A study of the impact of x-ray tube performance on angiography system imaging efficiency

This work compared the impact of x-ray tube performance and automatic dose rate control (ADRC) parameter selection on system imaging efficiency of two Siemens angiography systems: a Siemens Megalix x-ray tube installed on an Artis Zee system (denoted 'MEGALIX') and a newer generation Gigalix x-ray tube installed on an Artis Q (denoted 'GIGALIX'). A method was used that accounted for two potential sources of bias in this comparison: differences in radiation output between the x-ray tubes and differences between the x-ray detectors on the two systems. First, ADRC x-ray factors (tube voltage, tube current, pulse length, focus size, spectral prefilter) and radiation output were recorded as a function of poly(methyl) methacrylate (PMMA) thickness on the MEGALIX unit. These factors were then applied manually on the GIGALIX system and incident air kerma rate (IAKR) and signal difference to noise ratio (SDNR) were measured. Second, the ADRC on the GIGALIX system was used to give the x-ray factors and both IAKR and SDNR relevant to the GIGALIX based system directly. This method enabled the SDNR to be measured from images acquired on the same x-ray detector. SDNR and IAKR were measured on both systems using a PMMA phantom covering thicknesses from 6 cm to 40 cm. A small 0.3 mm iron insert was used to measure SDNR, which was then multiplied by modulation transfer function based weighting factors for focal spot blurring and motion blurring. These factors were evaluated for an object motion of 25 mm s^-1 and at a spatial frequency of 1.4 mm^-1 in the object plane, relevant to interventional cardiology, giving a spatial frequency dependent SDNR(u). In the second phase of the study, a technical figure of merit (FOM) was used to express imaging performance of both systems, calculated as SDNR²(u)/IAKR. Averaged over all phantom thicknesses, the FOM of the GIGALIX-based system was 42% and 73% higher compared to that of the MEGALIX based system, for fluoroscopy and acquisition mode respectively. The results indicate that increased x-ray tube power and smaller foci can improve overall system efficiency and reduce doses.