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Evaluation of entrance surface dose and image quality according to the installation of Bismuth shield in the case of endovascular treatment of cerebral aneurysm

뇌동맥류 코일 색전술 시 Bismuth 차폐체 설치에 따른 입사 표면 선량 평가 및 화질 평가

  • Kim, Jae-Seok (Department of Biomedical Engineering, Ajou University) ;
  • Kim, Young-Kil (Department of Biomedical Engineering, Ajou University) ;
  • Choi, Jae-Ho (Department of Radiological Technology, Ansan University)
  • Received : 2019.05.17
  • Accepted : 2019.06.24
  • Published : 2019.07.31

Abstract

By applying an ergonomically developed Bismuth shield to the endovascular treatment of cerebral aneurysm the radiation dose of the scalp and lens from the medical radiation exposure was reduced. The enrtance surface dose was analyzed by measuring the occipital parts, bilateral temporal parts, bilateral quadriceps, and nasal tip of the developed bismuth shield using a photostimulable fluorescence dosimeter before (Group A) before use (Group B). Signal to noise ratio (SNR) and contrast to noise ratio (CNR) analysis were used to evaluate the image quality when Bismuth shielding was used. The mean entrance surface dose of A group and B group was 26.92% lower than that of A group. The analysis of CNR and SNR was the same for both Roadmap and DSA. The use of Bismuth shielding is an alternative that can reduce the radiation impairment due to temporary hair loss and other stochastic effects that may occur after cerebrovascular intervention.

인체공학적으로 개발된 Bismuth 차폐체를 뇌동맥류 코일 색전술에 적용함으로써 의료방사선 피폭으로부터 두피 및 수정체의 방사선 피폭을 감소시키고자 하였다. 광자극 형광 선량계를 이용하여 후두부, 양쪽 측두부, 양쪽 수정체부, 코 끝부를 개발된 Bismuth 차폐체를 사용 전 (A그룹) 후 (B그룹)로 측정하여 입사 표면 선량을 분석하였다. Bismuth 차폐체를 사용할 경우 화질에 대한 평가를 Signal to noise ratio (SNR)과 Contrast to noise ratio (CNR) 분석을 했다. A 그룹과 B 그룹의 입사 표면 평균 선량을 비교한 결과 A 그룹에 비해 B 그룹에서 평균 26.92% 감소되었다. CNR과 SNR의 분석은 로드맵과 디지털 감산조영 모두 동일하게 측정되었다. Bismuth 차폐체의 사용은 뇌혈관 중재적 시술 후 나타날 수 있는 일시적 탈모 및 기타 확률적 영향에 따른 방사선 장애를 화질의 저하 없이 감소시킬 수 있는 대안이 될 것으로 사료된다.

Keywords

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Fig. 1 Phantom mounted Bismuth shield & OSLD attachment

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Fig. 3 Image quality measurement experiment

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Fig. 4 SNR and CNR measurement of 9 points

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Fig. 5 5 points measurement of Roadmap

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Fig. 2 (A) Measurement model after installing bismuth unshield and (B) shield

Table. 1 Experimental X-ray Exposure condition

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Table. 2 Dose reduction and dose reduction rate in Relative organ dose (mGy-1cm-2)

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Table. 3 Comparison of paired t test between tissue equivalent dose and relative organ dose

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Table. 4 Comparison of SNR and CNR Paired t Test of Roadmap Image

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Table. 5 Comparison of grayscale level Paired t Test of Road map image (5 points)

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