Image noise reduction technology allows significant reduction of radiation dosage in cardiac device implantation procedures

摘要

Abstract Background Novel x‐ray systems with real‐time image noise reduction technology (INRT) to reduce radiation dose during fluoroscopy and cine acquisition have become available. This study evaluated the reduction of radiation dose in device implantation with INRT. Methods Radiation dose data from 132 consecutive new device implantation procedures (102 pacemaker [PM] or implantable cardioverter defibrillator [ICD] and 30 cardiac resynchronization therapy [CRT] devices) performed between January 2015 and December 2015 on an angiography system with INRT (Allura ClarityIQ) were collected. For comparison, radiation dose data from 147 consecutive device implantation procedures (121 PM/ICDs and 26 CRT devices) performed between June 2013 and September 2014 on a C‐arm system with continuous and pulsed fluoroscopy option (4 frames/second) were evaluated. Total dose area product (DAP), fluoroscopy DAP, and cine DAP were evaluated. Results Patient age, gender and body weight, procedure, and fluoroscopy times were similar between systems. In PM/ICD cases, DAP of INRT and C‐arm system was similar (423 ± 381 cGycm 2 ?vs 417 ± 517 cGycm[]) due to pulsed fluoroscopy with the C‐arm system (78% of time) and sparse use of cine. In CRT procedures requiring higher image quality (82% use of continuous fluoroscopy with C‐arm system), DAP of INRT was significantly lower (1,544 ± 834?cGycm[] vs 7,252 ± 6,431 cGycm,[] P??0.001) due to less fluoroscopy DAP (1,414 ± 757?cGycm[] vs 5,854 ± 6,767 cGycm[]) and less cine DAP (130 ± 106?cGycm[] vs 1,399 ± 1,342 cGycm[]). Considering all procedures, total DAP was reduced by 60% using INRT. Conclusion Novel INRT results in a substantial lowering of radiation dose in device implantation, in particular, in complex CRT implantation procedures requiring high image quality.