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Original research
Radiation dose reduction during neuroendovascular procedures
  1. Pearse P Morris1,
  2. Carol P Geer2,
  3. Jasmeet Singh2,
  4. Waleed Brinjikji1,
  5. Rickey E Carter3
  1. 1 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
  3. 3 Department of Biomedical Statistics, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Pearse P Morris, Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; morris.ppearse{at}


Aim To describe the impact of steps towards reduction of procedural doses of radiation during neuroendovascular procedures.

Methods Phantom exposures under controlled circumstances were performed using a Rando-Alderson adult-sized head phantom. Customized imaging protocols were devised for pediatric and adult imaging and implemented in clinical use. Outcome data for estimated skin doses (ESD) and dose–area product (DAP) following pediatric and adult diagnostic and interventional procedures over 4.5 years were analyzed retrospectively.

Results Dose estimates were reduced by 50% or more after introduction of customized imaging protocols in association with modification of personnel behavior compared with doses recorded with previously used vendor-recommended protocols.

Discussion Substantial reductions in radiation use during neuroendovascular procedures can be achieved through a combination of equipment modification and operator behavior.

  • angiography

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  • Contributors PPM is senior author and participated in data collection and manuscript preparation; CPG and JS participated in data collection and manuscript review/rewriting: WB participated in manuscript review and statistical analysis; REC participated in manuscript preparation and directed the statistical analysis and data review.

  • Competing interests None declared.

  • Ethics approval Wake Forest University Medical Center institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.