title: 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 59.4 Gy cm(2), for CAG from 155.1 to 52.0 Gy cm(2) and for PCI from 229.0 to 85.8 Gy cm(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.
authors.affiliation: Kyoto-Katsura Hospital, 17-banchi, Yamada Hirao-cho, Nishikyo-ku, Kyoto-shi, Kyoto, Zip 6158256, Japan. kcvc.nakamura@katsura.com.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakamura
authors.affiliation: Kyoto-Katsura Hospital, 17-banchi, Yamada Hirao-cho, Nishikyo-ku, Kyoto-shi, Kyoto, Zip 6158256, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Kyoto-Katsura Hospital, 17-banchi, Yamada Hirao-cho, Nishikyo-ku, Kyoto-shi, Kyoto, Zip 6158256, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Funatsu
authors.affiliation: Kyoto-Katsura Hospital, 17-banchi, Yamada Hirao-cho, Nishikyo-ku, Kyoto-shi, Kyoto, Zip 6158256, Japan.
authors.forename: Tadahisa
authors.initials: T
authors.lastname: Okada
authors.affiliation: Philips Healthcare, Best, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Mauti
authors.affiliation: Philips Electronics Japan, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Waizumi
authors.affiliation: Philips Electronics Japan, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D002932:Cineangiography; D003287:Contrast Media / Q000008:administration & dosage; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015641:Radiography, Interventional / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D003287:Contrast Media
keywords: DAP; Image processing; Interventional cardiology; Radiation dose; X-ray imaging technology
references.citation: Br J Radiol. 2003 Oct;76(910):726-30
references.pmid: 14512333
references.citation: Radiat Prot Dosimetry. 2013 Sep;156(3):296-302
references.pmid: 23528327
references.citation: Eur J Radiol. 2012 Oct;81(10):e968-76
references.pmid: 22840382
references.citation: Neuroradiology. 2013 Nov;55(11):1365-72
references.pmid: 24005833
references.citation: JACC Cardiovasc Interv. 2009 Jun;2(6):479-86
references.pmid: 19539249
references.citation: Br J Radiol. 2003 Aug;76(908):513-8
references.pmid: 12893691
references.citation: Heart Vessels. 2012 Sep;27(5):460-7
references.pmid: 21822708
references.citation: Int J Cardiovasc Imaging. 2007 Apr;23(2):143-7
references.pmid: 17033729
references.citation: N Engl J Med. 2009 Aug 27;361(9):849-57
references.pmid: 19710483
references.citation: Pediatr Radiol. 2006 Sep;36 Suppl 2:110-2
references.pmid: 16862422
references.citation: Heart Vessels. 2014 Mar;29(2):199-205
references.pmid: 23615833
references.citation: Heart Rhythm. 2013 Nov;10 (11):1678-82
references.pmid: 23973946
references.citation: Am J Cardiol. 2006 Sep 18;98(6A):42K-58K
references.pmid: 16949380
references.citation: EuroIntervention. 2008 Mar;3(5):593-9
references.pmid: 19608487
references.citation: Radiat Prot Dosimetry. 2005;117(1-3):241-6
references.pmid: 16461492
references.citation: Radiology. 2013 Nov;269(2):553-60
references.pmid: 23737536
references.citation: AJR Am J Roentgenol. 2009 Aug;193(2):559-69
references.pmid: 19620457
references.citation: Br J Radiol. 2009 Apr;82(976):303-12
references.pmid: 19124567
references.citation: AJR Am J Roentgenol. 2014 Oct;203(4):904-8
references.pmid: 25247959
references.citation: Curr Cardiol Rev. 2009 Jan;5(1):1-11
references.pmid: 20066141
references.citation: Heart Vessels. 2014 Mar;29(2):156-64
references.pmid: 23552901
references.citation: Heart Vessels. 2010 Nov;25(6):536-42
references.pmid: 20878408
references.citation: Br J Radiol. 2010 May;83(989):379-94
references.pmid: 20019175