Achieving reduced radiation exposure with maintained fluoroscopy effectiveness using ultralow-dose settings in...

Area of Science:

• Medical Imaging
• Cardiology
• Radiation Oncology

Background:

• Radiation exposure during cryoballoon pulmonary vein isolation (CB-PVI) requires optimization.
• Investigating different X-ray system settings is essential for reducing patient radiation doses.

Purpose of the Study:

• To compare radiation doses among three X-ray system settings during CB-PVI.
• To evaluate the impact of anti-scatter grids and dose settings on radiation exposure.

Main Methods:

• 148 patients undergoing first-time CB-PVI were prospectively enrolled into three groups: low dose with grid (LD+G), low dose without grid (LD-G), and ultralow dose with grid (ULD).
• Radiation doses (cumulative air Kerma) were compared across groups.
• A subset of 27 patients underwent CB-PVI using fluoroscopy only (no cine acquisition) for further dose comparison.

Main Results:

• Median cumulative air Kerma was significantly lower in the LD-G (71.8 mGy) and ULD (73.0 mGy) groups compared to LD+G (145.0 mGy).
• For patients without cine acquisition, median cumulative air Kerma was further reduced in LD-G (31.4 mGy) and ULD (22.7 mGy) groups versus LD+G (64.6 mGy).
• Procedure and fluoroscopy times showed no significant differences among groups.

Conclusions:

• Ultralow dose (ULD) X-ray settings combined with avoiding cine acquisition can effectively reduce radiation exposure during CB-PVI.
• These strategies maintain necessary fluoroscopy time, ensuring procedural safety and efficacy.