Large radiation dose savings during angiography and flouroscopy by use of enhanced image processing software enabling removal of anti scatter grid

Congress:

ECR 2019

Poster Number:

C-0379

Type:

Educational Exhibit

Keywords:

Dosimetric comparison, Radiation safety, Angioplasty, Image manipulation / Reconstruction, Fluoroscopy, Catheter arteriography, Radioprotection / Radiation dose, Radiographers, Cardiac

Authors:

G. R. Ison¹, R. Szirt², M. Binnekamp², D. Ramsay², J. Roy², A. Prasan², M. sadar²; ¹Sydney, ns/AU, ²Sydney/AU

DOI:

10.26044/ecr2019/C-0379

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-0379

Fig. 1

Fig. 2

Fig. 3: Chest Phantom . Grid half removed to show

Fig. 4: Without Grid

Learning objectives

In the ideals of Euro safe imaging, (quality & safety), the latest live image enhancement software in our cardiac / vascular interventional suites enabled a 41% reduction of radiation dose. By allowing the removal of the anti-scatter grid in low to medium BMI patients. A dose saving technique previously only used in low BMI patients due to increased image degradation on grid removal

Background

The anti-scatter grid increases the contrast and resolution of the x-ray image by absorbing divergent scattered x-rays before they enter the x-ray detector. An easy analogy is to consider how polarizing sunglasses reduce the reflected glare from snow or water. As X- ray scatter increases with patient BMI the anti-scatter grids effectiveness on improving image quality also increaseswith BMI and has been mandatory in all but paediatric or very low BMI adult patients. Unfortunately this scatter absorption process also attenuates the amount of useful non-divergent...

Findings and procedure details

During this experiment we performed fluoroscopy on a 20cm (Ave BMI) chest phantom in the AP projection with and without the anti-scatter grid. A Westmead test object was used to measure image contrast and resolution in both cases. In removing the anti-scatter grid we found a large 41% reduction in the dose area product of the primary x-ray beam with only a 11% reduction in line pair resolution and only a 10% reduction in contrast range.

Conclusion

Our results show that for small to medium patients, the latest generation image enhancement software in our cardiac/vascular interventional suite ( Canon InfinexTM) allows the removal of the anti-scatter grid in a new patient cohort (medium BMI) than previously available (Low BMI) patients. This allows a significant reduction of radiation dose to both the patient and the operator whilst maintaining comparable image quality.

Personal information

Glenn Ison Senior Medical Radiation Practioner St George Hospital Sydney NSW Australia

References

Selective anti-scatter grid removal during coronary angiography and PCI: a simple and safe technique for radiation reduction. https://www.ncbi.nlm.nih.gov/pubmed/28120155#