Table 3

Factors and techniques for reducing radiation dose

Manufacturer settings, tools, and protocolsBasic radiation physicsOperator practices
Biplane
Flat panel detectors
Large display monitor		Remove scatter grids when possibleTailor examination: limit number of vessels catheterized and number of DSA acquisitions per vessel
Familiarize oneself with manufacturer-specific dose reduction procedure workflows

  • Store fluoroscopy, positions

  • Overlay

  • DSA run to roadmap conversion

Minimize air gap (eg, raise the table, lower the detector)Start with slower ariable frame rates
Prudent use of faster frame rates for high-flow lesions and as needed
Design pediatric protocols:

  • lower dose per pulse

  • lower dose per frame

Tight collimationMinimize angulation
Variable frame rate (VFR) protocols:

  • lower routine arterial-phase acquisitions to 2–3 f/s followed by 1 f/s for venous phase

Filtration (copper)Monitor dose during and at the end of the procedure

  • Ka,r (mGy)

  • PKA (in uGym2)

  • Fluoroscopy time

References(26 28 29 38 39)

  • DSA, Digital Subtraction Angiography.