X-ray Dose Reduction Study for Cardiac Angiography and Intervention

Study Overview
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Brief Summary
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ClarityIQ is a novel X-ray imaging technology, that combines advanced real-time image noise reduction algorithms, with state-of-the-art hardware to reduce patient entrance dose significantly. This is realized by anatomy-specific optimization of the full acquisition chain (grid switch, beam filtering, pulse width, spot size, detector and image processing engine) for every clinical task individually. Furthermore, smaller focal spot sizes and shorter pulses are used, which are known to positively influence image quality . The final effect on the clinical image quality is investigated in this study.

Detailed Description
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Fluoroscopically guided procedures are associated with a risk of radiation injury to the skin, caused by high peak skin dose. The increasingly complex nature of many of the interventions performed requires the use of significant amounts of radiation for their completion. Of particular relevance to dose reduction concerns are obese patients, for whom additional radiation is often necessary to obtained sufficient diagnostic quality, as well as patients suffering from chronic total coronary occlusions (CTO), for whom long procedures with extended radiation time and contrast usage are common. In order to introduce a dose reduction technology the most important aspect is to validate the diagnostic image information. Philips has developed a new algorithm that is capable to process images with similar image quality but acquired at lower dose.

Official Title
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Clinical Validation and Evaluation of ClarityIQ Cardiac Image Processing for Cardiac Angiography and Intervention

Conditions
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Vascular Diseases

Intervention / Treatment
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* Radiation: Angiographic run with new algorithm and low dose (50% dose)
* Radiation: Angiographic run with predecessor algorithm and dose (100%)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients older than 18 years of age undergoing coronary angiography Exclusion Criteria: Patients not willing or unable to give consent to participate Patients already involved in a clinical trial Patients under the age of 18 Pregnant women and breastfeeding women Patients with severe kidney disease (eGFR < 60)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: ClarityIQ<br>Angiographic run with new algorithm and low dose (50% dose) | Radiation: Angiographic run with new algorithm and low dose (50% dose)<br>* Angiographic run with new algorithm and low dose (50% lower dose compared to Xper)<br>* Other names: ClarityIQ;|
| Experimental: AlluraXper<br>Angiographic run with predecessor algorithm and dose (100% dose) | Radiation: Angiographic run with predecessor algorithm and dose (100%)<br>* Angiographic run with predecessor algorithm and dose (100% dose)<br>* Other names: AlluraXper;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Image Quality | Overall proportion where diagnostic image quality of ClarityIQ is scored equal or better compared to AlluraXper by the blinded readers. Reading is performed by simultaneous visual comparison of the image quality of AlluraXper and ClarityIQ by multiple blinded reviewers.The images are presented in a randomized order. The hypothesis is that the overall proportion where diagnostic image quality of ClarityIQ is scored equal or better is ≥ than 0.80. Combined for all raters, the lower bound of the one-sided 95% CI (lower bound of the two-sided 90% CI)is used. | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Radiation Dose Measurements: Dose Area Product (DAP) | Percentage of change of ClarityIQ vs. AlluraXper in Dose Area Product (DAP) calculated by DAP/frame. Negative percentage means a reduction in dose for ClarityIQ vs. AlluraXper. | Participants were followed for the duration of the procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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X-rays, Image processing, Cardiovascular procedure