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Daily Bulletin

Novel Imaging Approach Could Reduce Radiation Dose by 70% for Angiography Procedures

Wednesday, Nov. 30, 2022

A new method of image processing being developed and tested by radiologists at Semmelweis University in Budapest has the ability to drastically reduce the radiation dose when performing radiographic imaging for angiography.

Digital Variance Angiography (DVA) is an image processing method for angiographies with an image quality advantage over digital subtraction angiography (DSA).

Over the last five years, several clinical studies have been performed to research the future usability of DVA for low-dose radiographic imaging and carbon-dioxide angiography.

Peter Legeza, MD, Semmelweis University, Department of Vascular and Endovascular Surgery, spoke about some of the research during his Tuesday presentation.

"Our study involved patients undergoing conventional diagnostic angiographies for lower extremity arterial disease," said Dr. Legeza. "Patients were randomized into two groups. One group received the standard of care radiation dose with the use of digital subtraction angiography (DSA), while in the other group we used a radiation dose reduced by 70%, and used the technique of DVA imaging."

DVA Needs Further Research in Other Parts of the Body

The research found that DVA images with the reduced radiation dose performed similarly or better than DSA images with the standard radiation dose, according to Dr. Legeza.

DVA imaging allowed a highly significant reduction in total (-45%) and angiography-related (-63%) radiation dose in lower extremity angiography, without affecting the image quality. Low-dose DVA2 images compared to standard dose DSA images showed a tendency of even better visual scores in the popliteal and talocrural regions, and outperformed DVA1 in the femoral, popliteal and talocrural regions, therefore this algorithm might be especially beneficial in below-the-knee imaging.

Dr. Legeza is passionate about this project because of the opportunity to dramatically reduce the radiation exposure for patients, the operating physician, and the interventional radiology team performing these procedures.

"Any intervention should apply the lowest radiation dose as reasonably achievable," said Dr. Legeza. "Therefore, after seeing that DVA is associated with a better image quality compared to DSA, it was clear to us that our group should focus on using this extra quality for reducing radiation, and contrast media dose."

DVA is still a new technology, and Dr. Legeza said it needs to be studied on different parts of the body and in different types of interventions, but so far there have been promising results with carotid artery stenting, prostatic artery embolization, and hepatic artery embolization.

"Radiation protection is a key element of endovascular interventions. Both the patient and the interventional team need to prevent radiation related injuries. DVA imaging contributes to this protection without affecting the diagnostic value of the angiographic images," he said.

Access the presentation, "Digital Variance Angiography Significantly Reduces the Radiation Dose During Lower Extremity Diagnostic Angiographies Without Affecting the Image Quality," (T3-SSVA02-4) on demand at