title: A Radiation Dose Reduction Technology to Improve Patient Safety During Cardiac Catheterization Interventions.
abstract: OBJECTIVE
  A novel radiation dose reduction technology was evaluated in a cardiac catheterization laboratory during routine clinical care to determine if it could reduce radiation dose to patients undergoing coronary angiography and percutaneous coronary intervention. These results were compared to patients undergoing similar procedures in a cardiac catheterization laboratory without this technology.
  
  
  BACKGROUND
  There is a safety priority in clinical care to reduce X-ray radiation dose to patients in order to lower the risk of deterministic and stochastic effects. Dose reduction technologies must be verified in clinical settings to prove if they reduce X-ray radiation dose and to what extent.
  
  
  METHODS
  Radiation dose data and procedure characteristics of 268 consecutive patients were collected and analyzed from a cardiac catheterization laboratory with dose reduction technology installed (referred to as Lab A, n = 135) and from a cardiac catheterization laboratory without this technology (referred as Lab B, n = 133).
  
  
  RESULTS
  For diagnostic procedures, the median total dose-area product in Lab A was reduced by 46% (P < 0.0001) compared to Lab B, with no differences in terms of body mass index (P = 0.180), total fluoroscopy times (P = 1), number of acquired images (P = 0.920), and contrast medium (P = 0.660). For interventional procedures, the median total dose-area product in Lab A was reduced by 34% (P = 0.015) compared to Lab B, with no differences in terms of body mass index (P = 0.665), total fluoroscopy times (P = 0.765), number of acquired images (P = 0.923), and contrast medium (P = 0.969).
  
  
  CONCLUSIONS
  This new dose reduction technology significantly reduces X-ray radiation dose without affecting fluoroscopy time, number of images, and contrast medium used during diagnostic and interventional coronary procedures.
authors.affiliation: University of Colorado Denver, Aurora, Colorado.|Philips Healthcare, Markham, Ontario, Canada.
authors.forename: John A
authors.initials: JA
authors.lastname: Bracken
authors.affiliation: Philips Healthcare, Best, The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: Mauti
authors.affiliation: University of Colorado Denver, Aurora, Colorado.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kim
authors.affiliation: University of Colorado Denver, Aurora, Colorado.
authors.forename: John C
authors.initials: JC
authors.lastname: Messenger
authors.affiliation: University of Colorado Denver, Aurora, Colorado.
authors.forename: John D
authors.initials: JD
authors.lastname: Carroll
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods; D002985:Clinical Protocols; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D061214:Patient Safety; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D058996:Quality Improvement; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control; D011870:Radiologic Health / Q000379:methods / Q000592:standards; D013673:Technology Assessment, Biomedical / Q000379:methods