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Original research
Impact of a selective lens dose reduction protocol in 3D rotational angiography on radiation exposure to the eye lens during cerebral angiography: a randomized controlled trial
  1. Jae-Chan Ryu1,
  2. Jong-Tae Yoon2,
  3. Byung Jun Kim3,
  4. Mi Hyeon Kim2,
  5. Eun Ji Moon2,
  6. Pae Sun Suh2,
  7. Yun Hwa Roh2,
  8. Hye Hyeon Moon2,
  9. Boseong Kwon2,
  10. Deok Hee Lee2,
  11. Yunsun Song2
  1. 1Neurology, Korea University Ansan Hospital, Ansan, Korea (the Republic of)
  2. 2Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  3. 3Advanced Therapies, Siemens Healthineers Co Ltd, Seoul, Korea (the Republic of)
  1. Correspondence to Dr Yunsun Song, Department of Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of); songsongggg{at}


Background We aimed to investigate the radiation dose to the eye lens (lens dose) during cerebral angiography and to evaluate the effectiveness of the lens dose reduction protocol for 3-dimensional rotational angiography (3D-RA) in reducing overall lens dose exposure.

Methods We conducted a randomized, controlled clinical trial at a tertiary hospital with patients undergoing cerebral angiography. The lens dose reduction protocol in 3D-RA involved raising the table to position the patient’s eye lens away from the rotation axis. The lens dose was estimated by measuring the entrance surface air kerma using a photoluminescent glass dosimeter. The lens doses of 3D-RA, overall examination, and image quality were analyzed and compared between the two groups.

Results A total of 20 participants (mean age, 58±9.4 years; including 12 men [60%]) were enrolled and randomly assigned to either the conventional group or the dose reduction group. The median lens dose in 3D-RA was significantly lower in the dose reduction group compared with the conventional group (1.1 mGy vs 4.5 mGy, p<0.001). The total dose was significantly lower in the dose reduction group (median of 7.5 mGy vs 10.2 mGy, p=0.003). In the conventional group, 3D-RA accounted for 46% of the total lens dose, while in the dose reduction group, its proportion decreased to 16%. No significant differences were observed in the image quality between the groups.

Conclusion The lens dose reduction protocol resulted in a significant reduction in the lens dose of the 3D-RA as well as entire cerebral angiography, while maintaining the image quality.

  • Aneurysm
  • Angiography
  • Technique
  • Intervention

Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request to the corresponding author.

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Data availability statement

Data are available upon reasonable request. Data are available upon reasonable request to the corresponding author.

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  • J-CR and J-TY are joint first authors.

  • Contributors YS: Guarantor of the integrity of the entire study; J-CR, JT-Y, DHL, YSS: study concepts/study design or data acquisition or data analysis/interpretation; All authors: manuscript drafting or manuscript revision for important intellectual content; All authors: approval of the final version of the submitted manuscript; All authors: agree to ensure any questions related to the work are appropriately resolved; J-CR, JT-Y, DHL, YSS: literature research; J-CR, JT-Y: clinical studies; J-CR, JT-Y: statistical analysis; and J-CR, JT-Y, BSK, DHL, YS: manuscript editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.