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
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 x-rays to the detector,
thus this method of improving the image quality,
also initiates a larger primary beam dose to the patient and a larger scatter dose to the imaging staff.
Latest Digital Angiographic suites have live software image enhancement that have enabled an improvement in the signal to noise ratio (background scatter effect) and targeted enhancement of relevant areas,
e.g.
dedicated pixel enhancement of iodine contrast density.
In the case of St George Hospital our new Canon infinextm systems.Using the software systems SNRFTM,
ADCFTM and DPRFtm have greatly increased image quality.
We endeavoured,
by testing both image quality and radiation dose.
To see if these latest digital image enhancements could facilitate angiography without the anti-scatter grid in normal BMI patients thus hopefully reducing primary beam power dramatically and thus reducing radiation dose for this cohort.