X-ray angiography outperforms digital subtraction angiography, reduces radiation exposure 

Kinetic imaging in x-ray angiography outperforms digital subtraction angiography in providing better image quality and reducing radiation exposure to improve viewing of small blood vessels and patient care, according to research published online Oct. 16 in Radiology.  

Researchers led by Péter Sótonyi, MD, PhD, of the Heart and Vascular Center at Semmelweis University in Budapest, Hungary found the average signal-to-noise ratio of kinetic x-ray angiography images was more than threefold higher than digital subtraction angiography images.  

“Kinetic imaging can be used on image series acquired with existing angiography protocols and provides information similar to digital subtraction angiography but with greater signal-to-noise ratio and higher image quality,” Sótonyi et al. wrote.  

A total of 42 patients (average age 69 years, 76 percent men) who underwent lower limb x-ray angiography exams between February and June 2017 were involved.  The researchers then compared signal-to-noise ratios of digital subtraction angiography and kinetic image pairs.  

Overall, the researchers reviewed 1,902 regions of interest selected from 110 image pairs.  Average signal-to-noise in raw kinetic images was 3.3-fold and 2.3-fold higher than raw and postprocessed digital subtraction angiography images, according to the researchers.  

Additionally, 232 pairs of raw and postprocessed kinetic images were compared. Postprocessing improved the quality of kinetic images in 63.9 percent (2668 of 4176) of the comparisons.  

Also, 238 pairs of kinetic and digital subtraction angiography images were compared. Kinetic imaging provided higher quality images than digital subtraction angiography in 69 percent (2462 of 3570) of the comparisons, according to the researchers.  

The researchers determined that kinetic imaging may be suitable for lower limb angiography by using existing clinical instrumentation and protocols.  

“Kinetic imaging can be used on image series acquired with existing angiography protocols and provides similar information to DSA but with an improved SNR and higher image quality,” the researchers wrote. “Kinetic imaging may be a safer alternative to DSA that has been used in the last decade in angiography.”