Novel X‐ray imaging technology enables significant patient dose reduction in interventional cardiology while maintaining diagnostic image quality

Introduction: The use of computed tomography (CT) imaging as a diagnostic modality is increasing rapidly and CT is the dominant contributor to diagnostic medical radiation exposure. The aim of this project was to reduce the effective radiation dose to patients undergoing cranial CT examination, while maintaining diagnostic image quality. Methods: Data from a total of 1003, 132 and 27 patients were examined for three protocols: CT head, CT angiography (CTA), and CT perfusion (CTP), respectively. Following installation of adaptive iterative dose reduction (AIDR) 3D software, tube current was lowered in consecutive cycles, in a stepwise manner and effective radiation doses measured at each step. Results: Baseline effective radiation doses for CT head, CTA and CTP were 1.80, 3.60 and 3.96 mSv, at currents of 300, 280 and 130–150 mA, respectively. Using AIDR 3D and final reduced currents of 160, 190 and 70–100 mA for CT head, CTA and CTP gave effective doses of 1.29, 3.18 and 2.76 mSv, respectively. Conclusion: We demonstrated that satisfactory reductions in the effective radiation dose for CT head (28.3%), CTA (11.6%) and CTP (30.1%) can be achieved without sacrificing diagnostic image quality. We have also shown that iterative reconstruction techniques such as AIDR 3D can be effectively used to help reduce effective radiation dose. The dose reductions were performed within a short period and can be easily achievable, even in busy departments.

Download Full-text

Diagnostic image quality of hand-held and wall-mounted X-ray devices in bitewing radiography: a non-inferiority clinical trial

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20200471 ◽

2021 ◽

pp. 20200471

Author(s):

Reinier Cornelis Hoogeveen ◽

Siham Ouchene ◽

WER Berkhout

Keyword(s):

Clinical Trial ◽

Image Quality ◽

Future Research ◽

Diagnostic Image Quality ◽

Data Set ◽

Diagnostic Image ◽

X Ray ◽

The Difference ◽

Diagnostic Modalities

Objectives: The present clinical trial was intended to clarify whether subjective assessments of diagnostic X-ray image quality achieved via hand-held (HH) Nomad Pro 2 (KaVo Kerr, Brea, CA, USA) X-ray device is non-inferior that of the wall-mounted (WM) KaVo Focus (KaVo Dental, Bieberich, Germany). Methods: A prospective, cross-over, and in vivo non-inferiority clinical trial was conducted to compare these two diagnostic modalities. Based on sampling calculations, 205 patients were selected for study, generating 410 paired bitewing radiographs in randomized sequence. The films were assessed independently, engaging three observers blinded to modality for random, side-by-side-comparisons. Diagnostic image quality was rated as follows: no preference, HH preference, or WM preference. Observer judgements were combined accordingly to reach a majority. Results: Collective observer ratings indicated no preference for diagnostic image quality in 63.9% of cases, with WM preference at 16.6% and HH preference at 19.5%. The difference in HH and WM preferences (19.5%–16.6% = 2.9%) was within the expected 95% confidence interval. Majority agreement was reached in 82.7%. Conclusions: Subjectively assessed diagnostic image quality in bitewing radiographs acquired by HH and WM devices did not differ significantly. The hand-held device is thus non-inferior to the WM in this regard. Our data set of paired bitewing radiographs may subsequently aid in future research.

Download Full-text