CARBON DIOXIDE ANGIOGRAPHY: SIMULATION OF OPERATIVE CONDITIONS FOR DIAGNOSTIC IMAGE OPTIMIZATION

Carbon dioxide angiography is based on the visualization (i.e., the radiographic contrast) of gas bubbles injected in blood vessels. By using an experimental X-ray bench, the energy response of a flat panel detector has been measured (Varian CB4030) and, with a dedicated phantom and a software simulation, the image contrast of vessels is injected with Iodine and CO2. Moreover, the dynamical behavior of a moving gas bubble has been studied with the software simulator. The results show that the contrast generated by carbon dioxide is about one fourth of that obtained with iodine, demonstrating that CO2 angiography should use different radiological settings with respect to iodine angiography. In particular, a kVp increase has a lower reduction of contrast-to-noise-ratio (CNR) with carbon dioxide than with iodinated contrast medium (CM), suggesting possible technological improvements both on radiological emission and image enhancement methods.

[1]  Romano Zannoli,et al.  Mechanical aspects of CO₂ angiography. , 2013, Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics.

[2]  N. Lanconelli,et al.  Characterization of biological tissues using X-ray attenuation data , 2008, 2008 IEEE Nuclear Science Symposium Conference Record.

[3]  P. Persson,et al.  Pathophysiology of contrast medium-induced nephropathy. , 2005, Kidney international.

[4]  C. Wilcox,et al.  CO2 digital angiography: a safer contrast agent for renal vascular imaging? , 1994, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[5]  D. Kessel,et al.  The Current Status of the Use of Carbon Dioxide in Diagnostic and Interventional Angiographic Procedures , 2006, CardioVascular and Interventional Radiology.

[6]  S. Trerotola,et al.  Carbon dioxide angiography of the transplanted kidney: technical considerations and imaging findings. , 1998, AJR. American journal of roentgenology.

[7]  P. Goodney,et al.  Fifteen-year trends in lower limb amputation, revascularization, and preventive measures among medicare patients. , 2015, JAMA surgery.

[8]  P. Aspelin,et al.  Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines , 2011, European Radiology.

[9]  D R Dance,et al.  A Monte Carlo program for the calculation of contrast, noise and absorbed dose in diagnostic radiology. , 1994, Computer methods and programs in biomedicine.

[10]  G. Poludniowski.  Calculation of x-ray spectra emerging from an x-ray tube. Part II. X-ray production and filtration in x-ray targets. , 2007, Medical physics.

[11]  Romano Zannoli,et al.  Automated carbon dioxide digital angiography for lower-limb arterial disease evaluation: safety assessment and comparison with standard iodinated contrast media angiography. , 2015, The Journal of invasive cardiology.