‐material decompositions, analog charge summing for charge sharing correction, and optimized image quality with respect to the tube voltage and energy thresholds assuming cadmium telluride SXDs with three energy bins. Results Our analysis reveals that a three‐material decomposition using iodine contrast agents will require x‐ray exposures that are approximately 400 times those of DSA to achieve the same SDNR as DSA in coronary applications, and is therefore not feasible in a clinical setting. However, three‐material decompositions with Gd contrast agents have the potential to provide SDNR that is ∼45% of that of DSA for matched patient air kerma. For two‐material decompositions that suppress soft‐tissue, ERA has the potential to produce images with SDNR that is 50%–75% of that of DSA for matched patient air kermas but lower levels of tube loading. Achieving these SDNR levels will require the use of analog charge summing for charge sharing correction, which increased SDNR by up to a factor of 1.7 depending on the contrast agent and whether or not a two‐material or three‐material decomposition was assumed. Conclusions We conclude that three‐material ERA implemented with Gd contrast agents and two‐material ERA implemented with either iodine or Gd contrast agents, should be investigated as alternatives to DSA in situations where motion artifacts preclude the use of DSA, such as in coronary imaging.

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Section: Introductionmentioning

confidence: 99%

Theoretical comparison of energy‐resolved and digital‐subtraction angiography

2022

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“…For example, it is possible to investigate regulatory mechanisms or organs interplay as the relationship between acute kidney injury and some adverse cardiac dysfunctions (66). Another example comes from professional cycling: arterial endofibrosis is a common pathology in cyclists (67) and it led to clinical improvement in its diagnosis and treatment (68). (74).…”

Section: Coping Strategy Coming From Extreme Sportsmentioning

confidence: 99%

Look to the stars—Is there anything that public health and rehabilitation can learn from elite sports?

Millet

Chamari

2023

Front. Sports Act. Living

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“…Peak systolic velocity (PSV) is significantly higher in the symptomatic limb, which supports the high sensitivity of this method in diagnosing endofibrosis 4 . Other available imaging modalities include digital subtraction angiography (DSA), computed tomography angiography (CTA), and magnetic resonance imaging (MRI) 14 . Our novel proposal for the diagnostic algorithm of this entity, according to the available literature, is depicted in Figure 1.…”

Section: Diagnosismentioning

confidence: 99%