Dual-axis rotational coronary angiography can reduce peak skin dose and scattered dose: a phantom study

The purpose of this study was to evaluate peak skin dose received by the patient and scattered dose to the operator during dual-axis rotational coronary angiography (DARCA), and to compare with those of standard coronary angiography (SA). An anthropomorphic phantom was used to simulate a patient undergoing diagnostic coronary angiography. Cine imaging was applied on the phantom for 2 s, 3 s, and 5 s in SA projections to mimic clinical situations with normal vessels, and uncomplicated and complicated coronary lesions. DARCA was performed in two curved trajectories around the phantom. During both SA and DARCA, peak skin dose was measured with thermoluminescent dosimeter arrays and scattered dose with a dosimeter at predefined height (approximately at the level of left eye) at the operator's location. Compared to SA, DARCA was found lower in both peak skin dose (range: 44%-82%, p < 0.001) and scattered dose (range: 40%-70%, p < 0.001). The maximal reductions were observed in the set mimicking complicated lesion examinations (82% reduction for peak skin dose, p < 0.001; 70% reduction for scattered dose, p < 0.001). DARCA reduces both peak skin dose and scattered dose in comparison to SA. The benefi t of radiation dose reduction could be especially signifi cant in complicated lesion examinations due to large reduction in X-ray exposure time. The use of DARCA could, therefore, be recommended in clinical practice to minimize radiation dose.