title: Novel X-ray image noise reduction technology reduces patient radiation dose while maintaining image quality in coronary angiography.
abstract: OBJECTIVE
  The consequences of high radiation dose for patient and staff demand constant improvements in X-ray dose reduction technology. This study assessed non-inferiority of image quality and quantified patient dose reduction in interventional cardiology for an anatomy-specific optimised cine acquisition chain combined with advanced real-time image noise reduction algorithms referred to as 'study cine', compared with conventional angiography.
  
  
  METHODS
  Fifty patients underwent two coronary angiographic acquisitions: one with advanced image processing and optimised exposure system settings to enable dose reduction (study cine) and one with standard image processing and exposure settings (reference cine). The image sets of 39 patients (18 females, 21 males) were rated by six experienced independent reviewers, blinded to the patient and image characteristics. The image pairs were randomly presented. Overall 85 % of the study cine images were rated as better or equal quality compared with the reference cine (95 % CI 0.81-0.90). The median dose area product per frame decreased from 55 to 26 mGy.cm(2)/frame (53 % reduction, p < 0.001).
  
  
  CONCLUSIONS
  This study demonstrates that the novel X-ray imaging technology provides non-inferior image quality compared with conventional angiographic systems for interventional cardiology with a 53 % patient dose reduction.
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands. tim.tencate@radboudumc.nl.
authors.forename: T
authors.initials: T
authors.lastname: Ten Cate
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van Wely
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Gehlmann
authors.affiliation: Philips Healthcare, Best, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Mauti
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Camaro
authors.affiliation: Main-Taunus-Privatklinik, Bad Soden, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Reifart
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Suryapranata
authors.affiliation: Department of Interventional Cardiology, RadboudUMC, Geert Grooteplein-Zuid 22, 6525, Nijmegen, GA, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: de Boer
keywords: DAP; Dose reduction; Image processing; Interventional cardiology; Safety