Clinical Evaluation of Radiation Reduction for Optimized Safety

NCT ID: NCT06348875

Last Updated: 2025-11-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2026-02-15

Study Completion Date

2026-07-15

Brief Summary

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The primary objective of this study is to determine whether a reduced radiation protocol (RRP) in which angiograms are acquired at ultralow radiation doses and then processed using spatiotemporal enhancement software can produce similar quality angiographic images as compared with standard techniques.

Detailed Description

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Coronary angiography is an essential diagnostic tool for determining the presence and severity of coronary artery disease, a leading cause of morbidity and mortality worldwide. While the basic techniques of coronary angiography have remained unchanged, the field of medical imaging has undergone significant advancements in hardware and software, offering new possibilities for enhanced visualization of the coronary arteries, better diagnostic accuracy, and improved patient and staff safety. However, the use of radiation during coronary angiography, which is necessary for image acquisition, exposes patients, physicians, and staff to potential risks, including radiation-induced tissue damage and an increased long-term risk of cancer. While the risks to patients attributable to the relatively low radiation doses they receive during single catheterization procedures are minimal, the cumulative risks of occupational radiation exposure are higher among physicians and staff, who are repetitively exposed to scattered radiation on a daily basis and accumulated over the course of years working in the catheterization laboratory. This occupational radiation exposure has been associated with an increased risk of cataracts, premature atherosclerosis, and certain cancers among physicians and staff. There is therefore a pressing need to explore strategies to minimize radiation doses used during coronary angiography without compromising the diagnostic accuracy of coronary artery disease detection.

Recent advancements in computational power and image processing algorithms provide opportunities for substantial reductions in radiation doses used during coronary angiography. One such advancement is spatiotemporal enhancement processing (STEP) which improves the signal to noise ratio of time sequenced angiographic data and enhances the visibility of vascular structure. This innovative STEP technique has the promise of minimizing patient and operator radiation exposure while maintaining adequate image quality. The purpose of this pilot study is to investigate a novel strategy of radiation dose reduction and data processing in coronary angiography. This pilot study will be performed in patients undergoing clinically-indicated diagnostic coronary angiography.

The study will compare angiograms acquired at ultralow radiation doses and processed with spatiotemporal enhancement software (STEP-angiograms) to standard of care angiograms (SOC-angiograms) acquired with normal radiation dose settings and no additional processing. The objectives are to assess offline whether the low radiation STEP-angiograms are of equivalent diagnostic quality as SOC-angiograms. In future research studies, the STEP software will be tested in the clinical setting to evaluate how the software may improve patient safety, enhance the overall quality of care, promote the responsible use of radiation in coronary angiography procedures, and reduce occupational radiation doses among physician and staff in the catheterization laboratory.

Conditions

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Coronary Artery Disease Myocardial Infarction Coronary Disease Coronary Stenosis Angina Pectoris Chest Pain

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Referred for clinically indicated coronary angiography
* ≥18 years of age
* Not pregnant
* English speaking
* Not imprisoned
* Able to provide written informed consent

Exclusion Criteria

* Hemodynamically or electrically unstable.
* Indication for coronary angiography is emergent, including ST-segment elevation myocardial infarction
* History of coronary artery bypass grafting
* An eGFR \<60
* Pregnant or lactating
* A BMI of 45 or greater
* Any other factor that the investigator feels would put the patient at increased risk or otherwise make the patient unsuitable for participation in the protocol
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Angiowave Imaging

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aram Salzman

Role: STUDY_CHAIR

Angiowave Imaging

Sean Madden, PhD

Role: STUDY_DIRECTOR

Angiowave Imaging

Ryan Madder, MD

Role: PRINCIPAL_INVESTIGATOR

Corewell Health

Locations

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Corewell Health West

Grand Rapids, Michigan, United States

Site Status

Countries

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United States

Central Contacts

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Sean Madden, PhD

Role: CONTACT

Phone: 7812692664

Email: [email protected]

Aram Salzman

Role: CONTACT

Phone: 6179018989

Email: [email protected]

Facility Contacts

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Ryan Madder, MD

Role: primary

Timothy Joseph, MD

Role: backup

References

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Ryan TJ. The coronary angiogram and its seminal contributions to cardiovascular medicine over five decades. Circulation. 2002 Aug 6;106(6):752-6. doi: 10.1161/01.cir.0000024109.12658.d4. No abstract available.

Reference Type BACKGROUND
PMID: 12163439 (View on PubMed)

The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP. 2007;37(2-4):1-332. doi: 10.1016/j.icrp.2007.10.003.

Reference Type BACKGROUND
PMID: 18082557 (View on PubMed)

Valentin J. Avoidance of radiation injuries from medical interventional procedures. Ann ICRP. 2000;30(2):7-67. doi: 10.1016/S0146-6453(01)00004-5.

Reference Type BACKGROUND
PMID: 11459599 (View on PubMed)

Andreassi MG, Cioppa A, Botto N, Joksic G, Manfredi S, Federici C, Ostojic M, Rubino P, Picano E. Somatic DNA damage in interventional cardiologists: a case-control study. FASEB J. 2005 Jun;19(8):998-9. doi: 10.1096/fj.04-3287fje. Epub 2005 Mar 31.

Reference Type BACKGROUND
PMID: 15802491 (View on PubMed)

Karatasakis A, Brilakis HS, Danek BA, Karacsonyi J, Martinez-Parachini JR, Nguyen-Trong PJ, Alame AJ, Roesle MK, Rangan BV, Rosenfield K, Mehran R, Mahmud E, Chambers CE, Banerjee S, Brilakis ES. Radiation-associated lens changes in the cardiac catheterization laboratory: Results from the IC-CATARACT (CATaracts Attributed to RAdiation in the CaTh lab) study. Catheter Cardiovasc Interv. 2018 Mar 1;91(4):647-654. doi: 10.1002/ccd.27173. Epub 2017 Jul 14.

Reference Type BACKGROUND
PMID: 28707381 (View on PubMed)

Other Identifiers

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CLN-PLAN-102v1

Identifier Type: -

Identifier Source: org_study_id