Image quality and dose reduction in cardiac interventional procedures: application of an optimization strategy with typical dose value analysis

Abstract

This study aimed to evaluate the impact of dose-optimization strategies on radiation exposure during cardiac catheterization and angioplastyprocedures. The investigation was carried out at a high-complexity referral center using retrospective data, clinical-protocol adjustments, and image-quality assessments with dedicated simulators. Implemented measures included reducing the cine dose per frame and enabling post-processing filters, resulting in reductions of up to 39% in reference-point kermaand 25% in noise intensity under low-dose conditions. In total, 714 procedures performed over five semesters were analyzed. Diagnostic reference levels (DRLs) were determined and compared with data from national and international literature. A statistically significant reduction in DAP(16.3%) and Kₐ,r(12.8%) was observed for catheterization procedures (p<0.05). Although angioplasty procedures showed a similar trend, case variability limited statistical significance. The results demonstrate the effectiveness of technical interventions andcontinuous monitoring in lowering exposure levels,without compromising diagnostic image quality.Keywords:reference level;digital fluoroscopy; dose; image quality; optimization.