Generative learning approach for radiation dose reduction in X-ray guided cardiac interventions

Background Navigation guidance in cardiac interventions is provided by X-ray angiography. Cumulative radiation exposure is a serious concern for pediatric cardiac interventions. Purpose A generative learning-based approach is proposed to predict X-ray angiography frames to reduce the radiation exposure for pediatric cardiac interventions while preserving the image quality. Methods Frame predictions are based on a model-free motion estimation approach using a long short-term memory architecture and a content predictor using a convolutional neural network structure. The presented model thus estimates contrast-enhanced vascular structures such as the coronary arteries and their motion in X-ray sequences in an end-to-end system. This work was validated with 56 simulated and 52 patients' X-ray angiography sequences. Results Using the predicted images can reduce the number of pulses by up to three new frames without affecting the image quality. The average required acquisition can drop by 30% per second for a 15 fps acquisition. The average structural similarity index measurement was 97% for the simulated dataset and 82% for the patients' dataset. Conclusions Frame prediction using a learning-based method is promising for minimizing radiation dose exposure. The required pulse rate is reduced while preserving the frame rate and the image quality. With proper integration in X-ray angiography systems, this method can pave the way for improved dose management.