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Research ArticleNeurointervention

Impact of Patient Head Posture on Lens Radiation Exposure During Cerebral Angiography

Su Jeong Yang, Jong-Tae Yoon, Jae-Chan Ryu, Byung Jun Kim, Mi Hyeon Kim, Boseong Kwon, Deok Hee Lee and Yunsun Song
American Journal of Neuroradiology January 2025, 46 (1) 102-106; DOI: https://doi.org/10.3174/ajnr.A8447
Su Jeong Yang
aFrom the Department of Radiology (S.J.Y.), Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea
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  • ORCID record for Su Jeong Yang
Jong-Tae Yoon
bBiomedical Engineering Research Center (J.-T.Y., M.H.K.), Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
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Jae-Chan Ryu
cDepartment of Neurology (J.-C.R), Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Byung Jun Kim
dAdvanced Therapies (B.J.K.), Siemens Healthineers Ltd, Seoul, Korea
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Mi Hyeon Kim
bBiomedical Engineering Research Center (J.-T.Y., M.H.K.), Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
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Boseong Kwon
eDepartment of Radiology (B.K., D.H.L., Y.S.), Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Deok Hee Lee
eDepartment of Radiology (B.K., D.H.L., Y.S.), Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Yunsun Song
eDepartment of Radiology (B.K., D.H.L., Y.S.), Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abstract

BACKGROUND AND PURPOSE: Cerebral angiography remains crucial for detailed characterization and preoperative assessments for intracranial aneurysm. Despite its diagnostic importance, cerebral angiography poses challenges due to its invasiveness, the risk of neurologic complications, and radiation exposure. To investigate the impact of head posture on lens radiation exposure during cerebral angiography, this study focused on the correlation between radiation doses to the eye lens, head flexion angles, and head size.

MATERIALS AND METHODS: A retrospective analysis was performed on 20 patients who underwent cerebral angiography for unruptured intracranial aneurysms between October and November 2022. Radiation doses to the lens, which were measured in a prior prospective study by using photoluminescent glass dosimeters, were analyzed alongside head flexion angles, anterior-posterior (AP) head diameters, and kerma-area product (KAP) to evaluate their correlation with lens radiation exposure. The lateral radiation source is located on the left side of the patients.

RESULTS: The cohort consisted of 20 patients (60% women, mean age: 62.3 ± 9.9 years). The radiation dose to the left eye (the eye closer to the x-ray source) was 2.8 times higher than that to the right eye (9.18 ± 3.31 mGy versus 3.3 ± 0.60 mGy, P < .001). A strong positive correlation was observed between the left eye lens dose and head flexion angle (R = 0.815, P < .001). While the AP head diameter correlated significantly with the flexion angle, it showed no significant correlation with lens dose. The KAP was inversely correlated with both the left lens dose (R = −0.597, P = .005) and the flexion angle (R = −0.689, P < .001).

CONCLUSIONS: Our findings underscore the meaningful impact of head posture on lens radiation exposure during cerebral angiography. Adjusting head positioning may provide a practical approach to reduce radiation exposure to the lens. Furthermore, it is worth noting that the left lens received more radiation than the right, likely due to the x-ray source being on the left side of the patient.

ABBREVIATIONS:

AP
anterior-posterior
KAP
kerma-area product
PLD
photoluminescent glass dosimeter
VA
vertebral artery
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American Journal of Neuroradiology: 46 (1)
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Cite this article
Su Jeong Yang, Jong-Tae Yoon, Jae-Chan Ryu, Byung Jun Kim, Mi Hyeon Kim, Boseong Kwon, Deok Hee Lee, Yunsun Song
Impact of Patient Head Posture on Lens Radiation Exposure During Cerebral Angiography
American Journal of Neuroradiology Jan 2025, 46 (1) 102-106; DOI: 10.3174/ajnr.A8447

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Impact of Head Posture on Angiography Exposure
Su Jeong Yang, Jong-Tae Yoon, Jae-Chan Ryu, Byung Jun Kim, Mi Hyeon Kim, Boseong Kwon, Deok Hee Lee, Yunsun Song
American Journal of Neuroradiology Jan 2025, 46 (1) 102-106; DOI: 10.3174/ajnr.A8447
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