Image Perception, Observer Performance, and Technology Assessment

Comprehensive assessment of patient image quality and radiation dose in latest generation cardiac x-ray equipment for percutaneous coronary interventions

[+] Author Affiliations
Amber J. Gislason-Lee, Daniel Egleston, Josephine Bexon, Stephen M. Kengyelics, Andrew G. Davies

University of Leeds, Division of Biomedical Imaging, Leeds, United Kingdom

Claire Keeble

University of Leeds, Division of Epidemiology and Biostatistics, Leeds, United Kingdom

J. Med. Imag. 4(2), 025501 (May 02, 2017). doi:10.1117/1.JMI.4.2.025501
History: Received August 2, 2016; Accepted April 14, 2017
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Abstract.  This study aimed to determine whether a reduction in radiation dose was found for percutaneous coronary interventional (PCI) patients using a cardiac interventional x-ray system with state-of-the-art image enhancement and x-ray optimization, compared to the current generation x-ray system, and to determine the corresponding impact on clinical image quality. Patient procedure dose area product (DAP) and fluoroscopy duration of 131 PCI patient cases from each x-ray system were compared using a Wilcoxon test on median values. Significant reductions in patient dose (p0.001) were found for the new system with no significant change in fluoroscopy duration (p=0.2); procedure DAP reduced by 64%, fluoroscopy DAP by 51%, and “cine” acquisition DAP by 76%. The image quality of 15 patient angiograms from each x-ray system (30 total) was scored by 75 clinical professionals on a continuous scale for the ability to determine the presence and severity of stenotic lesions; image quality scores were analyzed using a two-sample t-test. Image quality was reduced by 9% (p0.01) for the new x-ray system. This demonstrates a substantial reduction in patient dose, from acquisition more than fluoroscopy imaging, with slightly reduced image quality, for the new x-ray system compared to the current generation system.

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© 2017 Society of Photo-Optical Instrumentation Engineers

Citation

Amber J. Gislason-Lee ; Claire Keeble ; Daniel Egleston ; Josephine Bexon ; Stephen M. Kengyelics, et al.
"Comprehensive assessment of patient image quality and radiation dose in latest generation cardiac x-ray equipment for percutaneous coronary interventions", J. Med. Imag. 4(2), 025501 (May 02, 2017). ; http://dx.doi.org/10.1117/1.JMI.4.2.025501


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