Reducing Patient Radiation Dose With Image Noise Reduction Technology in Transcatheter Aortic Valve Procedures.
Identifieur interne : 000160 ( PubMed/Curation ); précédent : 000159; suivant : 000161Reducing Patient Radiation Dose With Image Noise Reduction Technology in Transcatheter Aortic Valve Procedures.
Auteurs : Michael Lauterbach [Allemagne] ; Karl Eugen Hauptmann [Allemagne]Source :
- The American journal of cardiology [ 1879-1913 ] ; 2016.
English descriptors
- KwdEn :
- Aged, 80 and over, Aortic Valve Stenosis (diagnostic imaging), Aortic Valve Stenosis (surgery), Dose-Response Relationship, Radiation, Female, Fluoroscopy (adverse effects), Fluoroscopy (methods), Follow-Up Studies, Germany (epidemiology), Humans, Incidence, Intraoperative Period, Male, Multidetector Computed Tomography (adverse effects), Multidetector Computed Tomography (methods), Prognosis, Radiation Injuries (epidemiology), Radiation Injuries (etiology), Radiation Injuries (prevention & control), Retrospective Studies, Surgery, Computer-Assisted (adverse effects), Surgery, Computer-Assisted (methods), Transcatheter Aortic Valve Replacement (methods).
- MESH :
- adverse effects : Fluoroscopy, Multidetector Computed Tomography, Surgery, Computer-Assisted.
- diagnostic imaging : Aortic Valve Stenosis.
- epidemiology : Germany, Radiation Injuries.
- etiology : Radiation Injuries.
- methods : Fluoroscopy, Multidetector Computed Tomography, Surgery, Computer-Assisted, Transcatheter Aortic Valve Replacement.
- prevention & control : Radiation Injuries.
- surgery : Aortic Valve Stenosis.
- Aged, 80 and over, Dose-Response Relationship, Radiation, Female, Follow-Up Studies, Humans, Incidence, Intraoperative Period, Male, Prognosis, Retrospective Studies.
Abstract
X-ray radiation exposure is of great concern for patients undergoing structural heart interventions. In addition, a larger group of medical staff is required and exposed to radiation compared with percutaneous coronary interventions. This study aimed at quantifying radiation dose reduction with implementation of specific image noise reduction technology (NRT) in transcatheter aortic valve implantation (TAVI) procedures. We retrospectively analyzed 104 consecutive patients with TAVI procedures, 52 patients before and 52 after optimization of x-ray radiation chain, and implementation of NRT. Patients with 1-step TAVI and complex coronary intervention, or complex TAVI procedures, were excluded. Before the procedure, all patients received a multislice computed tomography scan, which was used to size aortic annulus, select the optimal implantation plane, valve type and size, and guide valve implantation using a software tool. Air kerma and kerma-area product were compared in both groups to determine patient radiation dose reduction. Baseline parameters, co-morbidity, or procedural data were comparable between groups. Mean kerma-area product was significantly lower (p <0.001) in the NRT group compared with the standard group (60 ± 39 vs 203 ± 106 Gy × cm(2), p <0.001), which corresponds to a reduction of 70%. Mean air kerma was reduced by 64% (494 ± 360 vs 1,355 ± 657 mGy, p <0.001). In conclusion, using optimized x-ray chain combined with specific image noise reduction technology has the potential to significantly reduce by 2/3 radiation dose in standard TAVI procedures without worsening image quality or prolonging procedure time.
DOI: 10.1016/j.amjcard.2015.12.016
PubMed: 26742472
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Electronic address: lauterbach@uni-mainz.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier</wicri:regionArea></affiliation></author><author><name sortKey="Hauptmann, Karl Eugen" sort="Hauptmann, Karl Eugen" uniqKey="Hauptmann K" first="Karl Eugen" last="Hauptmann">Karl Eugen Hauptmann</name><affiliation wicri:level="1"><nlm:affiliation>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:26742472</idno><idno type="pmid">26742472</idno><idno type="doi">10.1016/j.amjcard.2015.12.016</idno><idno type="wicri:Area/PubMed/Corpus">000160</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000160</idno><idno type="wicri:Area/PubMed/Curation">000160</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000160</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Reducing Patient Radiation Dose With Image Noise Reduction Technology in Transcatheter Aortic Valve Procedures.</title><author><name sortKey="Lauterbach, Michael" sort="Lauterbach, Michael" uniqKey="Lauterbach M" first="Michael" last="Lauterbach">Michael Lauterbach</name><affiliation wicri:level="1"><nlm:affiliation>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier, Germany. Electronic address: lauterbach@uni-mainz.de.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier</wicri:regionArea></affiliation></author><author><name sortKey="Hauptmann, Karl Eugen" sort="Hauptmann, Karl Eugen" uniqKey="Hauptmann K" first="Karl Eugen" last="Hauptmann">Karl Eugen Hauptmann</name><affiliation wicri:level="1"><nlm:affiliation>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier</wicri:regionArea></affiliation></author></analytic><series><title level="j">The American journal of cardiology</title><idno type="eISSN">1879-1913</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged, 80 and over</term><term>Aortic Valve Stenosis (diagnostic imaging)</term><term>Aortic Valve Stenosis (surgery)</term><term>Dose-Response Relationship, Radiation</term><term>Female</term><term>Fluoroscopy (adverse effects)</term><term>Fluoroscopy (methods)</term><term>Follow-Up Studies</term><term>Germany (epidemiology)</term><term>Humans</term><term>Incidence</term><term>Intraoperative Period</term><term>Male</term><term>Multidetector Computed Tomography (adverse effects)</term><term>Multidetector Computed Tomography (methods)</term><term>Prognosis</term><term>Radiation Injuries (epidemiology)</term><term>Radiation Injuries (etiology)</term><term>Radiation Injuries (prevention & control)</term><term>Retrospective Studies</term><term>Surgery, Computer-Assisted (adverse effects)</term><term>Surgery, Computer-Assisted (methods)</term><term>Transcatheter Aortic Valve Replacement (methods)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Fluoroscopy</term><term>Multidetector Computed Tomography</term><term>Surgery, Computer-Assisted</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Aortic Valve Stenosis</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Germany</term><term>Radiation Injuries</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Radiation Injuries</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Fluoroscopy</term><term>Multidetector Computed Tomography</term><term>Surgery, Computer-Assisted</term><term>Transcatheter Aortic Valve Replacement</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Radiation Injuries</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Aortic Valve Stenosis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged, 80 and over</term><term>Dose-Response Relationship, Radiation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Intraoperative Period</term><term>Male</term><term>Prognosis</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">X-ray radiation exposure is of great concern for patients undergoing structural heart interventions. In addition, a larger group of medical staff is required and exposed to radiation compared with percutaneous coronary interventions. This study aimed at quantifying radiation dose reduction with implementation of specific image noise reduction technology (NRT) in transcatheter aortic valve implantation (TAVI) procedures. We retrospectively analyzed 104 consecutive patients with TAVI procedures, 52 patients before and 52 after optimization of x-ray radiation chain, and implementation of NRT. Patients with 1-step TAVI and complex coronary intervention, or complex TAVI procedures, were excluded. Before the procedure, all patients received a multislice computed tomography scan, which was used to size aortic annulus, select the optimal implantation plane, valve type and size, and guide valve implantation using a software tool. Air kerma and kerma-area product were compared in both groups to determine patient radiation dose reduction. Baseline parameters, co-morbidity, or procedural data were comparable between groups. Mean kerma-area product was significantly lower (p <0.001) in the NRT group compared with the standard group (60 ± 39 vs 203 ± 106 Gy × cm(2), p <0.001), which corresponds to a reduction of 70%. Mean air kerma was reduced by 64% (494 ± 360 vs 1,355 ± 657 mGy, p <0.001). In conclusion, using optimized x-ray chain combined with specific image noise reduction technology has the potential to significantly reduce by 2/3 radiation dose in standard TAVI procedures without worsening image quality or prolonging procedure time.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26742472</PMID><DateCreated><Year>2016</Year><Month>02</Month><Day>13</Day></DateCreated><DateCompleted><Year>2016</Year><Month>06</Month><Day>21</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>26</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1913</ISSN><JournalIssue CitedMedium="Internet"><Volume>117</Volume><Issue>5</Issue><PubDate><Year>2016</Year><Month>Mar</Month><Day>01</Day></PubDate></JournalIssue><Title>The American journal of cardiology</Title><ISOAbbreviation>Am. J. Cardiol.</ISOAbbreviation></Journal><ArticleTitle>Reducing Patient Radiation Dose With Image Noise Reduction Technology in Transcatheter Aortic Valve Procedures.</ArticleTitle><Pagination><MedlinePgn>834-8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.amjcard.2015.12.016</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0002-9149(15)02366-8</ELocationID><Abstract><AbstractText>X-ray radiation exposure is of great concern for patients undergoing structural heart interventions. In addition, a larger group of medical staff is required and exposed to radiation compared with percutaneous coronary interventions. This study aimed at quantifying radiation dose reduction with implementation of specific image noise reduction technology (NRT) in transcatheter aortic valve implantation (TAVI) procedures. We retrospectively analyzed 104 consecutive patients with TAVI procedures, 52 patients before and 52 after optimization of x-ray radiation chain, and implementation of NRT. Patients with 1-step TAVI and complex coronary intervention, or complex TAVI procedures, were excluded. Before the procedure, all patients received a multislice computed tomography scan, which was used to size aortic annulus, select the optimal implantation plane, valve type and size, and guide valve implantation using a software tool. Air kerma and kerma-area product were compared in both groups to determine patient radiation dose reduction. Baseline parameters, co-morbidity, or procedural data were comparable between groups. Mean kerma-area product was significantly lower (p <0.001) in the NRT group compared with the standard group (60 ± 39 vs 203 ± 106 Gy × cm(2), p <0.001), which corresponds to a reduction of 70%. Mean air kerma was reduced by 64% (494 ± 360 vs 1,355 ± 657 mGy, p <0.001). In conclusion, using optimized x-ray chain combined with specific image noise reduction technology has the potential to significantly reduce by 2/3 radiation dose in standard TAVI procedures without worsening image quality or prolonging procedure time.</AbstractText><CopyrightInformation>Copyright © 2016 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lauterbach</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier, Germany. Electronic address: lauterbach@uni-mainz.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hauptmann</LastName><ForeName>Karl Eugen</ForeName><Initials>KE</Initials><AffiliationInfo><Affiliation>Third Medical Clinic, Department of Cardiology, Krankenhaus der Barmherzigen Brüder Trier (a teaching affiliate of the University Medical Center of the Johannes Gutenberg-University Mainz), Trier, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>12</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Cardiol</MedlineTA><NlmUniqueID>0207277</NlmUniqueID><ISSNLinking>0002-9149</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001024" MajorTopicYN="N">Aortic Valve Stenosis</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004307" MajorTopicYN="N">Dose-Response Relationship, Radiation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005471" MajorTopicYN="N">Fluoroscopy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005858" MajorTopicYN="N">Germany</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007432" MajorTopicYN="N">Intraoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D061330" MajorTopicYN="N">Multidetector Computed Tomography</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011832" MajorTopicYN="N">Radiation Injuries</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D025321" MajorTopicYN="N">Surgery, Computer-Assisted</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D065467" MajorTopicYN="N">Transcatheter Aortic Valve Replacement</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>10</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2015</Year><Month>12</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>12</Month><Day>03</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>1</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>1</Month><Day>9</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>6</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26742472</ArticleId><ArticleId IdType="pii">S0002-9149(15)02366-8</ArticleId><ArticleId IdType="doi">10.1016/j.amjcard.2015.12.016</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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