title: Three-dimensional rotational X-ray acquisition technique is reducing patients' cancer risk in coronary angiography.
abstract: OBJECTIVE
  The purpose of this study was to assess patient-specific organ doses and cancer risk with 3D-rotational acquisitions versus the current standard of multiple single-plane coronary angiography (CA).
  
  
  BACKGROUND
  Catheter-based CA remains one of the most commonly performed diagnostic invasive procedures delivering a relatively high radiation dose to the patient. With the introduction of flat-panel technology, three-dimensional rotational angiography became an alternative for the conventional two-dimensional angiography. However, limited information is available on the difference in patient radiation exposure with both acquisition techniques.
  
  
  METHODS
  Eighty adult patients (45 males, age 38-93 years) were randomly assigned to the rotational or standard angiography group. Exposure parameters were registered and skin dose distribution was measured during the procedure. Patient-specific organ doses and related cancer risks were assessed with dedicated software.
  
  
  RESULTS
  Rotational angiograms were associated with 33% lower KAP-values (decrease from 49.99 Gycm(2) to 33.37 Gycm(2), P < 0.001). A significant (P < 0.001) lower peak skin dose was measured with rotational acquisitions (80 mGy, median) versus planar imaging (172 mGy, median). Moreover, the skin dose was smoothed over the whole chest of the patient. Contrast medium consumption decreased from 104 mL to 73 mL (P < 0.001) with the use of 3D-imaging. The reduction in radiation exposure resulted in a corresponding decrease of organ doses. The latter contributed to an overall cancer risk reduction of 21% for males and 50% for females.
  
  
  CONCLUSIONS
  The current study demonstrates that in CA radiation risk reduction is feasible by using a rotational acquisition technique.
authors: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors: Liesbeth
authors: L
authors: Eloot
authors: Klaus
authors: K
authors: Bacher
authors: Femke
authors: F
authors: Steenbeke
authors: Benny
authors: B
authors: Drieghe
authors: Peter
authors: P
authors: Gheeraert
authors: Yves
authors: Y
authors: Taeymans
authors: Hubert
authors: H
authors: Thierens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002932:Cineangiography / Q000009:adverse effects / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology / Q000517:prevention & control; D061214:Patient Safety; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted; D018570:Risk Assessment; D012307:Risk Factors; D012867:Skin / Q000528:radiation effects
chemical_list: D003287:Contrast Media
keywords: radiation dose; radiation risk; rotational angiography