Investigating the parameters that affect the radiation exposure and establishing typical values based on procedure complexity for cerebral angiography and brain aneurysm embolization

The purpose of this study is to investigate the parameters that affect the radiation exposure and to establish typical values (TV) based on procedure complexity for cerebral angiography (CA) and brain aneurysm embolization (BAE). Clinical parameters and exposure data were retrospectively reviewed for 348 examinations performed between March 2016 and December 2019 at a single specialized neuroradiology center. TV were derived as the median value of the distribution of exposure parameters such as total air kerma area product (P${}_{KA,T}$), air kerma at the patient entrance reference point, fluoroscopy time, and number of frames. A statistical analysis was conducted to investigate the exposure variability with patient's gender, number of treated vessels during CA and patient gender, aneurysm location and dimension, and treatment strategies during BAE. Patient gender was associated with a significant increase in the exposure level for both CA and BAE. For CA, TV were in term of P${}_{KA,T}$ of 52 Gycm${}^2$ for male vs. 28 Gycm${}^2$ for female patients. For BAE, these were 113 Gycm${}^2$ for male vs. 75 Gycm${}^2$ for female patients. Exposure levels increased significantly with the number of treated vessels in CA. TV were 20 Gycm${}^2$ for one vessel vs. 77 Gycm${}^2$ for 5–6 vessels CA. For BAE, aneurysm location was also a key factor that affects the patient exposure. TV were 55 Gycm${}^2$ for aneurysms grouped in location 1 vs. 105 Gycm${}^2$ for those grouped in location 2. Male gender, number of treated vessels, and aneurysm location are key parameters affecting patient exposure during CA and BAE procedures.