Angiography by Synchrotron Radiation

Because coronary disease represents the principal health problem in the Western, industrialized world, and because of the risks and costs associated with conventional methods of visualizing the coronary arteries, an effort has been underway at the Stanford Synchrotron Radiation Laboratory to develop a less invasive coronary imaging procedure based on iodine K-edge dichromography. A pair of line images, recorded within a few milliseconds of each other, is taken with two monochromatic X-ray beams whose energy closely brackets the K-edge of iodine, 33.17 keV. The logarithmic subtraction of the images produced by these beams results in an image which greatly enhances signals arising from attenuation by iodine and almost totally suppresses signals arising from attenuation by soft tissue and bone. The high sensitivity to iodine allows the visualization of arterial structures after an intravenous injection of contrast agent and its subsequent 20-30 fold dilution. The experiments began in 1979, with initial studies done on phantoms and excised pig hearts. The first images of anesthetized dogs were taken in 1982. The results of experiments on dogs will be reviewed, showing the stepwise evolution of the imaging system, leading to the use of the system on human subjects in 1986. The images recorded on human subjects will be described and the remaining problems discussed.