Can we reduce the radiation dose further without compromising image quality in 3D rotational angiography (3DRA)? A single center qualitative evaluation of 3DRA in congenital heart disease (CHD) patients.

INTRODUCTION

This retrospective study compares two 3D rotational angiography (3DRA) protocols in patients with congenital heart disease (CHD), with the aim of identifying the optimal balance between radiation dose reduction and preservation of diagnostic image quality. The overarching goal is to facilitate safer percutaneous interventions by minimizing exposure while maintaining imaging adequacy.

METHODS

A single-center retrospective analysis was conducted, evaluating two 3DRA acquisition protocols with distinct exposure parameters. Image quality was assessed subjectively by two cardiologists using Likert scales and objectively through signal-to-noise ratio (SNR) measurements. Particular attention was given to the visualization of cardiovascular structures and the overall clinical utility of the images.

RESULTS

The low-dose protocol achieved a significant reduction in radiation dose (p = 0.009). SNR values were significantly higher in the low-dose group (p < 0.05), while qualitative assessments showed only minor differences between protocols. Image quality and procedural usefulness remained consistently diagnostic in all cases.

CONCLUSION

Significant dose reduction in 3DRA is achievable without compromising diagnostic performance, supporting safer imaging practices for this radiosensitive patient population.

IMPLICATIONS FOR PRACTICE: Optimized 3DRA protocols provide a meaningful reduction in radiation exposure for pediatric CHD patients while preserving procedural efficacy, reinforcing their adoption in routine clinical practice.