RADIQAL Study (Radiation Dose and Image Quality Trial)

NCT ID: NCT06944509

Last Updated: 2025-07-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

824 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-14

Study Completion Date

2026-12-31

Brief Summary

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The Azurion R4.0 is developed by Philips Medical Systems Nederland B.V., a Philips Healthcare company. The Azurion is an interventional X-ray system which is used for live X-ray imaging during invasive cardiac procedures. The proposed Azurion R4.0 includes new x-ray image postprocessing (Xres5) compared to its predecessor, which was equipped with ClarityIQ image post-processing (Xres4).

Azurion R4.0 is a cleared device for EU-MDR regulated countries, submission for FDA510K clearance in the US is pending. Sites in the US will only be activated in the study after FDA clearance.

This is a prospective, randomized, unblinded, comparative, international, multi-center clinical investigation. Randomization will be 1:1 between Xres5 and ClarityIQ (Xres4). Stratification will be performed per site on intended procedure type (based on clinical presentation) and patient BMI.

Primary objective is to demonstrate that in coronary procedures, Xres5 can reduce overall patient radiation dose compared to the current ClarityIQ without affecting procedural performance.

It is expected that 824 subjects are necessary to collect sufficient data for the evaluation of the objectives of this clinical study. The enrollment period is expected to last for 12 months. The study will be executed in Spain, Czech republic, Denmark and the US.

Detailed Description

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The study procedures consist of three main steps: 1) patient screening and written informed consent, 2) baseline assessment and randomization and 3) treatment with the Azurion system with Xres5 \[intervention\] or the standard of care (ClarityIQ/Xres4) \[control\]. Patients will be randomly assigned to either the intervention group or the control group (using the standard of care) in a 1:1 ratio. The coronary procedure will be conducted as per institutional standards and at the discretion of the operator, but the standard image processing will be based on the randomization result. If randomized to the intervention group (Xres5), it will always be possible for the operator to cross over to the standard of care imaging processing (Clarity IQ). For the study sites in EU the primary staff in the intervention room will be wearing electronic staff dosimeters which will log the radiation exposure per staff member per procedure.

After the procedure, characteristics of the patient and procedure are captured in an eCRF. The imaging runs will be uploaded in the cloud after de-identification. After the study the radiation dose (DAP and Air Kerma) will be read out from the system.

The study procedures will end after the coronary procedure is completed. There will be no modifications in the standard of care patient treatment or follow-up.

Conditions

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Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a prospective, randomized, unblinded, comparative, international, multi-center clinical investigation.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Intervention (Xres5)

treatment with the Azurion system with Xres5

Group Type EXPERIMENTAL

treatment with the Azurion system with Xres5

Intervention Type DEVICE

treatment with the Azurion system with Xres5

Control (ClarityIQ)

the standard of care (ClarityIQ/Xres4)

Group Type ACTIVE_COMPARATOR

Azurion with Clairy IQ

Intervention Type OTHER

Azurion system with the standard of care (ClarityIQ/Xres4)

Interventions

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treatment with the Azurion system with Xres5

treatment with the Azurion system with Xres5

Intervention Type DEVICE

Azurion with Clairy IQ

Azurion system with the standard of care (ClarityIQ/Xres4)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Subject will be undergoing a diagnostic angiography and/or coronary intervention /elective PCI.
* Subject is able to give written informed consent.
* Subject is 18 years of age or older, or of legal age to give informed consent per state or national law.

Exclusion Criteria

* Subject with known contrast allergy that cannot be adequately premedicated.
* Subject with previous contraindication for diagnostic angiography and/or diagnostic/elective PCI.
* Subject participates in a potentially confounding drug or device study during the course of the study.
* Subject unwilling or unable to comply with the protocol and/or unable to understand verbal and/or written informed consent.
* Expected use of non-standard contrast concentrations (e.g. dilution of contrast).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Philips Clinical & Medical Affairs Global

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University of Colorado

Denver, Colorado, United States

Site Status NOT_YET_RECRUITING

Emory University Hospital

Atlanta, Georgia, United States

Site Status NOT_YET_RECRUITING

NYP Columbia

New York, New York, United States

Site Status NOT_YET_RECRUITING

University Hospital Královské Vinohrady

Prague, , Czechia

Site Status RECRUITING

Aarhus university hospital

Aarhus, , Denmark

Site Status RECRUITING

Hospital Clinico San Carlos

Madrid, , Spain

Site Status RECRUITING

Countries

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United States Czechia Denmark Spain

Central Contacts

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Martijn van Mourik

Role: CONTACT

+31 (6) 41477135

Facility Contacts

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Prof. Dr. Messenger

Role: primary

+1 303-315-5969

William Prof. Dr. Nichelson

Role: primary

+1 404-712-2000

Ajay Prof. Dr. Kirtane

Role: primary

+1 212-305-2500

Viktor Prof. Dr. Kočka

Role: primary

(+)420 267162701

Nicolaj Prof. Dr. Brejnholt Støttrup

Role: primary

(+)45 27118810

Javier MD PhD FESC Escaned

Role: primary

+34 917044596

References

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Philips Medical Systems Nederland B.V., "Safety and feasibility study with a new X-ray processing algorithm (Xres5) for coronary procedures"

Reference Type BACKGROUND

Gislason-Lee AJ, Keeble C, Malkin CJ, Egleston D, Bexon J, Kengyelics SM, Blackman D, Davies AG. Impact of latest generation cardiac interventional X-ray equipment on patient image quality and radiation dose for trans-catheter aortic valve implantations. Br J Radiol. 2016 Nov;89(1067):20160269. doi: 10.1259/bjr.20160269. Epub 2016 Sep 29.

Reference Type BACKGROUND
PMID: 27610932 (View on PubMed)

Nakamura S, Kobayashi T, Funatsu A, Okada T, Mauti M, Waizumi Y, Yamada S. Patient radiation dose reduction using an X-ray imaging noise reduction technology for cardiac angiography and intervention. Heart Vessels. 2016 May;31(5):655-63. doi: 10.1007/s00380-015-0667-z. Epub 2015 Apr 4.

Reference Type BACKGROUND
PMID: 25840815 (View on PubMed)

Hruby A, Hu FB. The Epidemiology of Obesity: A Big Picture. Pharmacoeconomics. 2015 Jul;33(7):673-89. doi: 10.1007/s40273-014-0243-x.

Reference Type BACKGROUND
PMID: 25471927 (View on PubMed)

Smith IR, Rivers JT. Measures of radiation exposure in cardiac imaging and the impact of case complexity. Heart Lung Circ. 2008 Jun;17(3):224-31. doi: 10.1016/j.hlc.2007.10.004. Epub 2008 Jan 31.

Reference Type BACKGROUND
PMID: 18242136 (View on PubMed)

Cusma JT, Bell MR, Wondrow MA, Taubel JP, Holmes DR Jr. Real-time measurement of radiation exposure to patients during diagnostic coronary angiography and percutaneous interventional procedures. J Am Coll Cardiol. 1999 Feb;33(2):427-35. doi: 10.1016/s0735-1097(98)00591-9.

Reference Type BACKGROUND
PMID: 9973023 (View on PubMed)

Fetterly KA, Lennon RJ, Bell MR, Holmes DR Jr, Rihal CS. Clinical determinants of radiation dose in percutaneous coronary interventional procedures: influence of patient size, procedure complexity, and performing physician. JACC Cardiovasc Interv. 2011 Mar;4(3):336-43. doi: 10.1016/j.jcin.2010.10.014.

Reference Type BACKGROUND
PMID: 21435613 (View on PubMed)

Other Identifiers

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IGT-200140-RADIQAL

Identifier Type: -

Identifier Source: org_study_id

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