Rotational X‐ray coronary angiography

Abstract

We designed and implemented a digital flat-panel-based rotational X-ray coronary angiography technique hypothesizing that luminal disease could be identified with less radiation exposure and contrast usage compared to conventional angiography. Individuals scheduled for diagnostic coronary angiography were prospectively enrolled. In addition to conventional acquisitions in standard planes, subjects underwent one additional left coronary artery (LCA) or right coronary artery (RCA) rotational (spin) acquisition using a predefined trajectory. Radiation exposure and contrast volume were recorded for each run. Seventy-five subjects were enrolled. When compared with standard five-view cine acquisition, LCA spin angiography with one cranial and one caudal run resulted in 34.38% +/- 13.65% less radiation, 18.98% +/- 4.97% less contrast, and comparable assessment of stenosis severity. One spin acquisition compared with three standard cine acquisitions for RCA angiography resulted in 59.31% +/- 29.07% lower radiation, no significant change in contrast, and comparable assessment of stenosis severity. Rotational X-ray coronary angiography provides comparable visualization of coronary anatomy compared with traditional nonrotational coronary angiography with significantly less radiation exposure and contrast volume.

Reconstruction of coronary arteries from a single rotational X-ray projection sequence

“…The latter situation mainly arises because of a poor synchronization between rotation and contrast agent injection. Such defects happened for the first acquisitions, when the physicians did not master the rotational acquisition, but not for the last ones because of a fast learning curve [13]. It suggests that the quality of the reconstructions will increase for the future experiments.…”

“…The gantry performs a rotation while acquiring the images [13]. The gantry motion is characterized by constant SID (Source Intensifier Distance) value, constant CRA/CAU (Cranio/Caudal) angle value, and varying LAO/RAO (Left/Right Anterior Oblique) angle.…”

Coronary angiography in the angioplasty era: projections with a meaning

“…This method has been shown to reduce exposure to radiation and contrast and to offer comparable diagnostic accuracy. 6 The currently available systems, however, can rotate only in a single plane (either transverse or sagittal). Rotational angiography will possibly replace the use of single plane acquisitions when the combined rotation in two planes will allow inclusion of most of the skewed caudocranial views described above.…”

When is rotational angiography superior to conventional single‐plane angiography for planning coronary angioplasty?

“…RoCA has several advantages over traditional CA. First, in the context of diagnostic CA, RoCA is associated with a reduction in the volume of contrast agent used and the total radiation dose . RoCA has, therefore, gained popularity in patients with renal insufficiency .…”