| 1. |
- Nocum, D. J., et al.
(författare)
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Comparison of image quality assessments between interventional radiographers and interventional radiologists using digital subtraction angiography
- 2023
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Ingår i: Journal of Medical Imaging. - 2329-4302. ; 10:2
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of our study was to compare the image quality assessments of vascular anatomy between interventional radiographers and interventional radiologists using digital subtraction angiography (DSA) runs acquired during an interventional radiology procedure. Approach: Visual grading characteristics (VGC) analysis was used to assess image quality by comparing two groups of images, where one group consisted of procedures in which radiation dose was optimized (group A, n = 10) and one group where dose optimization was not performed (group B, n = 10). The radiation dose parameters were optimized based on theoretical and empirical evidence to achieve radiation dose reductions during uterine artery embolization procedures. The two observer groups comprised of interventional radiologists (n = 4) and interventional radiographers (n = 4). Each observer rated the image quality of 20 DSA runs using a five-point rating scale. Results: The VGC analysis produced an area under the VGC curve (AUC(VGC)) of 0.55 for interventional radiographers (P = 0.61) and AUCVGC of 0.52 for interventional radiologists (P = 0.83). The optimization of radiation dose parameters demonstrated a reduction in kermaarea product by 35% (P = 0.026, d = 0.5) and reference air kerma (Ka, r) by 43% (P = 0.042, d = 0.5) between group A and group B. Conclusions: VGC analysis indicated that the image quality assessments of interventional radiographers were comparable with interventional radiologists, where a reduction in radiation dose revealed no effect on both observer groups regarding their image quality assessment of vascular anatomy. (C) 2023 Society of Photo-Optical Instrumentation Engineers (SPIE)
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| 2. |
- Nocum, D. J., et al.
(författare)
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Predictors of radiation dose for uterine artery embolisation are angiography system-dependent
- 2022
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Ingår i: Journal of Radiological Protection. - : IOP Publishing. - 0952-4746 .- 1361-6498. ; 42:1
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Tidskriftsartikel (refereegranskat)abstract
- This study sought to achieve radiation dose reductions for patients receiving uterine artery embolisation (UAE) by evaluating radiation dose measurements for the preceding generation (Allura) and upgraded (Azurion) angiography system. Previous UAE regression models in the literature could not be applied to this centre's practice due to being based on different angiography systems and radiation dose predictor variables. The aims of this study were to establish whether radiation dose is reduced with the upgraded angiography system and to develop a regression model to determine predictors of radiation dose specific to the upgraded angiography system. A comparison between Group I (Allura, n = 95) and Group II (Azurion, n = 95) demonstrated a significant reduction in kerma-area product (KAP) and Ka, r (reference air kerma) by 63% (143.2 Gy cm(2) vs 52.9 Gy cm(2); P < 0.001, d = 0.8) and 67% (0.6 Gy vs 0.2 Gy; P < 0.001, d = 0.8), respectively. The multivariable linear regression (MLR) model identified the UAE radiation dose predictors for KAP on the upgraded angiography system as total fluoroscopy dose, Ka, r, and total uterus volume. The predictive accuracy of the MLR model was assessed using a Bland-Altman plot. The mean difference was 0.39 Gy cm(2) and the limits of agreement were +28.49 and -27.71 Gy cm(2), and thus illustrated no proportional bias. The resultant MLR model was considered system-dependent and validated the upgraded angiography system and its advance capabilities to significantly reduce radiation dose. Interventional radiologist and interventional radiographer familiarisation of the system's features and the implementation of the newly established MLR model would further facilitate dose optimisation for all centres performing UAE procedures using the upgraded angiography system.
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| 3. |
- Nocum, D. J., et al.
(författare)
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UTERINE ARTERY EMBOLISATION: CONTINUOUS QUALITY IMPROVEMENT REDUCES RADIATION DOSE WHILE MAINTAINING IMAGE QUALITY
- 2021
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Ingår i: Radiation Protection Dosimetry. - : Oxford University Press (OUP). - 0144-8420 .- 1742-3406. ; 196:3-4, s. 159-166
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to introduce a continuous quality improvement (CQI) program for radiation dose optimisation during uterine artery embolisation (UAE) and assess its impact on dose reduction and image quality. The CQI program investigated the effects of optimising radiation dose parameters on the kerma-area product (KAP) and image quality when comparing a 'CQI intervention' group (n = 50) and 'Control' group (n = 50). Visual grading characteristics (VGC) analysis was used to assess image quality, using the 'Control' group as a reference. A significant reduction in KAP by 17% ( P = 0.041, d = 0.2) and reference air kerma (Ka, r) by 20% (P = 0.027, d = 0.2) was shown between the two groups. The VGC analysis resulted in an area under the VGC curve (AUCVGC) of 0.54, indicating no significant difference in image quality between the two groups (P = 0.670). The implementation of the CQI program and optimisation of radiation dose parameters improved the UAE radiation dose practices at our centre. The dose reduction demonstrated no detrimental effects on image quality.
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