Fischman AM, Ward TJ, Patel RS, et al. Prospective, Randomized Study of Coil Embolization versus Surefire Infusion System during Yttrium-90 Radioembolization with Resin Microspheres. J Vasc Interv Radiol. 2014 Nov;25(11):1709–1716.

To compare standard coil embolization versus the use of an antireflux microcatheter (ARM) in patients undergoing planning angiography before selective internal radiation therapy (SIRT). Over a 9-month period, 30 consecutive patients were randomized [it a 1:1 ratio between coil embolization and ARM groups. Mean fluoroscopy time was significantly reduced in the ARM group versus the coil embolization group (1.8 min [range, 0.4-4.9 min] vs 6.0 min [range, 1.9-15.7 min]; P = .002). There was no difference between groups in dose delivered on the day of SIRT( = .71). There were no major or minor adverse events at 30 days.

Etard C, Bigand E, Salvat C, et al. Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France. Eur Radiol. 2017 Oct;27(10):4281-4290.

A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions.

Corliss BM, Bennett J, Brennan MM, et al. The Patient Size Setting: A Novel Dose Reduction Strategy in Cerebral Endovascular Neurosurgery Using Biplane Fluoroscopy. World Neurosurg. 2018 Feb;110:e636-e641.

In some fluoroscopy machines, the dose-rate output of the fluoroscope is tied to a selectable patient size. Although patient size may play a significant role in visceral or cardiac procedures, head morphology is less variable, and high dose outputs may not be necessary even in very obese patients. We hypothesized that very small patient size setting can be used to reduce dose for cerebral angiography without compromising image quality.

Carl B, Bopp M, Pojskic M, et al. Standard navigation versus intraoperative computed tomography navigation in upper cervical spine trauma. Int J Comput Assist Radiol Surg. 2019 Jan;14(1):169-182.

In surgery of C1-C2 fractures, standard navigation for screw placement based on preoperative image data was compared with intraoperative imaging guidance applying intraoperative computed tomography (iCT) with a special focus on accuracy of screw placement, workflow, and radiation exposure.


The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC.

Borota L, Jangland L, Åslund P, et al. Spot fluoroscopy: a novel innovative approach to reduce radiation dose in neurointerventional procedures. Acta Radiol. 2017 May;58(5):600-608.

To evaluate the effect of SF on the radiation dose. The use of SF led to a reduction of 50% of the total fluoroscopic dose-area product (CF = 106.21 Gycm2, SD = 99.06 Gycm2 versus SF = 51.80 Gycm2, SD = 21.03 Gycm2, p = 0.003884) and significant reduction of the total fluoroscopic dose-area product rate (CF = 1.42 Gycm2/min, SD = 0.57 Gycm2/s versus SF = 0.83 Gycm2/min, SD = 0.37 Gycm2/min, p = 0.00106). The use of SF did not lead to an increase in fluoroscopy time or an increase in total fluoroscopic cumulative air kerma, regardless of collimation.