| Summary: | Yes === Cardiologists use x-ray image sequences of the moving heart acquired in real-time to diagnose and
treat cardiac patients. The amount of radiation used is proportional to image quality; however, exposure to radiation
is damaging to patients and personnel. The amount by which radiation dose can be reduced without compromising
patient care was determined. For five patient image sequences, increments of computer-generated
quantum noise (white + colored) were added to the images, frame by frame using pixel-to-pixel addition, to
simulate corresponding increments of dose reduction. The noise adding software was calibrated for settings
used in cardiac procedures, and validated using standard objective and subjective image quality measurements.
The degraded images were viewed next to corresponding original (not degraded) images in a two-alternativeforced-
choice staircase psychophysics experiment. Seven cardiologists and five radiographers selected their
preferred image based on visualization of the coronary arteries. The point of subjective equality, i.e., level
of degradation where the observer could not perceive a difference between the original and degraded images,
was calculated; for all patients the median was 33% 15% dose reduction. This demonstrates that a 33%
15% increase in image noise is feasible without being perceived, indicating potential for 33% 15% dose reduction
without compromising patient care. === Funded in part by Philips Healthcare, the Netherlands. Part of this work has been performed in the project PANORAMA, co-funded by grants from Belgium, Italy, France, the Netherlands, and the United Kingdom, and the ENIAC Joint Undertaking.
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