Debbie Starkey

The development and evaluation of a medical imaging training immersive environment

A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory.

Bi-plane and single plane angiography: a study to compare contrast usage and radiation doses for adult cardiac patients in diagnostic studies

OBJECTIVE: This study compares the performance of bi-plane coronary angiography against single plane angiography in terms of the volume of contrast used (ml) and the total dose-area product (DAP) (μGym2) to the patient measured directly via flat panel detectors. METHODS: A total of 5176 adult diagnostic cardiac angiograms from a hospital in Brisbane, Australia were retrospectively studied. Patients with aortograms, iliac or femoral artery imaging, and stenting or graft interventions were excluded. Students t-tests were used to compare means, and confounding variables were compared using multivariate regression. This quantified the effects of bi-plane system use holding constant other factors (e.g.) body mass index (BMI), age, room, sex, number of digital acquisitions and fluoro time. RESULTS: Bi-plane imaging had an average difference in mean contrast use of -15.1 ml [15.5% 95% confidence interval (CI) (-13.2, -17.0) p<0.001], multivariate regression demonstrated a -27.0 ml reduction in contrast use [28% 95% CI (-29.0, -24.83) p<0.0001] when the significant effects of fluoro time, number of digital acquisitions, BMI and sex were held constant. Bi-plane imaging had an average difference in mean DAP of + 887.1 μGym2 [23% 95% CI (+1110.7, +663.4) p < 0.001], whilst multivariate regression found a +628.3 Gym2 increase in DAP [16% 95% CI (+467.5, +789.3) p<0.001] when the significant effects of fluoro time, number of digital acquisitions, BMI and sex were held constant. CONCLUSION: These results demonstrate that bi-plane imaging uses less contrast media than single-plane imaging for coronary angiography at the expense of more radiation. Bi-plane imaging may be preferable in patients with renal impairment, however single plane imaging may be preferable in those without renal impairment. ADVANCES IN KNOWLEDGE: This is a large cohort and statistically comprehensive study comparing bi-plane and single plane coronary angiography. Other studies 4, 5, 6, 12 have used Students t-tests to measure the difference between means, however this provides no causative information on the differences found. This study provides a view of the causative impact of bi-plane usage on DAP and contrast use via multivariate regression modelling.