title: Novel X-ray imaging technology enables significant patient dose reduction in interventional cardiology while maintaining diagnostic image quality.
abstract: OBJECTIVE
  The purpose of this study was to quantify the reduction in patient radiation dose during coronary angiography (CA) by a new X-ray technology, and to assess its impact on diagnostic image quality.
  
  
  BACKGROUND
  Recently, a novel X-ray imaging technology has become available for interventional cardiology, using advanced image processing and an optimized acquisition chain for radiation dose reduction.
  
  
  METHODS
  70 adult patients were randomly assigned to a reference X-ray system or the novel X-ray system. Patient demographics were registered and exposure parameters were recorded for each radiation event. Clinical image quality was assessed for both patient groups.
  
  
  RESULTS
  With the same angiographic technique and a comparable patient population, the new imaging technology was associated with a 75% reduction in total kerma-area product (KAP) value (decrease from 47 Gycm2 to 12 Gycm2, P<0.001). Clinical image quality showed an equivalent detail and contrast for both imaging systems. On the other hand, the subjective appreciation of noise was more apparent in images of the new image processing system, acquired at lower doses, compared to the reference system. However, the higher noise content did not affect the overall image quality score, which was adequate for diagnosis in both systems.
  
  
  CONCLUSIONS
  For the first time, we present a new X-ray imaging technology, combining advanced noise reduction algorithms and an optimized acquisition chain, which reduces patient radiation dose in CA drastically (75%), while maintaining diagnostic image quality. Use of this technology may further improve the radiation safety of cardiac angiography and interventions.
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Eloot
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Hubert
authors.initials: H
authors.lastname: Thierens
authors.affiliation: Heart Centre, Ghent University Hospital, Ghent, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Taeymans
authors.affiliation: Heart Centre, Ghent University Hospital, Ghent, Belgium.
authors.forename: Benny
authors.initials: B
authors.lastname: Drieghe
authors.affiliation: Heart Centre, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: De Pooter
authors.affiliation: Heart Centre, Ghent University Hospital, Ghent, Belgium.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Van Peteghem
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Buytaert
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gijs
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Régine
authors.initials: R
authors.lastname: Lapere
authors.affiliation: Department of Basic Medical Sciences, Ghent University, Ghent, Belgium.
authors.forename: Klaus
authors.initials: K
authors.lastname: Bacher
mesh_terms: D000368:Aged; D000465:Algorithms; D002932:Cineangiography / Q000295:instrumentation / Q000379:methods*; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results
keywords: coronary angiography; coronary artery disease; imaging; radiation dose