Amber J. Gislason-Lee MSc, Presenter: Research funded, Koninklijke Philips NV

Claire Keeble MSc, Abstract Co-Author: Nothing to Disclose

Michael Lupton, Abstract Co-Author: Nothing to Disclose

David Barmby, Abstract Co-Author: Nothing to Disclose

Andrew Graham Davies MSc, Abstract Co-Author: Philips Healthcare, the Netherlands

Recent releases of interventional X-ray equipment have seen innovations in image processing employed by manufacturers to reduce patient dose in applications such as vascular imaging. Philips’ ClarityIQ combines anatomy-specific X-ray optimization with real-time image noise reduction algorithms to reduce patient dose in interventional cardiac imaging. A Clarity system was recently installed in our local cardiac catheterization laboratories; the aim of this study was to investigate whether the Clarity system reduced patient procedure dose (yet not increase procedure duration) in percutaneous coronary interventions (PCI).

Previously collected patient dose data from the cardiac catheterisation labs was analysed by a statistician; sample size calculations showed that a minimum of 100 patients from each of two labs would be required for comparison. Patient procedure details were recorded for 130 PCI patients from the Clarity lab and 140 PCI patients from a Philips Xper (previous generation) lab in the same cardiology department. The Wilcoxon statistical test, which does not require equal numbers in each group, was used to compare median values from the two interventional X-ray systems.  

The medians of total patient procedure dose were 2181 and 6060 cGy cm2 from the Clarity and Xper systems respectively. Clarity median total patient doses were 1354 cGy cm2 from fluoroscopy and 827 cGy cm2 from digital image acquisition. Xper median total patient doses were 2734 cGy cm2 from fluoroscopy and 3327 cGy cm2 from acquisition. The Wilcoxon test showed strong statistical significance in these differences in total patient dose, at the 5% significance level (p << 0.001 in all cases). The median total fluoroscopy time [min:sec] was 12:39 for the Clarity system and 11:47 for the Xper system.

The total patient procedure dose for PCI patients was 64% lower in the Clarity cardiac catherization lab than the Xper lab. Corresponding differences in total digital image acquisition and fluoroscopy doses were 50% and 75%. There was no statistically significant difference in total fluoroscopy time between the two labs.

Substantial radiation dose savings can be realised for high dose cardiac interventional procedures by using state of the art X-ray equipment with innovative image processing; routine patient procedure data was used.

Gislason-Lee, A, Keeble, C, Lupton, M, Barmby, D, Davies, A, Does New Image Enhancement Technology Provide a Substantial Radiation Dose Reduction for Patients in Percutaneous Coronary Interventional Procedures?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045453.html