Spot fluoroscopy cuts radiation in image-guided neuro interventions

The innovative imaging technique called “spot fluoroscopy” has shown promise as a way to reduce radiation doses to patients during neurointerventional procedures, as well as scatter doses to staff and clinicians, according to a small study published online Aug. 13 in Acta Radiologica.

The spot function enables the fluoroscope operator to collimate a rectangular region of interest anywhere within the general field of view, the study authors explain. By comparison, conventional fluoroscopy limits the operator to centering the collimation and rendering it symmetric.

Ljubisa Borota, MD, of Uppsala University in Sweden and colleagues treated 35 intracranial-aneurysm patients with endovascular coiling.

During the procedures, the team used spot fluoroscopy in 16 patients and conventional fluoroscopy in 19.

The researchers found that using spot fluoroscopy led to a 50 percent reduction in the total fluoroscopic dose-area product and a significant reduction of the total fluoroscopic dose-area product rate.

Regardless of collimation method, their use of spot fluoroscopy did not lead to an increase in fluoroscopy time.

Nor did it bring about an increase in total fluoroscopic cumulative air kerma.

That’s an acronym for kinetic energy released per unit mass (or air); it expresses the radiation concentration delivered to a particular point, such as the entrance surface of a patient’s body, the authors note.

“The results of our study strongly indicate that spot fluoroscopy, as a novel and original method for collimation of x-rays, provides considerable lowering of the fluoroscopic dose, and, in this way, a safer intervention for both patients and staff,” Borota et al. conclude.

Spot fluoroscopy is a feature in systems made and marketed by Toshiba, of which two of the study’s eight authors are employees.

Among the limitations the authors acknowledge are the study’s small analysis sample, non-blinded cohorts and operator-dependent results.

Acta Radiologica publisher Sage has posted the full study for free.