Optimization of image stacking as applied to x-ray angiographic sequences

frames but may carefully examine only 1 or 2 frames. Obviously, this "wastes" x-ray dose. It is well knownthat contrast agent poses significant acute and chronic risk to patients. These adverse reactions range fromdiscomfort, nausea, and hives to renal toxicity and even death. Considering economics, contrast agent costsabout $250 per patient study. In addition, the cost of treatment in response to adverse contrast agent reactioncan be quite significant. Thus, it is desirable to minimize x-ray dose and contrast agent volume.In this paper, we use a mathematical model of flowing contrast agent in blood and couple this with aninjector, x-ray system, and image processor to create a final output image. With this specification, we canexamine the extent to which contrast agent can be efficiently used. We examine the tradeoffs between contrastagent volume, x-ray dose, frame rate, and other clinical variables in this preliminary study.Our measure of image quality is the contrast to noise ratio (CNR). Previous studies reported improvementsin CNR at a given artery location,1 however, they cannot be directly translated into contrast agent savings.We can better assess the relationships with a mathematical model of the system. With such a model, we can