Biplan ve Monoplan Serebral Anjiyografide Radyasyon Maruziyetinin Karşılaştırmalı Analizi: Tek Merkezli Retrospektif Çalışma

Abstract

Amaç: Tanısal serebral anjiyografi sırasında biplan ve monoplan dijital çıkarma anjiyografi (DSA) sistemleri arasında hastaların maruz kaldığı radyasyon dozunu karşılaştırmak ve modern çift düzlemli teknoloji ile sağlanan doz etkinliğini değerlendirmek. Gereç ve Yöntem: Bu retrospektif tek merkezli çalışma kapsamında Kasım 2021 – Nisan 2022 arasında tanısal serebral DSA uygulanan ardışık 61 hasta değerlendirildi. İşlemler, Siemens Artis Zee monoplan sistemi (n = 31) ve Philips Azurion ClarityIQ biplan sistemi (n = 30) kullanılarak gerçekleştirildi. Her işlem için toplam floroskopi süresi, floroskopi doz-alan çarpımı (DAP), ekspojur DAP, toplam DAP ve kümülatif hava kerma değerleri kaydedildi. Gruplar bağımsız örneklem t-testi veya Mann–Whitney U testi ile karşılaştırıldı; p < 0.05 anlamlı kabul edildi. Bulgular: Monoplan ve biplan grupları arasında floroskopi süresi benzerdi (p = 0.736). Biplan sistem daha fazla sayıda görüntü elde etmesine rağmen (p < 0.001), anlamlı derecede daha düşük radyasyon dozu sağladı. Medyan ekspojur DAP ve toplam DAP değerleri biplan grupta yaklaşık %25–35 oranında azalmıştı ve toplam hava kerma belirgin olarak daha düşüktü (p < 0.001). Floroskopi DAP değeri biplan sistemde hafifçe yüksek bulundu (p = 0.008); bunun zaman zaman çift düzlem kullanımına bağlı olduğu düşünüldü. Sonuç: Daha fazla projeksiyon elde edilmesine rağmen biplan DSA sistemi, monoplan sisteme kıyasla anlamlı derecede daha düşük toplam radyasyon maruziyeti sağlamıştır. Bu bulgular, gelişmiş doz azaltma algoritmalarına (ClarityIQ) sahip modern biplan teknolojisinin tanısal serebral anjiyografide daha etkili doz yönetimi ve artmış hasta güvenliği sunduğunu göstermektedir.

Keywords

• Radyasyon Dozu
• Anjiyografi
• Floroskopi
• Cihaz Tasarımı
• Doz Azaltma Teknikleri

Ethical Statement

Bu çalışma retrospektif bir araştırma olup İstanbul Üniversitesi Etik Kurulu tarafından onaylanmıştır (Onay No: 1596135).

COMPARATIVE ANALYSIS OF RADIATION EXPOSURE IN BIPLANE VERSUS MONOPLANE CEREBRAL ANGIOGRAPHY: A SINGLE-CENTER RETROSPECTIVE STUDY

Abstract

Purpose: To compare patient radiation exposure between biplane and monoplane digital subtraction angiography (DSA) systems during diagnostic cerebral angiography and evaluate the dose-efficiency of modern dual-plane technology. Material-Methods: This retrospective single-center study included 61 consecutive patients who underwent diagnostic cerebral DSA between November 2021 and April 2022. Examinations were performed using a Siemens Artis Zee monoplane system (n = 31) and a Philips Azurion ClarityIQ biplane system (n = 30). For each procedure, total fluoroscopy time, fluoroscopy dose-area product (DAP), exposure DAP, total DAP, and cumulative air kerma were recorded. Groups were compared using independent-samples t-tests or Mann–Whitney U tests, with p < 0.05 considered statistically significant. Results: Fluoroscopy time was comparable between the monoplane and biplane groups (p = 0.736). The biplane system produced a significantly greater number of image acquisitions (p < 0.001) yet achieved markedly lower radiation doses. Median exposure DAP and total DAP were reduced by approximately 25–35%, and total air kerma was significantly lower in the biplane group (p < 0.001). Fluoroscopy DAP was slightly higher for the biplane system (p = 0.008), likely reflecting occasional dual-plane use during complex catheter navigation. Conclusion: Despite acquiring more projections, the biplane DSA system demonstrated substantially lower total radiation exposure compared with the monoplane system. These results indicate that modern biplane technology with advanced dose-reduction algorithms (ClarityIQ) offers improved dose efficiency and enhanced patient safety in diagnostic cerebral angiography.

Keywords

• Radiation Dose
• Angiography
• Fluoroscopy
• Equipment Design
• Dose Reduction Techniques

Ethical Statement

This retrospective study was approved by the Ethics Committee of Istanbul University (Approval No: 1596135).

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