Radiation Dose Reduction By Using The Modified Method For Imaging The Right Coronary Artery
Bojan Stanetic1,2, Lejla Besic2, Milorad Grujicic 2,3, Miodrag Ostojic1,2,3,4,5,6,7
1 Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
2 Medical Faculty, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
3 Department of Nephrology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
4 Medical Faculty School of Medicine, Belgrade, Serbia
5 Serbian Academy of Sciences and Arts, Serbia
6 Academy of Sciences and Arts of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
7 Institute for Cardiovascular Diseases “Dedinje”, Belgrade, Serbia
Corresponding Author: Bojan Stanetic MD, PhD. Department of Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina; E-mail: bojan.stanetic@gmail.com; Phone: + 387 65 614 340; ORCID ID: 0000-0003-2219-7679
Cite this article: Stanetic B, Besic L, Grujicic M, Ostojic M. Radiation Dose Reduction by Using the Modified Method for Imaging the Right Coronary Artery. Sar Med J 2025; 2(2):90-97.. 
10.70119/0036-25
Pages: 90 – 97 / Published online: 16 December 2025
Original submission: 19 May 2025; Revised submission: 16 August 2025; Accepted: 25 September 2025
Abstract
Introduction. Radiological procedures have greatly advanced cardiology; however, exposure to ionizing radiation increases the risk of malignancy, consistent with the linear no-threshold model. During coronary angiography, radiologic technologists are responsible for patient preparation, equipment setup, image optimization, and minimizing radiation exposure. A modified imaging technique for the right coronary artery (RCA) has been developed to reduce radiation dose and fluoroscopy time.
Methods. This study compared patient and operator exposure to ionizing radiation (mGy) and fluoroscopy time(s) during RCA imaging using standard and modified methods. The modified technique employed a moving projection starting from a lateral tube position toward the hemi-axial plane, with simultaneous table movement, one radiograph, and a single 5-ml contrast injection at 3 ml/s. A total of 50 consecutive patients who underwent coronary angiography were analyzed.
Results. Participants (60% male; mean age 66.6 years, range 31–83) mostly had hypertension, dyslipidemia, and type 2 diabetes. The modified technique resulted in significantly lower radiation dose (23.78 vs. 34.78 mGy; p < 0.001), shorter fluoroscopy time (6.86 vs. 13.86 s; p = 0.002), and half the contrast medium use (5 ml vs. 10 ml). A moderate positive correlation was observed between fluoroscopy time and radiation dose (r = 0.294; p = 0.038).
Conclusion. The modified RCA imaging technique substantially decreases radiation exposure, fluoroscopy duration, and contrast volume, improving safety for both patients and staff. Its application represents a valuable step toward radiation protection optimization in invasive cardiology.
Keywords: Right Coronary Artery, Ionizing Radiation, Coronary Angiography, Fluoroscopy, Radiation Protection.
