Removing the Antiscatter Grid: A simple way to lower radiation during both Angiography and PCI

TLDR: In cardiac electrophysiology imaging without the anti-scatter grid has been proven as a means of achieving further radiation reduction, and an appreciable difference in image quality without the grid was noted only during fluoroscopy with movement.

Abstract: Aim: Radiation reduction is essential. In cardiac electrophysiology imaging without the anti-scatter grid has been proven as a means of achieving further radiation reduction. We evaluate the application of this gridless imaging technique to deliver further reductions in radiation risk to both patients and personnel during coronary angiography(C/C) and percutaneous coronary interventions (PCI). Methods and Results: We compared 6 consecutive coronary angiograms and 4 consecutive PCIs with and without the antiscatter grid in our new Toshiba Infinix-I angiography suite (Toshiba Medical Systems, Japan) in patients with a Body Mass Index (BMI) under 30. We chose this number as we felt it was a threshold BMI above which image quality may be compromised. For all cases all radiation and clinical data were recorded. All procedures were performed without complication. An appreciable difference in image quality without the grid was noted only during fluoroscopy with movement. However during still fluoroscopy and cine acquisition there was no notable difference. One possible future approach may also be selected use of the gridless technique with re-introduction of the grid in larger patients or during aspects of the procedure where image quality is important. The most marked difference in radiation reduction was seen during PCI.