Patient radiation doses in the most common interventional cardiology procedures in Croatia: first results (original) (raw)
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Patient Radiation Doses in Interventional Cardiology Procedure
Atom Indonesia, 2022
Interventional cardiology is a minimally-invasive imaging procedure that allows medical doctor to evaluate and treat structural heart diseases. Due to its main advantages of avoidance of the scars and pain, as well as long post-operative recovery, interventional cardiology procedures have rapidly been growing. However, the increasingly complex and time-consuming procedures in interventional cardiology may increase the radiation exposure received by patients. This paper describes a study to measure patient radiation doses in terms of air kerma and kerma air-product (KAP) for various types of interventional cardiology procedures conducted in Indonesia. The measurements were performed at the interventional cardiology or cardiac catheterization facilities in sixteen hospitals in ten cities in Indonesia during the years of 2015 to 2019. A total of 147 procedures conducted on adult patients were used in this study. The type of procedure, total KAP, and air kerma were recorded after each procedure was completed. The demographic data of the patients were also recorded. The results showed that the mean air kerma and KAP measured for CA (coronary angiography) procedure were 680.7357.85 mGy and 12.525.86 Gy cm 2 , respectively, while the values for PCI (percutaneous coronary intervention) procedure were 890.6638.76 mGy and 20.189.37 Gy cm 2 , respectively. These results are well within the ranges reported by other previous studies. The results are somewhat affected by the body mass index of patients, while the fatal cancer risks among patients of CA and PCI procedures are comparable with those among interventional radiology procedures patients.
Patient radiation doses in interventional cardiology procedures
Current cardiology reviews, 2009
Interventional cardiology procedures result in substantial patient radiation doses due to prolonged fluoroscopy time and radiographic exposure. The procedures that are most frequently performed are coronary angiography, percutaneous coronary interventions, diagnostic electrophysiology studies and radiofrequency catheter ablation. Patient radiation dose in these procedures can be assessed either by measurements on a series of patients in real clinical practice or measurements using patient-equivalent phantoms. In this article we review the derived doses at non-pediatric patients from 72 relevant studies published during the last 22 years in international scientific literature. Published results indicate that patient radiation doses vary widely among the different interventional cardiology procedures but also among equivalent studies. Discrepancies of the derived results are patient-, procedure-, physician-, and fluoroscopic equipmentrelated. Nevertheless, interventional cardiology pr...
2017
The objective of this study was to estimate the French national updated reference levels (RLs) for coronary angiography (CA) and percutaneous coronary intervention (PCI) by a dose audit from a large data set of unselected procedures and in standard-sized patients. Kerma-area product (PKA), air kerma at interventional point (Ka,r), fluoroscopy time (FT), and the number of registered frames (NFs) and runs (NRs) were collected from 51 229 CAs and 42 222 PCIs performed over a 12-month period at 61 French hospitals. RLs estimated by the 75th percentile in CAs and PCIs performed in unselected patients were 36 and 78 Gy.cm² for PKA, 498 and 1285 mGy for Ka,r, 6 and 15 min for FT, and 566 and 960 for NF, respectively. These values were consistent with the RLs calculated in standard-sized patients. The large difference in dose between sexes leads us to propose specific RLs in males and females. The results suggest a trend for a time-course reduction in RLs for interventional coronary procedu...
Patient radiation dosimetry during interventional cardiac procedures
Iranian Journal of Radiation Research, 2020
Background: Cardiac catheterization plays an essential role in the evaluation of suspected heart failure patients. This work aimed to determine the mean effective dose of patients undergoing catheterization tests and to estimate the associated radiation risk of malignancy. Material and Methods: Measurements were performed during 65 coronary angiographies (CA), 70 coronary angioplasties (PTCA) 27, radio fluoroscopy (RF) ablations and 25 electro physiologies procedures in a dedicated laboratory. The procedures were undertaken with the Siemens and General Electric X-ray equipment. A dose area product (DAP) meter was also used. The DAP values and fluoroscopy times were recorded for each patient. Results: The mean DAP values and patient effective doses were 19.53 Gy.cm and 1.71 mSv for CA, 49.74 Gy.cm2 and 4.57 mSv for PTCA, 153.34 Gy.cm and 16.38 mSv for ablations and 14.88 Gy.cm and 1.65 mSv for electrophysiology, respectively. The patient radiation risk was estimated at 13, 1.3, 1.3, ...
Assessment of radiation doses to cardiologists during interventional examinations
Medical Physics, 2009
The accuracy of two on line dosimetric techniques was investigated for the estimation of cardiologist doses. The first technique involves the establishment of a database relating the cardiologist extremity doses to patient DAP values. Doses of nine cardiologists were measured together with patient doses during the interventional cardiac examinations of 166 patients for this purpose. Data were collected from five cardiology departments. The mean of the eye, thyroid, waist, right-left wrist, and right-left leg doses per procedure were measured as 72.4 ͑31.6-107.1͒, 68.5 ͑13.3-174.6͒, 11.2 ͑0.9-28.4͒, 67.8 ͑21.9-120.3͒ to 216 ͑52.7-425.4͒, and 137 ͑51.4-386.2͒ to 384 ͑135-1168.3͒ Gy/procedure. The effective doses were calculated according to the use of protection tools and a mean value of 12.14 ͑1.2-30.2͒ Sv/procedure was found. The ratios of staff dose to patient DAP were found to be within the range of 0.14-3.75 for each procedure. In the second method, cardiologist doses were calculated and compared with the measured values. Scatter doses were measured at the positions of cardiologists from Rando phantom exposures using similar conditions with patient procedures for this purpose. The parameters obtained from these exposures and patient examinations were used to calculate the doses to cardiologists.
Radiation Protection Dosimetry, 2015
This study evaluates per-procedure, collective and per capita effective dose to the population by interventional cardiology (IC) procedures performed during 2002-11 at the main hospital of Aosta Valley Region that can be considered as representative of the health-care level I countries, as defined by the UNSCEAR, based on its socio-demographic characteristics. IC procedures investigated were often multiple procedures in patients older than 60 y. The median extreme dose-area product values of 300 and 22 908 cGycm 2 were found for standard pacemaker implantation and coronary angioplasty, respectively, while the relative mean per-procedure effective dose ranged from 0.7 to 47 mSv. A 3-fold increase in frequency has been observed together with a correlated increase in the delivered per capita dose (0.05-0.27 mSv y 21) and the collective dose (5.8-35 man Sv y 21). Doses increased particularly from 2008 onwards mainly because of the introduction of coronary angioplasty procedures in the authors' institution. IC practice contributed remarkably in terms of effective dose to the population, delivering ∼10 % of the total dose by medical ionising radiation examination categories.
Polish Journal of Medical Physics and Engineering
Introduction: The current regulations in Poland in the field of interventional radiology only include diagnostic reference levels (DRL) for five procedures, containing only two for cardiological (hemodynamic) procedures, and only for adults. Given the insufficient number of DRLs, the need to introduce local levels based on the intervention procedures performed was identified. The purpose of this research was the evaluation of radiation doses (DRL, effective dose) received by patients in cardiological interventional procedures. Material and methods: The DRL level was defined as the 75th percentile of the distribution of dosimetric parameters KAP and Kair,ref for each type of cardiological procedure. Data include three different X-ray units and 27 interventional cardiologists, derived from February 2019 to June 2019 and from August 2021 to December 2021. In order to estimate the effective dose, the appropriate conversion factors for cardiological procedures were used. The total number...
2003
A detailed study of radiation doses received by 168 patients who underwent coronary angiography (CAG) and 102 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) in two Greek hospitals is presented. Radiation dose was measured in terms of dose-area product (DAP). The contribution of fluoroscopy and cineradiography to the total DAP was examined separately for each radiological projection used in both procedures. Effective dose and doses to various organs were estimated with the help of the ODS-60 software. Total DAP was found to correlate linearly to fluoroscopy time and cine film length. Mean DAP values were found to be 80.8 Ϯ 28.0 Gy cm 2 for CAG and 86.2 Ϯ 65.6 Gy cm 2 for PTCAs, whereas the estimated mean values of effective dose were 20.9 Ϯ 7.5 and 23.2 Ϯ 18.1 mSv respectively. DAP to effective dose conversion coefficients were estimated to be 0.26 mSv/Gy cm 2 for CAG and 0.27 mSv/Gy cm 2 for PTCAs.
Patient cumulative radiation exposure in interventional cardiology
Radioprotection, 2012
Organ doses to the lung, oesophagus, bone marrow and breast were mathematically evaluated. The median age of patients was 70 years. Their median cumulative dosearea product value was 48.4 Gy.cm 2 for the whole year and the median effective dose was 9.7 mSv. The median organ doses were 41 mGy for the lung, 31 mGy for the oesophagus, 10 mGy for the bone marrow and 4 mGy for the breast. Levels of doses close to the heart appear to be rather high in the case of repeated interventional cardiology procedures. Clinical characteristics should be taken into account when planning epidemiological studies on potential radiation-induced cancers.
Staff Radiation Doses in Interventional Cardiology: Correlation With Patient Exposure
Pediatric Cardiology, 2009
In pediatric interventional cardiology, cardiologists need to stay closer to the patient than during adult catheterization, and the use of biplane systems increases the scatter radiation. Occupational radiation risk is rather high, and estimation of lens doses becomes necessary. Deriving factors for assessing these doses from the patient doses displayed in catheterization laboratories can help in preserving staff radiation safety. A biplane X-ray system and polymethylmethacrylate plates of 4 to 20 cm to simulate pediatric patients have been used. Patient entrance dose rates, dose-area product, and doses to the eyes of the cardiologists for the typical operation modes have been measured. Correlations between patient and staff doses have been obtained. Scatter dose rates increase by a factor of 92 from low fluoroscopy to cine acquisition when phantom thickness increases from 4 to 20 cm. Scatter doses increase linearly with dose-area product for all the thicknesses. Administration of 1 Gy·cm2 to the patient involves 7 μSv to the eyes of the cardiologist (without extra protection). In conclusion, the experimental correlation factors found between phantom and scatter doses allow a fairly good estimation of staff doses from the dosimetric patient data.