Patient radiation dose reduction using an X-ray imaging noise reduction technology for cardiac angiography and intervention.

Abstract

Coronary angiography and intervention can expose patients to high radiation dose. This retrospective study quantifies the patient dose reduction due to the introduction of a novel X-ray imaging noise reduction technology using advanced real-time image noise reduction algorithms and optimized acquisition chain for fluoroscopy and exposure in interventional cardiology. Patient, procedure and radiation dose data were retrospectively collected in the period August 2012-August 2013 for 883 patients treated with the image noise reduction technology (referred as "new system"). The same data were collected for 1083 patients in the period April 2011-July 2012 with a system using state-of-the-art image processing and reference acquisition chain (referred as "reference system"). Procedures were divided into diagnostic (CAG) and intervention (PCI). Acquisition parameters such as fluoroscopy time, volume of contrast medium, number of exposure images and number of stored fluoroscopy images were collected to classify procedure complexity. The procedural dose reduction was investigated separately for three main cardiologists. The new system provides significant dose reduction compared to the reference system. Median DAP values decreased for all procedures (p<0.0001) from 172.7 to 59.4Gycm(2), for CAG from 155.1 to 52.0Gycm(2) and for PCI from 229.0 to 85.8Gycm(2) with reduction quantified at 66, 66 and 63%, respectively. Based on median values, the dose reduction for all procedures was 68, 60 and 67% for cardiologists 1, 2 and 3, respectively. The X-ray imaging technology combining advanced real-time image noise reduction algorithms and anatomy-specific optimized fluoroscopy and cine acquisition chain provides 66% patient dose reduction in interventional cardiology.