Yes / Objectives: This study aimed to determine the impact on radiation dose and image quality of a new cardiac interventional X-ray system for trans-catheter aortic valve implantation (TAVI) patients compared to the previously-used cardiac X-ray system.
Methods: Patient dose and image data were retrospectively collected from a Philips AlluraClarity (new) and Siemens Axion Artis (reference) X-ray system. Patient dose area product (DAP) and fluoroscopy duration of 41 patient cases from each X-ray system were compared using a Wilcoxon test. Ten patient aortograms from each X-ray system were scored by 32 observers on a continuous scale to assess the clinical image quality at the given phase of the TAVI procedure. Scores were dichotomised by acceptability and analysed using a Chi-squared test.
Results: Significant reductions in patient dose (p<<0.001) were found for the new system with no significant change in fluoroscopy duration (p=0.052); procedure DAP reduced by 55%, fluoroscopy DAP by 48% and “cine” acquisition DAP by 61%. There was no significant difference between image quality scores of the two X-ray systems (p=0.06).
Conclusions: The new cardiac X-ray system demonstrated a very significant reduction in patient dose with no loss of clinical image quality.
Advances in Knowledge: The huge growth of TAVI may impact on the radiation exposure of cardiac patients and particularly on operators including anaesthetists; cumulative exposure of interventional cardiologists performing high volume TAVI over 30-40 years may be harmful. The Phillips Clarity upgrade including improved image enhancement and optimised X-ray settings significantly reduced radiation without reducing clinically acceptable image quality.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/16948 |
| Date | 29 September 2016 |
| Creators | Gislason-Lee, Amber J., Keeble, C., Malkin, C.J., Egleston, D., Bexon, J., Kengyelics, S.M., Blackman, D., Davies, A.G. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © 2016 The authors. Published by the British Institute of Radiology. Reproduced in accordance with the publisher's self-archiving policy. |
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