Image quality and dose reduction in cardiac interventional procedures: application of an optimization strategy with typical dose value analysis

This study aimed to evaluate the impact of dose‑optimization strategies on radiation exposure during cardiac catheterization and angioplasty procedures. The investigation was carried out at a high‑complexity referral center using retrospective data, clinical‑protocol adjustments, and image‑quality assessments with dedicated simulators. Implemented measures included reducing the cine dose per frame and enabling post‑processing filters, resulting in reductions of up to 39 % in reference‑point kerma and 25 % in noise intensity under low‑dose conditions. In total, 714 procedures performed over five semesters were analyzed. Diagnostic reference levels (DRLs) were determined and compared with data from national and international literature. A statistically significant reduction in DAP (16.3 %) and Kₐ,r (12.8 %) was observed for catheterization procedures (p < 0.05). Although angioplasty procedures showed a similar trend, case variability limited statistical significance. The results demonstrate the effectiveness of technical interventions and continuous monitoring in lowering exposure levels, without compromising diagnostic image quality.