An advanced Scanning-Beam Digital X-ray (SBDX) system for cardiac angiography has been constructed. The 15-kW source operates at 70 - 120 kVp and has an electron beam that is electromagnetically scanned across a 23-cm X 23-cm transmission target. The target is directly liquid cooled for continuous full-power operation and is located behind a focused source collimator. The collimator is a rectangular grid of 100 X 100 apertures whose axes are aligned with the center of the detector array. X-ray beam divergence through the collimator apertures is matched to the 5.4-cm X 5.4 cm detector, which is 150 cm from the source. The detector is a 48 X 48 element CdZnTe direct-conversion photon-counting detector. A narrow x-ray beam scans the full field of view at up to 30 frames per second. A custom digital processor simultaneously reconstructs sixteen 1,0002 pixel tomographic images in real time. The slices are spaced 1.2 cm apart and cover the entire cardiac anatomy. The small detector area and large patient-detector distance result in negligible detected x-ray scatter. Image signal-to-noise ratio is calculated to be equal to conventional fluoroscopic systems at only 12% of the patient exposure and 25% of the staff exposure. Exposure reduction is achieved by elimination of detected scatter, elimination of the anti-scatter grid, increased detector DQE, and increased patient entrance area.© (1999) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.