Visual grading characteristics (VGC) analysis of uterine artery embolisation (UAE) image quality assessment by interventional radiologists and interventional radiographers

The purpose of this study was to investigate the performance of interventional radiologists and interventional radiographers in assessing the image quality of radiation dose optimised digital subtraction angiography (DSA) runs acquired during uterine artery embolisation (UAE) procedures. Visual grading characteristics (VGC) analysis was used to assess image quality, by comparing Group A (where UAE radiation dose was optimised; n = 50) with a reference Group B (control group not optimised; n = 50). The centre optimised radiation dose parameters for UAE procedures based on empirical and theoretical evidence to attain radiation dose reduction. Four interventional radiologists and four interventional radiographers rated the image quality of 20 randomised DSA runs using a five-point rating scale. The VGC analysis resulted in an area under the VGC curve (AUCVGC) of 0.52 for interventional radiologists (P = 0.83) and 0.55 for interventional radiographers (P = 0.61). Mann-Whitney U tests indicated no significant difference in the evaluation of image quality between the two groups of observers ( P > 0.05). The optimisation of radiation dose parameters demonstrated a reduction in kerma-area product (KAP) by 17% (P = 0.041, d = 0.2) and reference air kerma (Ka, r) by 20% (P = 0.027, d = 0.2) between Group A and Group B. Hence, radiation dose reduction revealed no effect on image quality assessments by two different groups of observers that are involved with UAE procedures.