{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:26:30Z","timestamp":1793917590646,"version":"4.8.0"},"reference-count":67,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiol Phys Technol"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    To evaluate the image quality and clinical radiation dose of a cerebral angiography system featuring contrast-to-noise ratio (CNR)-based exposure control for neurovascular endovascular treatment (EVT). Image quality was evaluated using a quality control phantom under fluoroscopy and digital subtraction angiography (DSA). Clinical radiation dose was retrospectively compared between a conventional angiography system using detector dose-based exposure control (61 cerebral aneurysm EVT procedures) and a new angiography system using CNR-based exposure control (99 procedures). Patient entrance reference air kerma (K\n                    <jats:sub>a,r<\/jats:sub>\n                    ) and air kerma\u2013area product (P\n                    <jats:sub>KA<\/jats:sub>\n                    ) were analyzed. The new system demonstrated significantly higher observer scores than the conventional system for both fluoroscopy and DSA, including spatial resolution, low-contrast resolution, and dynamic range. The median total K\n                    <jats:sub>a,r<\/jats:sub>\n                    was 1818 [1301\u20132744] mGy with the new system and 2283 [1580\u20133184] mGy with the conventional system, representing a 20% reduction (p &lt; 0.05). Conversely, the median total P\n                    <jats:sub>KA<\/jats:sub>\n                    increased by 26% (173 [120\u2013237] vs. 137 [93\u2013207] Gy\u00b7cm\n                    <jats:sup>2<\/jats:sup>\n                    , p &lt; 0.05), but remained below the current Japanese diagnostic reference level for cerebral aneurysm EVT. Compared with the conventional system, the new angiography platform demonstrated superior image quality under phantom conditions and was associated with a 20% reduction in total K\n                    <jats:sub>a,r<\/jats:sub>\n                    during cerebral aneurysm EVT. Although the total P\n                    <jats:sub>KA<\/jats:sub>\n                    increased by 26%, this increase may have reflected differences in the magnification strategy between the two systems, suggesting a need for further optimization.\n                  <\/jats:p>","DOI":"10.1007\/s12194-026-01141-y","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:14:13Z","timestamp":1790666053000},"page":"1738-1755","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transition from a detector-dose-based to a CNR-based cerebral angiography system: evaluation of image quality and radiation dose"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5442-410X","authenticated-orcid":false,"given":"Kota","family":"Hachiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Abiko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0913-2777","authenticated-orcid":false,"given":"Koichi","family":"Chida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshikazu","family":"Matsuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,29]]},"reference":[{"key":"1141_CR1","doi-asserted-by":"crossref","unstructured":"International Commission on Radiological Protection (ICRP). Education and training in radiological protection for diagnostic and interventional procedures. ICRP Publication 113. Ann. ICRP. 2009;39(5):1\u201368.","DOI":"10.1016\/j.icrp.2011.01.001"},{"key":"1141_CR2","doi-asserted-by":"crossref","unstructured":"ICRP. Radiological protection in fluoroscopically guided procedures outside the imaging department. ICRP Publication 117. Ann. ICRP. 2010;40(6)1\u2013102.","DOI":"10.1016\/j.icrp.2012.03.001"},{"issue":"10","key":"1141_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10100846","volume":"10","author":"Y Haga","year":"2020","unstructured":"Haga Y, Chida K, Sota M, et al. Hybrid operating room system for the treatment of thoracic and abdominal aortic aneurysms: evaluation of the radiation dose received by patients. Diagnostics (Basel). 2020;10(10):846. https:\/\/doi.org\/10.3390\/diagnostics10100846.","journal-title":"Diagnostics (Basel)"},{"issue":"2","key":"1141_CR4","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1093\/jrr\/rry110","volume":"60","author":"M Kato","year":"2019","unstructured":"Kato M, Chida K, Nakamura M, et al. New real-time patient radiation dosimeter for use in radiofrequency catheter ablation. J Radiat Res. 2019;60(2):215\u201320. https:\/\/doi.org\/10.1093\/jrr\/rry110.","journal-title":"J Radiat Res"},{"issue":"3","key":"1141_CR5","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1007\/s12194-020-00575-2","volume":"13","author":"Y Inaba","year":"2020","unstructured":"Inaba Y, Chida K, Murabayashi Y, et al. An initial investigation of a wireless patient radiation dosimeter for use in interventional radiology. Radiol Phys Technol. 2020;13(3):321\u20136. https:\/\/doi.org\/10.1007\/s12194-020-00575-2.","journal-title":"Radiol Phys Technol"},{"issue":"7","key":"1141_CR6","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.2106\/JBJS.24.00433","volume":"107","author":"Y Hijikata","year":"2025","unstructured":"Hijikata Y, Yamashita K, Hatsusaka N, et al. Prevalence of cataractous changes in the eyes and chronic inflammatory changes in the hands among spine surgeons. J Bone Joint Surg Am. 2025;107(7):e25. https:\/\/doi.org\/10.2106\/JBJS.24.00433.","journal-title":"J Bone Joint Surg Am"},{"issue":"3","key":"1141_CR7","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1161\/STROKEAHA.118.023967","volume":"50","author":"H Saber","year":"2019","unstructured":"Saber H, Navi BB, Grotta JC, et al. Real-world treatment trends in endovascular stroke therapy. Stroke. 2019;50(3):683\u20139. https:\/\/doi.org\/10.1161\/STROKEAHA.118.023967.","journal-title":"Stroke"},{"issue":"1","key":"1141_CR8","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-024-06064-4","volume":"166","author":"F Calvanese","year":"2024","unstructured":"Calvanese F, Auricchio AM, Pohjola A, et al. Changes in treatment of intracranial aneurysms during the last decade in a large European neurovascular center. Acta Neurochir. 2024;166(1):173. https:\/\/doi.org\/10.1007\/s00701-024-06064-4.","journal-title":"Acta Neurochir"},{"issue":"1","key":"1141_CR9","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3340\/jkns.2018.0179","volume":"63","author":"SU Lee","year":"2020","unstructured":"Lee SU, Kim T, Kwon OK, et al. Trends in the incidence and treatment of cerebrovascular diseases in Korea: Part I. Intracranial aneurysm, intracerebral hemorrhage, and arteriovenous malformation. J Korean Neurosurg Soc. 2020;63(1):56\u201368. https:\/\/doi.org\/10.3340\/jkns.2018.0179.","journal-title":"J Korean Neurosurg Soc"},{"issue":"3","key":"1141_CR10","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1177\/1747493019869706","volume":"15","author":"T Takagi","year":"2020","unstructured":"Takagi T, Yoshimura S, Sakai N, et al. Distribution and current problems of acute endovascular therapy for large artery occlusion from a two-year national survey in Japan. Int J Stroke. 2020;15(3):289\u201398. https:\/\/doi.org\/10.1177\/1747493019869706.","journal-title":"Int J Stroke"},{"issue":"11","key":"1141_CR11","doi-asserted-by":"publisher","first-page":"1328","DOI":"10.1016\/j.jacc.2020.07.037","volume":"76","author":"T Inohara","year":"2013","unstructured":"Inohara T, Kohsaka S, Spertus JA, et al. Comparative trends in percutaneous coronary intervention in Japan and the United States, 2013 to 2017. J Am Coll Cardiol. 2013;76(11):1328\u201340. https:\/\/doi.org\/10.1016\/j.jacc.2020.07.037.","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"1141_CR12","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1007\/s00270-022-03136-9","volume":"45","author":"JA Decker","year":"2009","unstructured":"Decker JA, Helmer M, Bette S, et al. Comparison and trends of endovascular, surgical and hybrid revascularizations and the influence of comorbidity in 1 million hospitalizations due to peripheral artery disease in Germany between 2009 and 2018. Cardiovasc Intervent Radiol. 2009;45(10):1472\u201382. https:\/\/doi.org\/10.1007\/s00270-022-03136-9.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"1141_CR13","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6498\/ad76b3","author":"S Kawauchi","year":"2024","unstructured":"Kawauchi S, Chida K, Moritake T, et al. Radiation dose analysis in interventional neuroradiology of unruptured aneurysm cases. J Radiol Prot. 2024. https:\/\/doi.org\/10.1088\/1361-6498\/ad76b3.","journal-title":"J Radiol Prot"},{"issue":"2","key":"1141_CR14","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1148\/radiol.2542082312","volume":"254","author":"S Balter","year":"2010","unstructured":"Balter S, Hopewel JW, Miller DL, et al. Fluoroscopically guided interventional procedures: a review of radiation effects on patients\u2019 skin and hair. Radiology. 2010;254(2):326\u201341. https:\/\/doi.org\/10.1148\/radiol.2542082312.","journal-title":"Radiology"},{"issue":"5","key":"1141_CR15","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1080\/02841850902852752","volume":"50","author":"K Chida","year":"2009","unstructured":"Chida K, Kagaya Y, Saito H, et al. Evaluation of patient radiation dose during cardiac interventional procedures: what is the most effective method? Acta Radiol. 2009;50(5):474\u201381. https:\/\/doi.org\/10.1080\/02841850902852752.","journal-title":"Acta Radiol"},{"issue":"1","key":"1141_CR16","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1002\/ccd.20961","volume":"69","author":"K Chida","year":"2007","unstructured":"Chida K, Fuda K, Saito H, et al. Patient skin dose in cardiac interventional procedures: conventional fluoroscopy versus pulsed fluoroscopy. Catheter Cardiovasc Interv. 2007;69(1):115\u201321. https:\/\/doi.org\/10.1002\/ccd.20961.","journal-title":"Catheter Cardiovasc Interv"},{"issue":"5","key":"1141_CR17","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/s0887-2171(02)90014-4","volume":"23","author":"FA Mettler","year":"2002","unstructured":"Mettler FA, Koenig TR, Wagner LK, et al. Radiation injuries after fluoroscopic procedures. Semin Ultrasound CT MR. 2002;23(5):428\u201342. https:\/\/doi.org\/10.1016\/s0887-2171(02)90014-4.","journal-title":"Semin Ultrasound CT MR"},{"issue":"5","key":"1141_CR18","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1001\/archderm.143.5.637","volume":"143","author":"TH Frazier","year":"2007","unstructured":"Frazier TH, Richardson JB, Fabr\u00e9 VC, et al. Fluoroscopy-induced chronic radiation skin injury: a disease perhaps often overlooked. Arch Dermatol. 2007;143(5):637\u201340. https:\/\/doi.org\/10.1001\/archderm.143.5.637.","journal-title":"Arch Dermatol"},{"issue":"9","key":"1141_CR19","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1258\/ar.2012.120192","volume":"53","author":"M Kato","year":"2012","unstructured":"Kato M, Chida K, Sato T, et al. The necessity of follow-up for radiation skin injuries in patients after percutaneous coronary interventions: radiation skin injuries will often be overlooked clinically. Acta Radiol. 2012;53(9):1040\u20134. https:\/\/doi.org\/10.1258\/ar.2012.120192.","journal-title":"Acta Radiol"},{"key":"1141_CR20","doi-asserted-by":"crossref","unstructured":"ICRP. 1990 recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP. 1991;21(1\u20133):1\u2013201.","DOI":"10.1016\/0146-6453(91)90067-Q"},{"key":"1141_CR21","doi-asserted-by":"crossref","unstructured":"ICRP. 2007 recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP. 2007;37(2\u20134):1\u2013332.","DOI":"10.1016\/j.icrp.2008.07.001"},{"key":"1141_CR22","doi-asserted-by":"crossref","unstructured":"ICRP. Avoidance of radiation injuries from medical interventional procedures. ICRP Publication 85. Ann ICRP. 2000;30(2):7\u201367.","DOI":"10.1016\/S0146-6453(01)00004-5"},{"issue":"9488","key":"1141_CR23","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1016\/S0140-6736(05)67214-5","volume":"366","author":"AJ Molyneux","year":"2005","unstructured":"Molyneux AJ, Kerr RS, Yu LM, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet. 2005;366(9488):809\u201317. https:\/\/doi.org\/10.1016\/S0140-6736(05)67214-5.","journal-title":"Lancet"},{"issue":"1","key":"1141_CR24","doi-asserted-by":"publisher","first-page":"164","DOI":"10.3174\/ajnr.A3642","volume":"35","author":"JS McDonald","year":"2014","unstructured":"McDonald JS, McDonald RJ, Fan J, et al. Comparative effectiveness of ruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coiling. AJNR Am J Neuroradiol. 2014;35(1):164\u20139. https:\/\/doi.org\/10.3174\/ajnr.A3642.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"4","key":"1141_CR25","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1161\/STROKEAHA.111.000196","volume":"44","author":"JS McDonald","year":"2013","unstructured":"McDonald JS, McDonald RJ, Fan J, et al. Comparative effectiveness of unruptured cerebral aneurysm therapies: propensity score analysis of clipping versus coiling. Stroke. 2013;44(4):988\u201394.","journal-title":"Stroke"},{"issue":"3","key":"1141_CR26","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1148\/radiol.13120099","volume":"267","author":"T Becske","year":"2013","unstructured":"Becske T, Kallmes DF, Saatci I, et al. Pipeline for uncoilable or failed aneurysms: results from a multicenter clinical trial. Radiology. 2013;267(3):858\u201368. https:\/\/doi.org\/10.1148\/radiol.13120099.","journal-title":"Radiology"},{"issue":"4","key":"1141_CR27","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1227\/01.NEU.0000339109.98070.65","volume":"64","author":"P Lylyk","year":"2009","unstructured":"Lylyk P, Miranda C, Ceratto R, et al. Curative endovascular reconstruction of cerebral aneurysms with the pipeline embolization device: the Buenos Aires experience. Neurosurgery. 2009;64(4):632\u201342. https:\/\/doi.org\/10.1227\/01.NEU.0000339109.98070.65.","journal-title":"Neurosurgery"},{"issue":"1","key":"1141_CR28","doi-asserted-by":"publisher","first-page":"34","DOI":"10.3174\/ajnr.A2421","volume":"32","author":"PK Nelson","year":"2011","unstructured":"Nelson PK, Lylyk P, Szikora I, et al. The Pipeline embolization device for the intracranial treatment of aneurysms trial. AJNR Am J Neuroradiol. 2011;32(1):34\u201340. https:\/\/doi.org\/10.3174\/ajnr.A2421.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"6","key":"1141_CR29","doi-asserted-by":"publisher","first-page":"1139","DOI":"10.3174\/ajnr.A2023","volume":"31","author":"I Szikora","year":"2010","unstructured":"Szikora I, Berentei Z, Kulcsar Z, et al. Treatment of intracranial aneurysms by functional reconstruction of the parent artery: the Budapest experience with the Pipeline embolization device. AJNR Am J Neuroradiol. 2010;31(6):1139\u201347. https:\/\/doi.org\/10.3174\/ajnr.A2023.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"9","key":"1141_CR30","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1136\/neurintsurg-2019-014815","volume":"11","author":"AS Arthur","year":"2019","unstructured":"Arthur AS, Molyneux A, Coon AL, et al. The safety and effectiveness of the Woven EndoBridge (WEB) system for the treatment of wide-necked bifurcation aneurysms: final 12-month results of the pivotal WEB intrasaccular therapy (WEB-IT) study. J Neurointerv Surg. 2019;11(9):924\u201330. https:\/\/doi.org\/10.1136\/neurintsurg-2019-014815.","journal-title":"J Neurointerv Surg"},{"issue":"5","key":"1141_CR31","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.3171\/2015.2.JNS142634","volume":"124","author":"L Pierot","year":"2016","unstructured":"Pierot L, Costalat V, Moret J, et al. Safety and efficacy of aneurysm treatment with WEB: results of the WEBCAST study. J Neurosurg. 2016;124(5):1250\u20136. https:\/\/doi.org\/10.3171\/2015.2.JNS142634.","journal-title":"J Neurosurg"},{"issue":"6","key":"1141_CR32","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.3174\/ajnr.A5178","volume":"38","author":"L Pierot","year":"2017","unstructured":"Pierot L, Gubucz I, Buhk JH, et al. Safety and efficacy of aneurysm treatment with the WEB: results of the WEBCAST 2 study. AJNR Am J Neuroradiol. 2017;38(6):1151\u20135. https:\/\/doi.org\/10.3174\/ajnr.A5178.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"12","key":"1141_CR33","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1136\/neurintsurg-2016-012841","volume":"9","author":"D Fiorella","year":"2017","unstructured":"Fiorella D, Molyneux A, Coon A, et al. Demographic, procedural and 30-day safety results from the WEB intra-saccular therapy study (WEB-IT). J Neurointerv Surg. 2017;9(12):1191\u20136. https:\/\/doi.org\/10.1136\/neurintsurg-2016-012841.","journal-title":"J Neurointerv Surg"},{"issue":"3","key":"1141_CR34","doi-asserted-by":"publisher","first-page":"173","DOI":"10.5797\/jnet.ra-diverter.2016-0031","volume":"11","author":"C Sakai","year":"2017","unstructured":"Sakai C, Sakai N, Kobayashi S, et al. Guidelines and post-market surveillance of flow diverter for intracranial aneurysms. J Neuroendovasc Ther. 2017;11(3):173\u20139. https:\/\/doi.org\/10.5797\/jnet.ra-diverter.2016-0031.","journal-title":"J Neuroendovasc Ther"},{"issue":"2","key":"1141_CR35","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s12194-022-00660-8","volume":"15","author":"K Chida","year":"2022","unstructured":"Chida K. What are useful methods to reduce occupational radiation exposure among radiological medical workers, especially for interventional radiology personnel? Radiol Phys Technol. 2022;15(2):101\u201315. https:\/\/doi.org\/10.1007\/s12194-022-00660-8.","journal-title":"Radiol Phys Technol"},{"issue":"9","key":"1141_CR36","doi-asserted-by":"publisher","DOI":"10.3390\/s20092741","volume":"20","author":"Y Inaba","year":"2020","unstructured":"Inaba Y, Nakamura M, Zuguchi M, et al. Development of novel real-time radiation systems using 4-channel sensors. Sensors (Basel). 2020;20(9):2741. https:\/\/doi.org\/10.3390\/s20092741.","journal-title":"Sensors (Basel)"},{"issue":"1","key":"1141_CR37","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s12194-008-0044-z","volume":"2","author":"K Chida","year":"2009","unstructured":"Chida K, Inaba Y, Masuyama H, et al. Evaluating the performance of a MOSFET dosimeter at diagnostic X-ray energies for interventional radiology. Radiol Phys Technol. 2009;2(1):58\u201361. https:\/\/doi.org\/10.1007\/s12194-008-0044-z.","journal-title":"Radiol Phys Technol"},{"issue":"12","key":"1141_CR38","doi-asserted-by":"publisher","first-page":"7641","DOI":"10.1002\/mp.15288","volume":"48","author":"T Werncke","year":"2021","unstructured":"Werncke T, Kemling M, Tashenov S, et al. Comparison of a contrast-to-noise ratio-driven exposure control and a regular detector dose-driven exposure control in abdominal imaging in a clinical angiography system. Med Phys. 2021;48(12):7641\u201356. https:\/\/doi.org\/10.1002\/mp.15288.","journal-title":"Med Phys"},{"issue":"5","key":"1141_CR39","doi-asserted-by":"publisher","first-page":"834","DOI":"10.3174\/ajnr.A5585","volume":"39","author":"M S\u00f6derman","year":"2018","unstructured":"S\u00f6derman M, Babic D, Homan R, et al. A patient dose-reduction technique for neuroendovascular image-guided interventions: image-quality comparison study. AJNR Am J Neuroradiol. 2018;39(5):834\u20139. https:\/\/doi.org\/10.3174\/ajnr.A5585.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"2","key":"1141_CR40","doi-asserted-by":"publisher","first-page":"112","DOI":"10.5469\/neuroint.2019.00085","volume":"14","author":"Y Kim","year":"2019","unstructured":"Kim Y, Lee WJ, Park JH, et al. Evaluation of image quality in cerebral angiography. Neurointervention. 2019;14(2):112\u20139. https:\/\/doi.org\/10.5469\/neuroint.2019.00085.","journal-title":"Neurointervention"},{"issue":"3","key":"1141_CR41","doi-asserted-by":"publisher","first-page":"499","DOI":"10.3174\/ajnr.A6425","volume":"41","author":"CM Strother","year":"2020","unstructured":"Strother CM, Bender F, Deuerling-Zheng Y, et al. Image quality of low-dose cerebral angiography. AJNR Am J Neuroradiol. 2020;41(3):499\u2013505. https:\/\/doi.org\/10.3174\/ajnr.A6425.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"8","key":"1141_CR42","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.6009\/jjrt.KJ00000922560","volume":"60","author":"Japan Association on Radiological Protection in Medicine","year":"2004","unstructured":"Japan Association on Radiological Protection in Medicine. The guidelines for avoidance of radiation-induced skin injuries in IVR. Japanese Journal of Radiological Technology. 2004;60(8):1035\u20138. https:\/\/doi.org\/10.6009\/jjrt.KJ00000922560.","journal-title":"Japanese Journal of Radiological Technology"},{"issue":"1","key":"1141_CR43","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1097\/HP.0b013e3182659c72","volume":"104","author":"K Chida","year":"2013","unstructured":"Chida K, Kaga Y, Haga Y, et al. Quality control phantom for flat panel detector X-ray systems. Health Phys. 2013;104(1):97\u2013101. https:\/\/doi.org\/10.1097\/HP.0b013e3182659c72.","journal-title":"Health Phys"},{"issue":"8","key":"1141_CR44","doi-asserted-by":"publisher","first-page":"4504","DOI":"10.1007\/s00330-020-06777-x","volume":"30","author":"R Forbrig","year":"2020","unstructured":"Forbrig R, Ozpeynirci Y, Grasser M, et al. Radiation dose and fluoroscopy time of modern endovascular treatment techniques in patients with saccular unruptured intracranial aneurysms. Eur Radiol. 2020;30(8):4504\u201313. https:\/\/doi.org\/10.1007\/s00330-020-06777-x.","journal-title":"Eur Radiol"},{"issue":"1","key":"1141_CR45","doi-asserted-by":"publisher","first-page":"2025","DOI":"10.5797\/jnet.oa.2025-0046","volume":"19","author":"Y Abe","year":"2025","unstructured":"Abe Y, Fuga M, Ishibashi T, et al. Reduced radiation exposure in treating wide-neck intracranial bifurcation aneurysms: Woven EndoBridge versus stent-assisted coiling. J Neuroendovasc Ther. 2025;19(1):2025\u201346. https:\/\/doi.org\/10.5797\/jnet.oa.2025-0046.","journal-title":"J Neuroendovasc Ther"},{"issue":"3","key":"1141_CR46","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1093\/rpd\/ncz298","volume":"188","author":"S Kawauchi","year":"2020","unstructured":"Kawauchi S, Chida K, Moritake T, et al. Treatment of internal carotid aneurysms using pipeline embolization devices: measuring the radiation dose of the patient and determining the factors affecting it. Radiat Prot Dosim. 2020;188(3):389\u201396. https:\/\/doi.org\/10.1093\/rpd\/ncz298.","journal-title":"Radiat Prot Dosim"},{"issue":"9","key":"1141_CR47","doi-asserted-by":"publisher","first-page":"746","DOI":"10.6009\/jjrt.2015_JSRT_71.9.746","volume":"71","author":"S Kawauchi","year":"2015","unstructured":"Kawauchi S, Moritake T, Hayakawa M, et al. Estimation of maximum entrance skin dose during cerebral angiography. Jpn J Radiol Technol. 2015;71(9):746\u201357. https:\/\/doi.org\/10.6009\/jjrt.2015_JSRT_71.9.746.","journal-title":"Jpn J Radiol Technol"},{"issue":"3","key":"1141_CR48","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y. Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transplant. 2013;48(3):452\u20138. https:\/\/doi.org\/10.1038\/bmt.2012.244.","journal-title":"Bone Marrow Transplant"},{"key":"1141_CR49","unstructured":"European Federation of Organisations for Medical Physics (EFOMP): EFOMP protocol: Quality control of dynamic X-ray imaging systems. Version 01.2024. 2024. Available at: EFOMP Protocol. Accessed Jun 1, 2026."},{"issue":"4","key":"1141_CR50","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1118\/1.2169907","volume":"33","author":"Y Jiang","year":"2006","unstructured":"Jiang Y, Wilson DL. Optimization of detector pixel size for stent visualization in x-ray fluoroscopy. Med Phys. 2006;33(4):1072\u201383. https:\/\/doi.org\/10.1118\/1.2169907.","journal-title":"Med Phys"},{"issue":"6","key":"1141_CR51","doi-asserted-by":"publisher","first-page":"844","DOI":"10.3348\/kjr.2014.15.6.844","volume":"15","author":"CW Chun","year":"2014","unstructured":"Chun CW, Kim BS, Lee CH, et al. Patient radiation dose in diagnostic and interventional procedures for intracranial aneurysms: experience at a single center. Korean J Radiol. 2014;15(6):844\u20139. https:\/\/doi.org\/10.3348\/kjr.2014.15.6.844.","journal-title":"Korean J Radiol"},{"issue":"3","key":"1141_CR52","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1007\/s00234-022-03092-8","volume":"65","author":"M Opitz","year":"2023","unstructured":"Opitz M, Zenk C, Zensen S, et al. Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age. Neuroradiology. 2023;65(3):637\u201344. https:\/\/doi.org\/10.1007\/s00234-022-03092-8.","journal-title":"Neuroradiology"},{"issue":"5","key":"1141_CR53","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1177\/0284185116658682","volume":"58","author":"L Borota","year":"2017","unstructured":"Borota L, Jangland L, \u00c5slund PE, et al. Spot fluoroscopy: a novel innovative approach to reduce radiation dose in neurointerventional procedures. Acta Radiol. 2017;58(5):600\u20138. https:\/\/doi.org\/10.1177\/0284185116658682.","journal-title":"Acta Radiol"},{"key":"1141_CR54","doi-asserted-by":"publisher","unstructured":"International Commission on Radiological Protection. Radiological protection in medicine. ICRP Publication 105. Ann ICRP. 2007;37(6):1\u201363. https:\/\/doi.org\/10.1016\/j.icrp.2008.10.001.","DOI":"10.1016\/j.icrp.2008.10.001"},{"key":"1141_CR55","unstructured":"Japan Network for Research and Information on Medical Exposure (J-RIME), National Diagnostic Reference Levels in Japan (2025) - Japan DRLs 2025-, 2025\u201307, https:\/\/j-rime.qst.go.jp\/report\/JapanDRLs2025_en.pdf. Accessed Nov. 11. 2025."},{"key":"1141_CR56","doi-asserted-by":"publisher","unstructured":"International Commission on Radiological Protection. Diagnostic reference levels in medical imaging. ICRP Publication 135. Ann ICRP. 2017;46(1):1\u2013144. https:\/\/doi.org\/10.1177\/0146645317717209.","DOI":"10.1177\/0146645317717209"},{"issue":"3\u20134","key":"1141_CR57","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1159\/000456622","volume":"6","author":"AE Hassan","year":"2017","unstructured":"Hassan AE, Amelot S. Radiation exposure during neurointerventional procedures in modern biplane angiographic systems: a single-site experience. Interv Neurol. 2017;6(3\u20134):105\u201316. https:\/\/doi.org\/10.1159\/000456622.","journal-title":"Interv Neurol"},{"key":"1141_CR58","doi-asserted-by":"crossref","unstructured":"ICRP. Occupational radiological protection in interventional procedures. ICRP Publication 139. Ann. ICRP. 2018;47(2)1\u2013118.","DOI":"10.1177\/0146645317750356"},{"issue":"1","key":"1141_CR59","doi-asserted-by":"publisher","DOI":"10.3390\/s23010512","volume":"23","author":"K Hattori","year":"2023","unstructured":"Hattori K, Inaba Y, Kato T, et al. Evaluation of a new real-time dosimeter sensor for interventional radiology staff. Sensors (Basel). 2023;23(1):512. https:\/\/doi.org\/10.3390\/s23010512.","journal-title":"Sensors (Basel)"},{"issue":"3","key":"1141_CR60","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6498\/ad6f19","volume":"44","author":"K Sagehashi","year":"2024","unstructured":"Sagehashi K, Haga Y, Takahira S, et al. Evaluation of radiation dose to the lens in interventional cardiology physicians before and after dose limit regulation changes. J Radiol Prot. 2024;44(3):031512. https:\/\/doi.org\/10.1088\/1361-6498\/ad6f19.","journal-title":"J Radiol Prot"},{"key":"1141_CR61","doi-asserted-by":"publisher","unstructured":"ICRP. 2012 ICRP statement on tissue reactions \/ early and late effects of radiation in normal tissues and organs - threshold doses for tissue reactions in a radiation protection context. ICRP Publication 118. Ann. ICRP. 2012;41(1\u20112):1\u2013322. https:\/\/doi.org\/10.1016\/j.icrp.2012.02.001.","DOI":"10.1016\/j.icrp.2012.02.001"},{"issue":"4","key":"1141_CR62","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1093\/jrr\/rraf031","volume":"66","author":"M Fujisawa","year":"2025","unstructured":"Fujisawa M, Haga Y, Takahira S, et al. Development of a headgear-based eye protection device for physicians performing fluoroscopy-guided bronchoscopy. J Radiat Res. 2025;66(4):372\u201384. https:\/\/doi.org\/10.1093\/jrr\/rraf031.","journal-title":"J Radiat Res"},{"issue":"5","key":"1141_CR63","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1093\/jrr\/rraf047","volume":"66","author":"R Shindo","year":"2025","unstructured":"Shindo R, Yamamoto K, Ohno S, et al. Evaluation of radiation protection by lead glasses for interventional radiology physicians wearing prescription glasses: considering dose reduction by prescription glasses excluding lead. J Radiat Res. 2025;66(5):486\u201395. https:\/\/doi.org\/10.1093\/jrr\/rraf047.","journal-title":"J Radiat Res"},{"issue":"4","key":"1141_CR64","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1093\/jrr\/rrae034","volume":"65","author":"S Ohno","year":"2024","unstructured":"Ohno S, Konta S, Shindo R, et al. Effect of backscatter radiation on the occupational eye-lens dose. J Radiat Res. 2024;65(4):450\u20138. https:\/\/doi.org\/10.1093\/jrr\/rrae034.","journal-title":"J Radiat Res"},{"issue":"18","key":"1141_CR65","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13183003","volume":"13","author":"A Yamada","year":"2023","unstructured":"Yamada A, Haga Y, Sota M, et al. Eye lens radiation dose to nurses during cardiac interventional radiology: an initial study. Diagnostics (Basel). 2023;13(18):3003. https:\/\/doi.org\/10.3390\/diagnostics13183003.","journal-title":"Diagnostics (Basel)"},{"issue":"1","key":"1141_CR66","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1007\/s12194-022-00650-w","volume":"15","author":"H Ishii","year":"2022","unstructured":"Ishii H, Chida K, Satsurai K, et al. Occupational eye dose correlation with neck dose and patient-related quantities in interventional cardiology procedures. Radiol Phys Technol. 2022;15(1):54\u201362. https:\/\/doi.org\/10.1007\/s12194-022-00650-w.","journal-title":"Radiol Phys Technol"},{"issue":"6","key":"1141_CR67","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1007\/s00234-002-0780-4","volume":"44","author":"GJ Kemerink","year":"2002","unstructured":"Kemerink GJ, Frantzen MJ, Oei K, et al. Patient and occupational dose in neurointerventional procedures. Neuroradiology. 2002;44(6):522\u20138. https:\/\/doi.org\/10.1007\/s00234-002-0780-4.","journal-title":"Neuroradiology"}],"container-title":["Radiological Physics and Technology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12194-026-01141-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12194-026-01141-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12194-026-01141-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:04:37Z","timestamp":1793916277000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12194-026-01141-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,29]]},"references-count":67,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["1141"],"URL":"https:\/\/doi.org\/10.1007\/s12194-026-01141-y","relation":{},"ISSN":["1865-0333","1865-0341"],"issn-type":[{"value":"1865-0333","type":"print"},{"value":"1865-0341","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,29]]},"assertion":[{"value":"30 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 September 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflicts of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of Yamagata City Hospital Saiseikan (approval number: 506\u2013026).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The requirement for informed consent was waived because of the retrospective nature of this study.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}}]}}