Patient dose reduction in coronary angiography when using a 3-dimensional rotational X-ray technique

Congress:

ECR 2011

Poster Number:

C-2049

Type:

Scientific Paper

Keywords:

Cardiac, Interventional vascular

Authors:

L. Eloot, K. Bacher, F. Steenbeke, Y. Taeymans, H. Thierens; Ghent/BE

DOI:

10.1594/ecr2011/C-2049

DOI-Link:

https://dx.doi.org/10.1594/ecr2011/C-2049

Fig. 1: Grid of 70 thermoluminiscence dosemeters, used for mapping the entrance skin...

Fig. 2: Philips Allura Xper FD10 cath lab

Fig. 3: DAP and fluoroscopy time in function of the experience of the operator.

Fig. 4: Typical skin dose distribution with 2D planar and 3D rotational imaging,...

Purpose

Coronary angiography (CA) is typically ranked as an examination delivering a high radiation exposure to patients with hot spots at the skin dose level. 3D rotational imaging is an alternative for 2D planar projections and is considered clinically equivalent in diagnostic value (ref 1,2). Yet, no information is available on the difference in patient radiation exposure with both techniques. The purpose of this study was to assess patient dose with the rotational spin mode versus the current standard conventional multiple single-plane CA.

Methods and Materials

For79 patients undergoing a coronary angiography, the entrance skin dose distribution was mapped using a grid of 70 thermoluminiscence dosemeters (TLDs) per patient (figure 1), allowing an accurate determination of the maximum skin dose (MSD). All procedures were performed on the same catheterization lab: amonoplane C-arm systemequipped with a flat panel detector (Phillips Allura Xper FD10, Philips, The Netherlands)(figure 2). Several physicians with a different level of experience (5 with over 5 years of experience, 4 with less than 5 years of experience)participated in this...

Results

Both patient populations included in this study were comparable with respect to age and BMI (p=0.86 and p=0.98, respectively). The mean total DAP value for conventional 2D CA amounted to67.9 ±37.0 Gycm². Rotational 3D CA enabled significant reduction of these representative DAP values towards a level of43.0 ±20.6 Gycm² (p<0.001). The latter could be attributed to a significant reduction in number of cinegraphic acquisitions (from 9.6 ± 2.2 to 5.3 ± 1.7). A significant (p<0.001) lower MSD was measured in the patient group using rotational...

Conclusion

This study showed a significant reduction in patient radiation exposure and contrast medium consumption using 3D rotational CA in stead of conventional 2D CA. Therefore, 3D rotational CA using a flat-detector C-arm is a promising alternative method to conventional 2D CA.

References

1. Tommasini G, Camerini A, Gatti A, et al. Panoramic coronary angiography. J Am Coll Cardiol 1998; 31(4):871-7. 2. Klein A, Garcia J. Rotational coronary angiography. Cardiol clin 2009; 27:395-405.

Personal Information

Liesbeth Eloot Medical Physics QCC-Gent Proeftuinstraat 86 B-9000 Ghent, Belgium [email protected]