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    Impact of latest generation cardiac interventional X-ray equipment on patient image quality and radiation dose for trans-catheter aortic valve implantations

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    Gislason_Lee_publisher_version_(2016).pdf (707.4Kb)
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    Publication date
    2016
    Author
    Gislason-Lee, Amber J.
    Keeble, C.
    Malkin, C.J.
    Egleston, D.
    Bexon, J.
    Kengyelics, S.M.
    Blackman, D.
    Davies, A.G.
    Keyword
    Trans-catheter aortic valve implantation
    TAVI
    Cardiac interventional X-ray
    Radiation dose
    Image quality
    Radiology
    Rights
    © 2016 The authors. Published by the British Institute of Radiology. Reproduced in accordance with the publisher's self-archiving policy.
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    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.
    URI
    http://hdl.handle.net/10454/16948
    Version
    Published version
    Citation
    Gislason-Lee AJ, Keeble C, Malkin CJ et al (2016) Impact of latest generation cardiac interventional X-ray equipment on patient image quality and radiation dose for trans-catheter aortic valve implantations. The British Journal of Radiology. 89(1067): 20160269.
    Link to publisher’s version
    https://doi.org/10.1259/bjr.20160269
    Type
    Article
    Collections
    Health Studies Publications

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