Comparison of Radiation Dose Between Dedicated Cardiac and General-Purpose Angiography Systems in Coronary...

Coronary intervention contributes substantially to patient radiation exposure. While dedicated cardiac angiography systems are optimized for coronary imaging, general-purpose systems are frequently used due to resource constraints.

The radiation dose difference between these system types during routine coronary procedures performed by the same operator team remains poorly quantified.

This retrospective study enrolled 212 patients undergoing coronary procedures by the same operator team, allocated to dedicated cardiac (Philips Azurion 7 M12, n = 106) or general-purpose (Philips Azurion 7 M20, n = 106) systems based on room availability. Procedures were stratified into diagnostic angiography (n = 106) and percutaneous coronary intervention (PCI) (n = 106). Primary endpoints were total dose-area product (DAP) and air kerma (AK). Secondary endpoints included fluoroscopy DAP, acquisition DAP, fluoroscopy time, and estimated magnification mode usage.

Baseline characteristics were balanced between groups. In diagnostic angiography, total DAP was 18.3% lower with the cardiac system (1850 vs. 2260 μGy·m², p = 0.004). In PCI, total DAP was 22.1% lower (3280 vs. 4210 μGy·m², p < 0.001). Acquisition DAP drove the difference in both procedure types, while fluoroscopy DAP and fluoroscopy time showed no significant differences. Estimated magnification mode usage was significantly lower with the cardiac system. Multivariable regression confirmed system type as an independent predictor of total DAP (β = -0.28, p = 0.002).

Dedicated cardiac angiography systems achieve 18%-22% lower radiation doses in coronary procedures compared to general-purpose systems, driven by more efficient acquisition algorithms and associated with reduced magnification mode usage as a behavioral marker, without increased fluoroscopy time.