Patient Radiation Dose Research Articles

OPTIMIZATION OF EXPOSURE FACTORS WITH VARIATION OF FILTER THICKNESS ON DOSE VALUES AND RADIOGRAPHIC IMAGE QUALITY IN PELVIS EXAMINATION

This study examines the impact of varying X-ray tube voltage (kV) and filter thickness on patient radiation dose and image quality in radiographic procedures. It aims to optimize exposure factors to minimize patient dose while maintaining diagnostic image quality, contributing to safer and more efficient radiological practices. This quantitative experimental study investigates the impact of varying filter thickness and tube voltage on patient radiation dose. Using X-ray equipment, dosimeters, and phantoms, measurements of Incident Air Kerma (INAK) and Entrance Surface Air Kerma (ESAK) and effective dose are taken, followed by image quality assessments to optimize exposure factors while maintaining diagnostic efficacy. The study demonstrated that increasing filter thickness decreases both INAK and ESAK values, with the most significant dose reduction occurring at 2 mm thickness. Optimal image quality and effective dose reduction were observed with the 1 mm filter at 80 kV, reducing the dose by 14.3% to 20% while maintaining good spatial resolution and contrast. The study concludes that using a 1 mm aluminum filter with 80 kV significantly reduces the effective dose while maintaining image quality. It is recommended that hospitals adopt additional filters, conduct further research with different materials, and optimize exposure factors. Training for radiology technicians on these practices is essential to enhance patient safety and image quality. Keywords: X-ray Equipment, Entrance Surface Air Kerma, Effective Dose, Image Quality.

BEST PRACTICE FOR OPTIMIZATION AND RADIATION SAFETY IN THE CARDIOVASCULAR CATHETERIZATION ROOM (CATHLAB) OF SENTRA MEDIKA CIBINONG HOSPITAL

Scattered radiation generated during fluoroscopy increases the potential for patients and staff to receive radiation doses, so it is necessary to take optimization steps for radiation safety to minimize the risk of exposure to scattered X-ray radiation. This study aims to implement radiation protection in cardiac and vascular catheterization laboratories and summarize best practices for implementing efforts to minimize radiation exposure. The method used was qualitative and quantitative from 2023 to 2024; with this qualitative approach, the supervision activities in TLD badges for radiation workers, the level of diagnostic guidance for patients, and the use of radiation protection equipment were observed. For the quantitative approach, measuring the dose rate was carried out, and optimizing the positioning of the distance between the patient's table and the radiation source was carried out by direct measurement. Based on research data, the observation results obtained that the apron is still by the minimum thickness, which is 0.35-0.5 mm Pb for intervention, the results of exposure tests around the cathlab room are around 0.08-0.12 μSv/hour still below the dose constraint value, Mapping the rate of exposure in the work area during the intervention procedure obtained an optimal safe distance of around 60-70 cm from the X-ray tube. The setup of the effective distance position for intervention patients is at a distance of 80 cm from the X-ray tube to the patient table, which can reduce the absorbed dose to the patient by around 30%, the use of low dose mode (7.5 fps) with pulsed fluoroscopy during the intervention obtained the absorbed dose received by the patient reduced by 70-72% for PCI procedures and 25-29% for the type of CAG procedure. It is hoped that the protocol that uses this best practice can minimize the risk of exposure to scattered radiation and optimize medical exposure. Keywords: cathlab, best practices radiation protection, dose rate, radiation exposure, patient radiation dose.

CT surveillance for type 1 autoimmune pancreatitis: cumulative radiation dose and diagnostic performance for disease relapse.

Long-term follow-up is essential for type 1 autoimmune pancreatitis (AIP) patients due to high relapse rates. The cumulative radiation dose from repeated CT scans during follow-up should not be ignored. We aim to investigate the cumulative radiation dose in AIP patients undergoing CT surveillance and the diagnostic performance of CT in detecting disease relapse. The diagnostic performance of MRI from a secondary cohort during the same period was also investigated. This retrospective single-institutional study included 247 type 1 AIP patients with one or more follow-up CT scans, and 120 patients with MR follow-ups. Four metrics were utilized to report the radiation dose, including the volume computed tomography dose index, the dose length product, size-specific dose estimate and effective dose. The diagnostic performance for AIP relapse was assessed, taking the final clinical diagnosis in retrospect as the reference standard. With a median 2.3-year follow-up period, AIP patients followed up with CT exhibited a median cumulative radiation dose of 37.5 mSv. 11.3% of patients have accumulated doses exceeding 100 mSv. For the 169 patients followed over a year, 30.8% sustained an average annual radiation dose surpassing 20 mSv. The sensitivity/specificity/accuracy of CT for detecting abdominal organ relapse was 64.1%/99.6%/97.0%. For AIP patients followed up with MRI, the sensitivity for detecting disease relapse was 90.5%. Considering the accumulation of radiation dose in AIP patients and the insufficient sensitivity in detecting disease relapse with CT, safer and more sensitive imaging follow-up strategies should be explored. Question CT, as the primary imaging modality for autoimmune pancreatitis (AIP) follow-up, raises concerns regarding radiation exposure and lacks reported diagnostic performance in detecting AIP relapse. Findings CT in AIP follow-up causes significant cumulative radiation exposure and exhibits insufficient sensitivity in relapse detection. Clinical relevance Type 1 AIP necessitates long-term imaging follow-up, yet current guidelines lack consensus regarding the prioritization of CT or MRI for such follow-up. CT is widely used but has radiation concerns and limited sensitivity, calling for safer, efficient strategies.

Exploring the Relationship Between Radiation-Induced Moya Moya Syndrome and Radiation Dose for Pediatric Patients Treated with Proton Radiation Therapy: Moya Moya in Peds Patients After Proton RT.

The incidence and risk factors associated with radiation-induced Moya-Moya Syndrome (RIMMS) in pediatric brain tumor patients treated with proton radiotherapy (PRT) remain poorly understood. The objective of this study was to determine the incidence of RIMMS in the setting of CNS proton radiotherapy (PRT) in a pediatric cohort and assess its relationship with dose to the Circle of Willis (COW) or optic chiasm (OC). We performed a retrospective review of pediatric brain tumor patient treated with intracranial PRT (1995-2021). The exposure of interest was mean dose to the optic chiasm due to close proximity to the COW vasculature. Wilcoxon rank-sum test was used to determine the association between OC dose and RIMMS. Univariable logistic regression modeling was used to determine the odds of developing RIMMS based on a cutpoint of 52Gy. Of 676 patients, 14 developed RIMMS, with a median onset of 1.9 years. The cumulative incidence of RIMMS at 8 years was 2.4%. Patients with RIMMS had higher mean OC dose than those without (51.5 Gy vs 23.7 Gy, p<0.0001). Univariable logistic regression showed patients with an OC dose > 52 Gy had increased RIMMS risk compared to those with dose < 52 Gy (OR = 9.9, p<0.001). The incidence of RIMMS remains low in our primarily proton-treated pediatric cohort with a cumulative incidence of 2.4% over 8 years and is similar to photon-treated cohorts. Development of RIMMS was associated with higher doses to the COW and OC.

Twelve-month outcome of robotic assisted PCI

Abstract Background Robotics in interventional cardiology (R-PCI) is a technique with high potential for optimising the outcome of patients with coronary heart disease. In order to compare R-PCI with conventional, manual PCI (M-PCI), it is necessary to analyse both the index procedure during the initial hospital stay and, in particular, the long-term outcome. Methods We report twelve-month follow up data of our prospective FRiK registry, started in mid 2021. This registry focuses on success rates and safety, radiation dose of patients and personnel as well as long-term outcome (after 6 and 12 months). Moreover, R-PCI is compared with M-PCI in these categories. Results 73 patients received R-PCI. PCI success rate was 100%, with 17.8% requiring manual assistance. Rate of complications (MACE - major adverse cardiovascular events) was 0%. Compared with 152 M-PCI patients, treated by the same interventionalists, there was a higher median procedural time (diagnostic and intervention) 102.5 (82.8-123.5) min vs. 73 (51-101.5) (p&amp;lt;0.001) and fluoroscopy time 18.3 (14.4-26.6) min vs. 16.2 (9.8-23.4) min (p=0.037) in R-PCI patients. However, there was no significant difference between the dose-area product 4062 (2337-5990) cGycm² vs. 3747 (2238-5904) cGycm² (p=0.878) and contrast volume use 180 (140-250) ml vs. 180 (135-235) ml (p=0.370, figure 1). Twelve months after the intervention, all patients in both groups were alive. R-PCI and M-PCI had comparable rates of rehospitalisation (11.4% vs. 8.1%, p=0.903) and unscheduled PCI (4.3% vs. 2.7%, p=0.932, figure 2). Target vessel failure occurred in one vs. two patients in the R-PCI and M-PCI group, respectively (1.4% vs. 1.3%, p=0.932). Conclusion R-PCI showed a high success rate, low rates for need of manual assistance, and a very high safety profile without any complications. Also at 12-month follow-up, R-PCI was comparable to the M-PCI in all categories.Comparison of procedural characteristicsComparison of twelve-month outcome

Optimisation of cone beam CT radiotherapy imaging protocols using a novel 3D printed head and neck anthropomorphic phantom

Objective.This study aimed to optimise Cone Beam Computed Tomography (CBCT) protocols for head and neck (H&N) radiotherapy treatments using a 3D printed anthropomorphic phantom. It focused on precise patient positioning in conventional treatment and adaptive radiotherapy (ART).Approach.Ten CBCT protocols were evaluated with the 3D-printed H&N anthropomorphic phantom, including one baseline protocol currently used at our centre and nine new protocols. Adjustments were made to milliamperage and exposure time to explore their impact on radiation dose and image quality. Additionally, the effect on image quality of varying the scatter correction parameter for each of the protocols was assessed. Each protocol was compared against a reference CT scan. Usability was assessed by three Clinical Scientists using a Likert scale, and statistical validation was performed on the findings.Main results. The work revealed variability in the effectiveness of protocols. Protocols optimised for lower radiation exposure maintained sufficient image quality for patient setup in a conventional radiotherapy pathway, suggesting the potential for reducing patient radiation dose by over 50% without compromising efficacy. Optimising ART protocols involves balancing accuracy across brain, bone, and soft tissue, as no single protocol or scatter correction parameter achieves optimal results for all simultaneously.Significance.This study underscores the importance of optimising CBCT protocols in H&N radiotherapy. Our findings highlight the potential to maintain the usability of CBCT for bony registration in patient setup while significantly reducing the radiation dose, emphasizing the significance of optimising imaging protocols for the task in hand (registering to soft tissue or bone) and aligning with the as low as reasonably achievable principle. More studies are needed to assess these protocols for ART, including CBCT dose measurements and CT comparisons. Furthermore, the novel 3D printed anthropomorphic phantom demonstrated to be a useful tool when optimising CBCT protocols.

Establishing Local Diagnostic Reference Levels for Head Computed Tomography Examinations

Background/Objectives: Head Computed Tomography (CT) is an essential diagnostic tool for identifying brain pathologies and visualizing blood vessels. However, CT exposes patients to ionizing radiation, making it necessary to establish local diagnostic reference levels (DRLs) to ensure patient safety. This study aimed to establish DRLs for head CT scans and assess the influence of patient characteristics on radiation dose. Methods: A retrospective analysis was conducted on 2043 non-contrast and 488 contrast-enhanced head CT scans performed between 1 July 2023 and 31 March 2024 using a SIEMENS SOMATOM Definition Edge machine. Computed Tomography Dose Index (CTDIvol) and Dose-Length Product (DLP) values were analyzed, with DRLs set at the 75th percentile. The influence of gender, height, and weight on radiation dose was also evaluated. Results: The DRL for both non-contrast and contrast-enhanced scans was 58.18 mGy for CTDIvol and 1018.11 mGy·cm for DLP per acquisition. Total DLP was 2046.09 mGy·cm for contrast-enhanced and 1027.99 mGy·cm for non-contrast scans. No significant correlation was found between patient characteristics and radiation dose, allowing for a uniform DRL to be established. Conclusions: Uniform DRLs were successfully established for head CT scans, ensuring safe radiation doses for both non-contrast and contrast-enhanced studies. The lack of correlation between patient-specific factors and dose supports the use of standardized DRLs, contributing to optimized radiation safety in head CT diagnostics.

Evaluation of automatic tube current modulation in a CT scanner using a customised homogeneous phantom

Objective.The introduction of automatic tube current modulation (ATCM) has resulted in complex relationships between scanner parameters, patient body habitus, radiation dose, and image quality. ATCM adjusts tube current based on x-ray attenuation variations in the scan region, and overall patient dose depends on a combination of factors. This work aims to develop mathematical models that predict CT radiation dose and image noise in terms of attenuating diameter and all relevant scanner parameters.Approach.A homogenous phantom, equipped with the features to conduct discrete and continuous adaption tests, was developed to model ATCM in a Philips CT scanner. Scanner parameters were varied based on theoretical dose relationships, and a MATLAB script was developed to extract data from DICOM images. R statistical software was employed for data analysis, plotting, and regression modelling.Main Results.Phantom data provided the following insights: Median tube current decreased by 81% as tube potential varied from 80 kVp to 140 kVp. Doubling the DoseRight Index (DRI) from 12 to 24, at 24 cm diameter, produced a 294% increase in mA and a 46% decrease in noise. Mean mA increased by 53% whilst mean noise increased by 5.7% as helical pitch increased from 0.6 to 0.925. Changing rotation time from 0.33s to 0.75s gave a 56% reduction in mean mA and no change in image noise. Increasing detector collimation (n×T) resulted in higher tube currents and lower output image noise values, asnandTwere varied independently. Interpreting these results to apply transformations relevant to each independent variable produced models for tube current and noise with adjusted R-squared values of 0.965 and 0.912, respectively.Significance.The models developed more accurately predict radiation dose and image quality for specific patients and scanner settings. They provide imaging professionals with a practical tool to optimize scan protocols according to patient diameters and clinical objectives.

Diagnostic reference levels for the city of Moscow during X-ray examinations

Diagnostic reference levels are one of the effective tools for optimizing patient radiation doses in diagnostic radiology. The staff of domestic radiology departments does not have an understanding of the development process and use of diagnostic reference levels during X-ray examinations, although this tool is a generally accepted in practice abroad. The article shows the experience of forming regional diagnostic reference levels based on measurements provided by the accredited testing laboratory of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department. The diagnostic reference levels for radiography in Moscow were developed for eight of the most common types of examinations based on the operation of 216 digital X-ray machines. The resulting levels, expressed in the dose-area product (cGy-cm2) and effective dose (mSv), were compared with the local diagnostic reference levels for the Ryazan region, Russia, and national diagnostic reference levels for other countries. The analysis showed continuity in the values. Some types of studies have been optimized. The developed diagnostic reference levels are the quality performance indicators foe diagnostic radiology departments and will be used to optimize a patient radiation dose during diagnostic studies in Moscow.

Institutional Variation in Patient Radiation Doses During Transcatheter Valve Interventions: A Statewide Experience

BackgroundLittle is known about institutional radiation doses during transcatheter valve interventions. ObjectivesThe authors sought to evaluate institutional variability in radiation doses during transcatheter valve interventions. MethodsUsing a large statewide registry, transcatheter edge-to-edge mitral valve repair, transcatheter mitral valve replacement, and transcatheter aortic valve replacement procedures between January 1, 2020, and December 31, 2022, with an air kerma (AK) recorded were analyzed. Patient and procedural characteristics were compared between cases with AK ≥2 and <2 Gy. Associations of variables with AK ≥2 Gy were investigated using Bayesian random effects modeling and median ORs for the performing hospital. ResultsAmong 9,446 procedures across 30 hospitals, median (Q1-Q3) procedural AK was 0.592 Gy (0.348-0.989 Gy) with AK ≥2 Gy in 533 cases (5.6%). Wide variation in procedural AK was observed, with an institutional frequency of AK ≥2 Gy ranging from 0.0% to 29.5%. Bayesian modeling identified the performing hospital as more strongly associated with the odds of a procedural AK ≥2 Gy than any patient or procedural factors (hospital median OR: 3.54 [95% credible interval: 2.52-16.66]). ConclusionsIn a large, multicenter state-wide registry, there is wide institutional variability in patient-level radiation doses during transcatheter valve interventions, with the performing hospital having a higher odds of an AK ≥2 Gy than any patient or procedural factors. Future interventions are warranted to reduce procedural-related variation in radiation exposure.

S668 FLIP Distensibility Index Correlates With Radiation Dose in Cancer Patients With Radiation Exposure and Dysphagia

S668 FLIP Distensibility Index Correlates With Radiation Dose in Cancer Patients With Radiation Exposure and Dysphagia

429 - Early Radiation Dose Warning System Improves Patient Safety And Radiation Dose Optimization In Neuro Interventional Procedures At Professor Ngoerah Public Hospital, Bali, Indonesia

429 - Early Radiation Dose Warning System Improves Patient Safety And Radiation Dose Optimization In Neuro Interventional Procedures At Professor Ngoerah Public Hospital, Bali, Indonesia

Effects of Head and Neck Cancer Radiotherapy on Cricothyroid Membrane Related Dimensions.

Radiation treatment can modify soft tissue dynamics depending on the extent and location of irradiation. We hypothesized that head and neck radiotherapy caused alterations in cricothyroid membrane (CTM) related dimensions. Primary objective was to evaluate changes in the cricothyroid membrane height (CTMH) and skin-to-CTM distance (STCD) in patients who underwent radiation treatment for head and neck cancers. Pre- and post-head-and-neck cancer-radiated computed tomography (CT) scans were analyzed retrospectively. The patients' demographics (age, sex, body mass index, cancer location), radiation dose and laterality, time from radiation initiation to CT scan assessments were summarized. CTMH and STCD were measured from pre-and post-radiation CT scans. Pre- and post-radiation comparisons were conducted using a paired t-test, or Wilcoxon signed-rank test if more appropriate. Chi-squared or Fisher's Exact test were used for categorical variables. Among 231 study patients, who underwent head and neck radiotherapy in our institution 73.2% were males, and the median age of total population was 66years (31-93). The median BMI was 25.2kg/m2 (13.8-47.2). The median time from first radiation dose to CT scan assessment was 29.5months (2-115).The median pre- and post-radiation CTMH were 8.7mm (3-16.2) and 7.5mm (3.1-14.3) respectively. The median pre- and post-radiation STCD were 11.7mm (2.9-71.1) and 10.2mm (3.9-38) respectively. In summary our patient population had significant reduction of cricothyroid membrane related dimensions following head-and-neck radiotherapy, which can limit the localization of the cricothyroid membrane. Retrospective cohort study.

TCT-554 Patient Radiation Dose During Bifurcation Percutaneous Coronary Intervention

TCT-554 Patient Radiation Dose During Bifurcation Percutaneous Coronary Intervention

Evaluation of X-ray Beam Collimation in Adult Chest Radiography.

Restricting the irradiated volume can reduce X-ray scattering incidents on the image receptor. Proper X-ray collimation during medical imaging reduces a patient's dose while improving image quality. Even though the patient radiation dose due to chest X-ray imaging is low, the 'as low as reasonably achievable' (ALARA) principle should be satisfied, especially for young patients. To evaluate the accuracy of collimation in digital chest radiography. Ninety-eight chest radiographs were studied retrospectively from February 2021 to December 2021. Chest images were collected from three main centers in the Madinah region of Saudi Arabia. The ratio of the field of interest area to the field of view (FOV) was measured and calculated to determine the accuracy of X-ray beam collimation. Out of 98 chest radiographs enrolled in the study, 87.8% (n=80) were adequately collimated, while 12.2% (n=18) were rejected due to inadequate collimation. The ratio of the field of interest collimated area of chest radiographs was 0.547, which indicated an acceptable value. Among the three centers, Center 2 showed higher, significant, adequate collimation than Center 1 (P<0.001) and Center 3 (P=0.007). There was a significant gender difference in collimation levelsas the level of collimation of female chest radiographs is inferior to that of males (P>0.001). The collimation of chest radiographs among the three centers was adequate. Based on the study findings, the X-ray beam collimation was sufficient, indicating good optimization and no unnecessary radiation exposure to patients and staff. The collimation of chest radiographs in females was significantly inferior to that of males.

How Effective is Deep Inspiration Breath Hold in Minimizing Cardiac Doses During Hybrid Radiotherapy Treatment for Left-Sided Breast Cancer with Comprehensive Regional Nodes?

In the context of left breast cancer radiotherapy, long term cardiopulmonary toxicity has been well-documented, significant efforts have been undertaken to mitigate such toxicity by using 4D gating, deep inspiration breath-hold(DIBH) and active breath control(ABC) techniques. To evaluate and compare the cardio-pulmonary radiation doses incurred during postmastectomy radiotherapy (PMRT) in two distinct breathing conditions such as DIBH and Free Breathing (FB), with a specific focus on the left chest wall with comprehensive regional nodal irradiation. A prospective dosimetric study was conducted on 15 patients who received adjuvant loco-regional radiotherapy of chest-wall (CW), supraclavicular fossa(SCF), and internal mammary region(IMC), with or without axilla. Two sets of planning CT scans were taken in DIBH and FB conditions. The dosimetric difference between DIBH CT and FB CT plans analyzed using Wilcoxon signed-rank test, employing SPSS software version 21.0. Comparison of DIBH and FB parameters for target coverage revealed a statistically significant advantage with DIBH in SCF(D95, V90, p<0.017) and IMC(D98, V90 & V95, p<0.03). Dosimetric characteristics of heart and LAD exhibited statistically significant lower doses with DIBH (V20, V25, and Dmean, p<0.001) compared to FB plans. Lung doses were similar with no discernible advantage of one technique over the other. Other OARs such as contralateral breast (p=0.027) and esophagus (p=0.001) received lower doses with the DIBH technique while the spinal cord (p=0.691) and thyroid(p=0.496) showed no significant difference. Maximum heart distance (p= 0.001), central lung distance (p= 0.011) and Haller index (p= 0.001) exhibited statistical significance between the two techniques, whereas chest wall separation showed no significant statistical difference (p=0.629). DIBH demonstrates a substantial reduction in cardiac and LAD doses compared to the FB technique. This study underscores the efficacy of DIBH as a viable strategy for mitigating cardiac and LAD radiation doses in left-sided breast cancer patients undergoing PMRT of chest wall with comprehensive regional nodes.

Multi-centre digital radiography reject analysis for different clinical room use types: The establishment of local reject reference levels for public hospital departments.

Reject analysis in digital radiography helps guide the training of staff to reduce patient radiation dose and improve department efficiency. The purpose of this study was to perform a multi-centre, vendor agnostic reject analysis across different room usage types, and to provide benchmarks for comparison. Retrospective reject and exposure log data were collected via USB from fixed general X-ray systems across multiple Australian sites, for collation and analysis. The overall reject rate, local reject reference level, absolute and relative reject rates for body part categories, reject rates by room usage types and the reject rate for each reason of rejection were calculated. Data were collected from 44 X-ray systems, across 11 hospitals. A total of 2,031,713 acquired images and 172,495 rejected images were included. The median reject rate was 9.1%. The local reject reference level (LRRL), set as the 75th percentile of all reject rates, was 10.6%. Median reject rates by room type were emergency (7.4%), inpatients + outpatients (9.6%), outpatients (9.2%), and hybrid (10.1%). The highest absolute reject rates by body part were chest (2.1%) and knee (1.4%). The highest relative rates by body part were knee (18.1%) and pelvis (17.2%). The most frequent reasons for image rejection were patient positioning (76%) and patient motion (7.5%). The results compare well with previously published data. The range of reject rates highlights the need to analyse typical reject rates in different ways. With analysis feedback to participating sites and the implementation of standardised reject reasons, future analysis should monitor whether reject rates reduce.

2058: prospective correlation research on shoulder radiation dose and impairment in breast cancer patients

2058: prospective correlation research on shoulder radiation dose and impairment in breast cancer patients

Comparative study of image quality and radiation dose in thoracic-abdominal-pelvic CT Enhancement with different tube voltages and reconstruction algorithms

ObjectivesTo evaluate the image quality and radiation dose in thoracic-abdominal-pelvic computed tomography enhancement using ATVM (Automatic Tube Voltage Modulation)coupled with AIIR versus routine tube voltage combined with Karl-3D IR. The optimal noise level for the AIIR in thoracic-abdominal-pelvic CT enhancement was also determined. MethodsGroup A was scanned using ATVM, and images were reconstructed using AIIR with 1–5 noise levels. Group B was scanned and reconstructed using the fixed tube voltage (120 kVp) combined with Karl 3D level 5 IR. The image quality of the reconstructed images of AIIR with 1–5 noise levels were compared and the best image reconstruction noise level for AIIR was preferred. Image quality and radiation dose were statistically analyzed for group A (best image reconstruction noise level for AIIR) and group B. ResultsAIIR level 3 is the optimal noise level for CT-enhanced image reconstruction of the thorax, abdomen, and pelvis. The mean SNR, CNR, and subjective evaluation of AIIR level 3 Group A images were better than those of Karl 3D level 5 Group B images (p < 0.05). The mean SSDE and the mean ED of the AIIR Group A patients were reduced by 46% and 41%, respectively, compared with those of Group B. ConclusionsATVM technology combined with the AIIR algorithm improved image quality and reduced patient radiation dose in thoracic-abdominal-pelvic CT scans. The optimal noise level for the reconstruction of high-quality arterial and venous-phase images was AIIR level 3.

One-year outcome of robotical vs. manual percutaneous coronary intervention.

Robotic-assisted percutaneous coronary intervention (R-PCI) is a promising technology for optimizing the treatment of patients with coronary heart disease. For a better understanding of the potential of R-PCI in clinical routine compared to conventional manual PCI (M-PCI) both initial treatment success of the index procedure and long-term outcome have to be analysed. Prospective evaluation from the FRiK (DRKS00023868) registry of all R-PCI cases with the CorPath GRX Cardiology by Siemens Healthineers and Corindus in the Freiburg University Heart Center between 04/2022 and 03/2023. Index procedure success and safety, radiation dose of patients and personnel, and 1-year outcome will be reported. Findings will be compared to a prospective control group of M-PCI patients treated by the same team of interventionalists during the same observation period. Seventy patients received R-PCI and were included in the registry. PCI success rate was 100%, with 19% requiring manual assistance. No complications (MACE-major adverse cardiovascular events) occurred. Compared with 70 matched-pair M-PCI patients, there was a higher median procedural time (103min vs. 67min, p < 0.001) and fluoroscopy time (18min vs. 15min, p = 0.002), and more contrast volume was used (180 ml vs. 160ml, p = 0.041) in R-PCI vs. M-PCI patients. However, there was no significant difference of the dose-area product (4062 vs. 3242 cGycm2, p = 0.361). One year after the intervention, there was no difference in mortality, rehospitalisation, unscheduled PCI or target vessel failure. Health-related quality of life evaluation 6 and 12months after the index procedure (NYHA, CCS, SAQ7 and EQ-5D-5L) was similar in both groups. R-PCI is feasible and safe. Compared to M-PCI, index procedure success rate is high, safety profile is favourable, and manual assistance was required in only few cases. At 1-year follow-up results for R-PCI vs. M-PCI considering mortality, rehospitalisation, morbidity and target vessel failure were equal.