Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

Abstract

Flat panel detector (FPD) technology in interventional cardiology is on the increase due to its varied advantages compared to the conventional image intensifier (II) systems. It is not clear whether FPD imparts lower radiation doses compared to II systems though a few studies support this finding. This study intends to compare radiation doses from II and FPD systems for coronaryangiography (CAG) and Percutaneous Transluminal Coronary Angioplasty (PTCA) performed in a tertiary referral center. Radiation doses were measured using dose area product (DAP) meter from patients who underwent CAG (n = 222) and PTCA (n = 75) performed using FPD angiography system. The DAP values from FPD were compared with earlier reported data using II systems from the same referral center where the study was conducted. The mean DAP values from FPD system for CAG and PTCA were 24.35 and 63.64 Gycm2 and those from II system were 27.71 and 65.44 Gycm2. Transition from II to FPD system requires stringent dose optimization strategies right from the initial period of installation.

Radiation doses and estimated risk from angiographic projections during coronary angiography performed using novel flat detector

“…It should be noted that the KAP values also depend on patient size, skill and experience of the operator, imaging protocol, and equipment functionalities. In comparison to II and FD systems as reported by Livingstone et al, (28) the present study shows that there is a reduction of 50% and 43% of radiation doses during cine acquisitions with the use of novel FD showed. The dose reduction reported in our study was similar to the study performed by Dekker et al, (6) suggesting that advanced image processing and real‐time noise reduction algorithm has the potential to reduce radiation doses without compromising image quality.…”

Radiation dose and risk in children undergoing cardiac interventions performed using flat detector angiography systems

“…Due to greater sensitivity to the effects of radiation in children compared to adults, an assessment of radiation doses is of prime importance. Hence, the use of state-of-the-art machines incorporated with low dose protocols, as seen in FD systems with improved image quality, is suggested when compared to older image intensifier systems [15]. This study reports exposure factors, radiation doses from fluoroscopy and cine acquisition for three cardiac interventions performed using two flat detector systems with one detector incorporating a real time noise reduction algorithm.…”

Physical Image Quality Metrics for the Characterization of X-ray Systems Used in Fluoroscopy-Guided Pediatric Cardiac Interventional Procedures: A Systematic Review

“…During the last decade, the outdated technology of II-based systems has been widely replaced by those based on FPD for fluoroscopic systems intended to be used in interventional procedures. Accordingly, it has been proposed to enhance dose optimization during the transition from II to FPD systems [34]. In general, both types of systems offer advantages for pediatric interventional cardiology, encompassing enhanced ergonomics, patient access, image quality, as well as potential for reduced patient radiation dose [6,19].…”