Evaluation of the Radiation Dose and Imaging Performance of New Cardiac Angiography Systems

Abstract

In March 2019, a new state of the art cardiac angiography system entered clinical use at University Hospital, Galway (UHG). The manufacturer claimed improved image quality and reduced patient dose in comparison to the current technology being used in the Cardiology Department. The new system has been evaluated by developing comprehensive image quality and radiation dose assessment protocols based on scientiQic literature. Following the evaluation of the cardiac angiography system, the results were compared to data published in the literature and with data available for the older generation technology. Furthermore, imaging protocols were reviewed and advice on system optimisation was offered. The results of the new system evaluation provided evidence that the radiation dose is reduced with the new technology; however, insufQicient evidence was available for the project Qindings to conQirm that the image quality was improved. Contrast detectability performance is dependent upon clinically selected modes of operation. The results of the contrast detail detectability did not show any improvement in comparison to the old technology. In fact, the image quality of low mode requires further work to improve it. In addition, both systems exhibited poor contrast detail detectability performance during Qluoroscopic imaging for large patient conditions. Spatial resolution was superior for the new Qlat panel system in the Qluoroscopy mode whereas in acquisition mode, the new Qlat panel system was inferior for 10 and 20 cm PMMA but superior at 30 cm PMMA. On the other hand, ESD data in conjunction with European dose reference level established indicate that patient radiation doses were lower with the new Qlat panel system. For the 42 large patients, the dose delivered was high, so reasonable image quality was obtained. Based on the Qindings of the project, further work is required to establish the relationship between radiation dose and image quality.