The difference in dose and image quality between magnification methods used after the introduction of larger 60-inch operator screens

OBJECTIVE: To determine whether the use of display matrix magnification on larger operator screens without the use of conventional magnification can reduce radiation dose to the patient, and what effect it would have on image quality. METHODS: The kerma-area product (KAP) resulting from standard projections in cardiac angiography were measured when an anthropomorphic phantom was imaged using conventional magnification method and display matrix magnification. The image quality was also evaluated by three observers using a TOR 18FG test tool for both magnification method. RESULTS: The mean radiation KAP for the seven views with conventional magnification was 36.65 µGy m(−2) whilst a reduction in KAP of 20.4% is possible using display matrix magnification (p < 0.05). The image resolution during acquisition was identical between both methods and only slightly reduced for the display matrix (1.6 LP mm(−1)) compared to conventional magnification (1.8 LP mm(−1)) when images were stored and retrieved on a Picture Archiving and Communication Systems (PACS) system. Both methods retained the same low-contrast detectability to PACS, with only a slight increase in detectability of 18 for display matrix magnification compared to 17 for conventional. CONCLUSION: Using display matrix magnification instead of conventional equipment magnification significantly reduces radiation does in all standard cardiac views without reducing image quality for the operator. This reduction in radiation dose is significant (p < 0.05) for the patients. The resolution did not change during acquisition, but contrast improved slightly (0.9% threshold contrast), but lost resolution of 0.2 LP mm(−1) when archived to PACS. ADVANCES IN KNOWLEDGE: This is a new method of reducing significant dose to the patient during cardiology examinations and may encourage further studies in other fluoroscopy lead examination to see if it could work for them.