Evaluation of Neuroangiography Settings and Protective Shielding on Radiation Exposure to Patient and Interventionist: A Comparative Dosimetric Study
4 affiliations
- 1Iranian Center of Neurological Research, Neuroscience Institute, Imam Khomeini Hospital Complex (Z.A., P.M.), Tehran University of Medical Sciences, Iran.
- 2Research Center for Social Determinants of Health, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran (N.I.).
- 3Jamaica Hospital Medical Center, Queens, NY (B.N., M.N., P.M.).
- 4Department of Neurology, School of Medicine (P.M.), Tehran University of Medical Sciences, Iran.
Abstract
Background
Neuroendovascular procedures expose surgeons and patients to significant radiation, increasing long-term health risks. Despite the known effects of imaging parameters on radiation exposure, the relative impacts of different imaging and shielding strategies have been less studied. We aimed to assess the effects of digital subtraction angiography parameter modifications on operator and patient radiation doses.Methods
Using a phantom skull in a neuroendovascular suite, radiation was measured under varying digital subtraction angiography settings, including image intensifier distance, collimation, magnification, frame rate, and protective shielding. Operator exposure was recorded using a dosimeter, and patient dose was obtained from the angiography system. Each configuration was tested in 3 independent trials. One-way ANOVA was used to determine statistical significance.Results
Lowering the frame rate (5.2-fold) and moving the image intensifier closer to the patient (3.5-fold) significantly reduced operator exposure (P<0.0001). Double shielding reduced operator dose 10-fold (P<0.0001). Patient dose was minimized by reducing magnification (9.3-fold; P<0.0001), lowering the frame rate (2.4-fold; P<0.0001), and decreasing image intensifier distance (1.7-fold; P<0.0001). Collimation decreased operator dose but slightly increased patient skin dose. Optimal parameter combinations maintained operator exposure well below recommended safety limits while minimizing patient dose.Conclusions
Low frame rates, close image intensifier positioning, minimal magnification, and double shielding substantially reduce radiation risk for both operators and patients. These evidence-based configurations provide a practical framework for safer neuroendovascular procedures.
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BibTeX
@article{azizan2026evaluation,
title = {{Evaluation of Neuroangiography Settings and Protective Shielding on Radiation Exposure to Patient and Interventionist: A Comparative Dosimetric Study}},
author = {Zahra Azizan and Neda Izadi and Binesh Ninan and Mohsen Nouri and Pouria Moshayedi},
journal = {Stroke (Hoboken, N.J.)},
year = {2026},
month = sep,
doi = {10.1161/svin.125.002287},
url = {https://europepmc.org/article/PMC/PMC13727182},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Evaluation of Neuroangiography Settings and Protective Shielding on Radiation Exposure to Patient and Interventionist: A Comparative Dosimetric Study
AU - Zahra Azizan
AU - Neda Izadi
AU - Binesh Ninan
AU - Mohsen Nouri
AU - Pouria Moshayedi
PY - 2026
DA - 2026/09/18
JO - Stroke (Hoboken, N.J.)
DO - 10.1161/svin.125.002287
UR - https://europepmc.org/article/PMC/PMC13727182
AB - Background Neuroendovascular procedures expose surgeons and patients to significant radiation, increasing long-term health risks. Despite the known effects of imaging parameters on radiation exposure, the relative impacts of different imaging and shielding strategies have been less studied. We aimed to assess the effects of digital subtraction angiography parameter modifications on operator and patient radiation doses.Methods Using a phantom skull in a neuroendovascular suite, radiation was measured under varying digital subtraction angiography settings, including image intensifier distance, collimation, magnification, frame rate, and protective shielding. Operator exposure was recorded using a dosimeter, and patient dose was obtained from the angiography system. Each configuration was tested in 3 independent trials. One-way ANOVA was used to determine statistical significance.Results Lowering the frame rate (5.2-fold) and moving the image intensifier closer to the patient (3.5-fold) significantly reduced operator exposure (P<0.0001). Double shielding reduced operator dose 10-fold (P<0.0001). Patient dose was minimized by reducing magnification (9.3-fold; P<0.0001), lowering the frame rate (2.4-fold; P<0.0001), and decreasing image intensifier distance (1.7-fold; P<0.0001). Collimation decreased operator dose but slightly increased patient skin dose. Optimal parameter combinations maintained operator exposure well below recommended safety limits while minimizing patient dose.Conclusions Low frame rates, close image intensifier positioning, minimal magnification, and double shielding substantially reduce radiation risk for both operators and patients. These evidence-based configurations provide a practical framework for safer neuroendovascular procedures.
SN - 2694-5746
ER -