Development of Digital Subtraction Angiography for Coronary Artery

Yamamoto, Masaaki; Okura, Yuki; Ishihara, Masaharu; Kagemoto, Masayuki; Harada, Kaoru; Ishida, Takayuki

doi:10.1007/s10278-008-9108-1

Cited by 15 publications

(8 citation statements)

References 19 publications

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“…6,7 Digital Subtraction Angiography (DSA) uses an xray modality to visualized blood flow in blood vessels by injecting a contrast dye then imaging the blood vessels using fluoroscopic techniques. 8 The advantages of DSA are high spatial resolution, faster diagnosis of abnormalities, and the gold standard in therapeutic management. However, DSA also has disadvantages such as invasive procedures, sometimes unable or difficult to determine the size and location of fistula precisely, highly dependent on contrast agents, and prolonged radiation exposure.…”

Section: Computed Tomographymentioning

confidence: 99%

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Amalia

Sarastika

Soeprijanto

2021

bsm

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Introduction: CT angiography (CTA) is the initial modality for diagnosing theCarotid Cavernous Fistula (CCF), identifying the type of CCF, measuring thediameter of the fistula and the diameter of the internal carotid artery (ICA) pre andpost fistula, and then confirmed by Digital Subtraction Angiography (DSA) as thegold standard. CTA is expected to provide more information to improve theaccuracy of CCF diagnosis to benefit therapy and prevent complications. Thisstudy aimed to determine the diagnostic value of CTA in CCF patients in Dr.Soetomo General Hospital Surabaya, using the DSA as a gold standard. Methods:An observational retrospective study of CCF patients met the inclusion andexclusion criteria and underwent CTA and DSA examinations at the RadiologyInstallation of Dr. Soetomo General Hospital, Surabaya, from January 2016 toJuly 2020. Results: In the comparison of types of CCF CTA to DSA, the directgroup was 53.8% and 57.7%, respectively, while the indirect group was 46.1% and42.3% with a very strong correlation (κ = 0.922; p = 0.000), sensitivity was 93.3%,specificity was 100 %, PPV of 100%, NPV of 91.7% and accuracy of 96.15%. Directtype evaluation on the DSA showed a large picture of the fistula diameter; the ICApre fistula's size was enlarged; therefore, the ICA post fistula diameter wasreduced or absent. There was a strong correlation of fistula diametermeasurement results between CTA and DSA (r = 0.695, p = 0.006).Conclusion: CTA has a similarity rate of 92.2% with DSA in identifying the typeof CCF. The accuracy value of CTA is close to DSA in fistula diametermeasurements.

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Section: Computed Tomographymentioning

confidence: 99%

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Amalia

Sarastika

Soeprijanto

2021

bsm

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“…In this procedure, a reference image without contrast agent is subtracted from all subsequent contrast enhanced images in order to remove background structures and therefore improve the visibility of contrast enhanced vessels. However, artifacts from patient movement, breathing and cardiac motion may have a negative impact on image quality [3,4].…”

Section: Introductionmentioning

confidence: 99%

Spectroscopic imaging at compact inverse Compton X-ray sources

et al. 2020

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While K-edge subtraction (KES) imaging is a commonly applied technique at synchrotron sources, the application of this imaging method in clinical imaging is limited although results have shown its superiority to conventional clinical subtraction imaging. Over the past decades, compact synchrotron X-ray sources, based on inverse Compton scattering, have been developed to fill the gap between conventional X-ray tubes and synchrotron facilities. These so called inverse Compton sources (ICSs) provide a tunable, quasi-monochromatic X-ray beam in a laboratory setting with reduced spatial and financial requirements. This allows for the transfer of imaging techniques that have been limited to synchrotrons until now, like KES imaging, into a laboratory environment. This review article presents the first studies that have successfully performed KES at ICSs. These have shown that KES provides improved image quality in comparison to conventional X-ray imaging. The results indicate that medical imaging could benefit from monochromatic imaging and KES techniques. Currently, the clinical application of KES is limited by the low K-edge energy of available iodine contrast agents. However, several ICSs are under development or already in commissioning which will provide monochromatic X-ray beams with higher X-ray energies and will enable KES using high-Z elements as contrast media. With these developments, KES at an ICS has the ability to become an important tool in pre-clinical research and potentially advancing existing clinical imaging techniques.

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“…However, motion artifacts caused by patient motion, respiration and cardiac motion limit the application of this method. The resulting artifacts are particularly severe when imaging coronary arteries [4].…”

Section: Introductionmentioning

confidence: 99%

K-edge subtraction imaging for coronary angiography with a compact synchrotron X-ray source

et al. 2018

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About one third of all deaths worldwide can be traced back to cardiovascular diseases. An interventional radiology procedure for their diagnosis is Digital Subtraction Angiography (DSA). An alternative to DSA is K-Edge subtraction (KES) imaging, which has been shown to be advantageous for moving organs and eliminating image artifacts caused by patient movement. As highly brilliant, monochromatic X-rays are required for this method, it has been limited to synchrotron facilities so far, restraining the feasibility in clinical routine. Compact synchrotron X-ray sources based on inverse Compton scattering, which have been evolving substantially over the past decade, provide X-rays with sufficient brilliance that meet spatial and financial requirements affordable in laboratory settings or for university hospitals. In this work, we demonstrate a first proof-of-principle K-edge subtraction imaging experiment using the Munich Compact Light Source (MuCLS), the first user-dedicated installation of a compact synchrotron X-ray source worldwide. It is shown experimentally that the technique of KES increases the visibility of small blood vessels overlaid by bone structures.

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Development of Digital Subtraction Angiography for Coronary Artery

Cited by 15 publications

References 19 publications

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Diagnostic Value of CT Angiography (CTA) in Carotid Cavernous Fistula (CCF) Patients Using the Digital Subtraction Angiography (DSA) as The Gold Standard: Observation in Dr. Soetomo General Hospital Surabaya from January 2016 to July 2020

Spectroscopic imaging at compact inverse Compton X-ray sources

K-edge subtraction imaging for coronary angiography with a compact synchrotron X-ray source

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