Author + information
- Divyesh Sharma,
- Ashish H. Shah,
- Christopher Overgaard and
- Vladimir Dzavik
Minimizing radiation exposures is one of the primary safety concerns in the catheterization laboratory. Use of lower frame rate during fluoroscopy is known to reduce radiation dose. However, there is little data on the impact of using lower frame rate on the angiographic image quality. We sought to assess the effect of low frame rate of fluoroscopy on total radiation dose and image quality during cardiac catheterization.
Methods and Results
We retrospectively reviewed a total of 100 procedures done with 2 default frame rate (FR) settings: a standard FR cohort (FR, 15 frames per second for Fluoroscopy) and a reduced FR cohort (FR, 7.5frame per second for fluoroscopy). In the reduced FR group, cine was used only during the initial and final angiography during the procedure and operator used “fluoroscopy image save” during the procedure. Total X-ray dose, fluoroscopy times, and contrast volume used were compared between the groups. Patient characteristics such as age, gender, height, weight, and body mass index were collected. Two independent operators assessed image quality using an objective 5-point angiographic image quality score. Dose area product (DAP) is significantly reduced in the reduced FR group (FR 15, 2593.2 mGy; FR 1112 mGy; P<0.0001). There were no significant differences in fluoroscopy time (FR 15, 31.4 minutes; FR 7.5, 27.1 minutes; P=0.68) and contrast volume (FR 15, 225.8 mL; FR 7.5, 303.7 mL, P=0.85) between the two groups. There was no difference in the angiographic image quality score between the cohorts (PR 15, 4.8; PR 7.5, 4.9; P=0.66). Moreover, there were no new findings revealed (e.g. edge dissection or loss of side branch) during the final cine angiographic image as compared to final fluoroscopy save images at the end of the procedure in either of the groups.
Low frame rate protocol resulted in significant reductions in total radiation dose without significant compromise in angiographic image quality.