PATIENT DOSIMETRY DURING INTERVENTIONAL CARDIAC PROCEDURES IN A DEDICATED CATHETERIZATION LABORATORY

First local diagnostic reference levels for fluoroscopically guided cardiac procedures in adult patients in Chile

The goal of this study was to generate the first values of local diagnostic reference levels for a range of fluoroscopically guided cardiac diagnostic and therapeutic procedures in adult patients in Chile and to compare radiation dose levels with others presented in the literature. The dosimetric data collection period was conducted over the whole of 2020. The local diagnostic reference levels were calculated as the 75th percentile of patient dose data distributions for kerma area-product values. The sample of collected clinical procedures (480) was divided into diagnostic and therapeutic procedures. The kerma area-product differences found between diagnostic and therapeutic procedures were statistically significant. The local diagnostic reference levels were 81.6 Gy cm2 and 166.9 Gycm2 for fluoroscopically guided cardiac diagnostic and therapeutic procedures, respectively. A comparison of our results with results found in the literature for the last 10 years, showed that there are no published papers for hospitals in Latin America and the Caribbean. It becomes urgent to be able to carry out more research of this type, given that the health reality between countries on different continents is very different. While in some the establishment of diagnostic reference levels is a legal obligation, in others it is a matter of good or bad will.

Radiation doses during cardiac catheterisation procedures in India: a multicentre study: Radiation dose study

AIMS

Established, evidence-based measures of radiation are required to minimise its hazards, while maintaining adequate image quality. The aim of this study is to evaluate radiation data and generate reference radiation levels for commonly performed coronary catheterisation procedures in India.

METHODS AND RESULTS

In this prospective, observational study, all procedures were performed in accordance with the established standards using Innova IGS 520/2100-IQ catheterisation laboratories. Demographic, procedural and radiation data were collected. Dose reference limits (DRL) were established as the 75th percentile of the total distribution. There were 2,906 coronary angiograms (CAG), 750 percutaneous coronary interventions (PCI) and 715 CAG+PCI. DRLs for dose area product were: 19.6 Gy·cm2 for CAG, 49.8 Gy·cm2 for PCI and 72.0 Gy·cm2 for CAG+PCI, respectively. Median cumulative air kerma levels were: 185 mGy for CAG, 533mGy for PCI, and 891 mGy for CAG+PCI. Male gender, higher BMI, combining CAG+PCI, fluoroscopy time, number of cine frames, and image acquisition settings were significant contributors to increased radiation dose.

CONCLUSIONS

This study established reference radiation dose levels for diagnostic and interventional coronary procedures in India, which were comparable to and in the lower range of international standards.