Digital Variance Angiography Reduces Radiation Exposure in Interventional Radiology

In a significant advancement for patient safety, researchers from the University of Freiburg in Germany have demonstrated that digital variance angiography (DVA) can substantially reduce radiation exposure during interventional radiology procedures. Their findings, published on July 9, 2025, in the journal *Scientific Reports*, reveal that DVA not only lowers radiation doses but also enhances image quality, thus providing a dual benefit in endovascular peripheral interventions (EPIs).

The study involved a comparison between DVA and traditional angiography methods among patients undergoing treatment for narrowed or blocked arteries in the lower extremities. Lead author Dr. Till Schürmann, a radiologist at the University of Freiburg, noted that "DVA reveals significant radiation dose reduction in lower extremity EPIs and enhances image contrast while decreasing noise." Specifically, the overall dose area product (DAP) for patients undergoing DVA was significantly lower than that for those receiving conventional angiography techniques.

According to the study, the DAP in the pelvic region dropped from 3238.6 cGy·cm² to 1230.4 cGy·cm², while in the femoral and popliteal regions, it fell from 1190.9 cGy·cm² to 550.8 cGy·cm². In the cruropedal regions, the DAP decreased from 827.6 cGy·cm² to 336.0 cGy·cm². Furthermore, median contrast-to-noise ratios (CNRs) improved from 8.8 to 14.4 in pelvic regions, 6.9 to 17.8 in femoral and popliteal regions, and 7.8 to 17.3 in cruropedal regions, indicating a marked enhancement in image quality.

DVA employs an innovative motion-based x-ray imaging technique that utilizes advanced software to visualize the distribution of iodinated contrast medium (ICM) in the vascular system. This method allows for lower doses of ICM, making it particularly advantageous during standard angiography examinations. The implications of this technology extend beyond mere radiation reduction; as noted by Dr. Schürmann, "DVA can significantly reduce (stochastic) health risk effects of radiation exposure for both patients and staff performing endovascular peripheral interventions."

This study adds to a growing body of evidence supporting the adoption of DVA in clinical practice. However, the researchers acknowledged a limitation in their methodology, stating that the evaluation of image quality was conducted objectively through CNR calculations, rather than through subjective qualitative assessments. They suggest that future studies should incorporate subjective evaluations to provide a more comprehensive understanding of image quality from a clinical perspective.

The potential for DVA to enhance patient safety while improving diagnostic imaging quality positions it as a valuable tool in interventional radiology. As healthcare continues to evolve with technological advancements, the integration of such innovative techniques may lead to safer and more effective treatment options for patients with vascular conditions.

In summary, the adoption of digital variance angiography represents a promising evolution in interventional radiology practices, addressing the critical need to minimize radiation exposure without compromising diagnostic efficacy. As further research validates these findings, medical institutions may increasingly incorporate DVA into their imaging protocols, paving the way for safer patient care in the future.