Korean Circ J.  2015 Nov;45(6):451-456. 10.4070/kcj.2015.45.6.451.

Radiation Exposure in Coronary Angiography: A Comparison of Cineangiography and Fluorography

• Hwang J
• Lee SY
• Chon MK
• Lee SH
• Hwang KW
• Kim JS
• Park YH
• Kim JH
• Chun KJ

• KMID: 2223782
• DOI: http://doi.org/10.4070/kcj.2015.45.6.451

Abstract

BACKGROUND AND OBJECTIVES
Coronary angiography (CAG) is the gold standard for diagnosing coronary artery disease. However, exposure to ionizing radiation delivered during CAG has various negative biological effects on humans. In this study, there was an evaluation of whether fluorography resulted in decreased radiation exposure, as compared with cineangiography.
SUBJECTS AND METHODS
Fifty-five patients were prospectively enrolled and divided into two CAG groups, in accordance with the operator's professional discretion: a conventional cineangiography group versus a fluorography group. Fluorography refers to the photography of fluoroscopic images that are retrospectively stored, e.g., using the "Store fluoro" function of the Siemens cardiac angiography system. The primary outcomes included the air kinetic energy released per unit mass {air kerma (AK) mGy} and the dose (kerma)-area product (DAP; microGy . m2), both measured using built-in software in the Siemens system. The secondary outcomes included the total procedure time and amount of contrast agent used with each CAG method.
RESULTS
The total AK and DAP were significantly lower in the fluorography group (159.3+/-64.9 mGy and 1337.9+/-629.6 microGy . m2, respectively) than in the cineangiography group (326.9+/-107.5 mGy and 2341.1+/-849.9 microGy . m2, respectively; p=0.000 for both). The total procedure time (cineangiography vs. fluorography, 12.8+/-4.7 vs. 12.5+/-2.9 min; p=0.779) and contrast agent amount (136.1+/-28.3 vs. 126.3+/-25.7, p=0.214) were comparable between the two groups.
CONCLUSION
Fluorography is a useful method to decrease the radiation exposure in selected patients requiring CAG.

Keyword

Coronary artery disease; Angiography; Radiation; Cineangiography; Fluoroscopy

MeSH Terms

Angiography
Cineangiography*
Coronary Angiography*
Coronary Artery Disease
Fluoroscopy
Humans
Photography
Prospective Studies
Radiation, Ionizing
Retrospective Studies

Figure

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  Fig. 1 Screening and enrollment of patients. After applying the exclusion criteria, a total of 55 patients were enrolled. HR: heart rate, GFR: glomerular filtration rate, BMI: body mass index.

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  Fig. 2 Total air kerma and dose-area product values. (A) The total air kerma and (B) total dosearea product values were significantly lower in the fluorography group than in the cineangiography group. DAP: dose-area product.

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  Fig. 3 Examples of angiographic images. These are angiographic images acquired through (A) cineangiography and (B) fluorography. The fluorography image (B) is comparable with the cineangiography image (A) and shows adequate details for decision-making.

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