Liesbeth Eloot, Presenter: Nothing to Disclose

Klaus Bacher PhD, Abstract Co-Author: Nothing to Disclose

Femke Steenbeke, Abstract Co-Author: Nothing to Disclose

Benny Drieghe, Abstract Co-Author: Nothing to Disclose

Peter Gheeraert, Abstract Co-Author: Nothing to Disclose

Yves Taeymans, Abstract Co-Author: Nothing to Disclose

Hubert Thierens PhD, Abstract Co-Author: Nothing to Disclose

Catheter-based coronary angiography (CA) is typically ranked as an examination delivering a high radiation dose to the patient. With the introduction of flat-panel technology, three-dimensional rotational angiography (3D RA) became an alternative for the conventional two-dimensional angiography. However, limited information is available on the difference in patient radiation exposure with both acquisition techniques. The purpose of this study was to assess patient-specific organ doses and cancer risk with the rotational mode versus the current standard of multiple single-plane coronary angiography.

80 adult patients (45 male, age 38 to 93 years), referred to the cardiac catheterization lab for a diagnostic CA, were randomly assigned to the rotational or standard angiography group. Exposure parameters (i.a. DAP and cumulative dose at interventional reference point (CD@IRP)) were registered and skin dose distribution was measured with a grid of thermoluminiscence dosimeters during the procedure. Patient-specific organ doses and related cancer risks were calculated with dedicated software.

Rotational angiograms were associated with 33% lower DAP values and a corresponding decrease of fluoroscopy time, cinegraphic runs and contrast medium consumption. The delivered skin dose was smoothed for the rotational X-ray technique and showed fewer hot spots than the planar acquisition technique. The CD@IRP showed not to be an appropriate parameter for estimation of the patient’s peak skin dose in CA. Overall lifetime attributable risk of cancer incidence decreased from 291 to 230 in 1 million cases for males, and from 555 to 277 in 1 million cases for females with the RA technique.

The reported features make rotational angiography the preferred angiographic acquisition method for coronary angiography procedures.

(dealing with high radiation doses in coronary angiography) "The substantial decrease in patients' radiation risk makes rotational angiography the preferred acquisition method for CA procedures."

Eloot, L, Bacher, K, Steenbeke, F, Drieghe, B, Gheeraert, P, Taeymans, Y, Thierens, H, Three-dimensional Rotational X-ray Acquisition Technique Is Reducing Patients’ Cancer Risk in Coronary Angiography.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12032547.html