title: Image noise reduction technology reduces radiation in a radial-first cardiac catheterization laboratory.
abstract: BACKGROUND
  Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting.
  
  
  RESULTS
  We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N=200) and a new image noise reduction fluoroscopy system (N=200). The primary endpoint was radiation dose (mGy cm2). Secondary endpoints were contrast dose, fluoroscopy times, number of cineangiograms, and radiation dose by operator between the two study periods. Radiation was reduced by 44.7% between the old and new cardiac catheterization laboratory (75.8mGycm2±74.0 vs. 41.9mGycm2±40.7, p<0.0001). Radiation was reduced for both diagnostic procedures (45.9%, p<0.0001) and interventional procedures (37.7%, p<0.0001). There was no statistically significant difference in radiation dose between individual operators (p=0.84). In multivariate analysis, radiation dose remained significantly decreased with the use of the new system (p<0.0001) and was associated with weight (p<0.0001), previous coronary artery bypass grafting (p<0.0007) and greater than 3 stents used (p<0.0004). TRA was used in 90% of all cases in both periods. Compared with a transfemoral approach (TFA), TRA was not associated with higher radiation doses (p=0.20).
  
  
  CONCLUSIONS
  Image noise reduction technology significantly reduces radiation dose in a contemporary radial-first cardiac catheterization clinical practice.
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.
authors.forename: Ateka
authors.initials: A
authors.lastname: Gunja
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.
authors.forename: Yagya
authors.initials: Y
authors.lastname: Pandey
authors.affiliation: Division of Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL; Faculty of Health Sciences, Simon Fraser University.
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Physiology and Biophysics, Center for Cardiovascular Research, University of Illinois at Chicago, Chicago, IL.
authors.forename: Beata M
authors.initials: BM
authors.lastname: Wolska
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.
authors.forename: Adhir R
authors.initials: AR
authors.lastname: Shroff
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL.
authors.forename: Amer K
authors.initials: AK
authors.lastname: Ardati
authors.affiliation: Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL; Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, IL. Electronic address: miv@uic.edu.
authors.forename: Mladen I
authors.initials: MI
authors.lastname: Vidovich
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D002641:Chicago; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D011237:Predictive Value of Tests; D017534:Radial Artery / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000009:adverse effects / Q000517:prevention & control*; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015641:Radiography, Interventional / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents
keywords: Image noise reduction technology; Radial cardiac catheterization; Radiation reduction