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Ma J, Liu K, Chen W, Wang T, Xu Z, Li Y, Zhao B, Zhou L, Wang F, Li C. A dual-centre study on the radioprotective effect of a novel X-ray protection device during coronary intervention. Clin Radiol 2023; 78:e758-e763. [PMID: 37419771 DOI: 10.1016/j.crad.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/04/2023] [Accepted: 06/04/2023] [Indexed: 07/09/2023]
Abstract
AIM To investigate the shielding efficiency of a novel X-ray protection device (NPD) compared with the traditional lead clothing (TLC) during coronary intervention. MATERIALS AND METHODS This study was performed prospectively in two centres. A total of 200 coronary interventions were included and assigned equally into the NPD or TLC group. The NPD is a floor-standing X-ray protection device, which mainly composes of a barrel-like frame and two layers of lead rubber. Thermoluminescent dosimeters (TLDs) were adopted to detect the cumulative absorbed doses, and were attached outside the NPD or TLC or body of the first operator at four different height levels in four directions during the procedure. RESULTS The cumulative doses outside the NPD were comparable to that of the TLC (2,398.33 ± 2,341.64 versus 1,624.09 ± 1,732.20 μSv, p=0.366), and the cumulative doses inside the NPD were significantly lower than those inside the TLC (40 ± 0 versus 732.28 ± 919.83 μSv, p<0.001). As the TLC did not cover the calf segment of the operator, the area at 50 cm height from the floor in the TLC group was unshielded. The shielding efficiency of NPD was significantly higher than that of the TLC (98.2 ± 0.63% versus 52.11 ± 38.97%, p=0.021). CONCLUSION The NPD has a significantly higher shielding efficacy than that of the TLC, in particular, it protects the operators' lower limb, liberates their lower body from wearing heavy lead apron, and may consequently reduce the radiation or body-load associated complications.
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Affiliation(s)
- J Ma
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - K Liu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Cardiology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - W Chen
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China
| | - T Wang
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Cardiology, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Z Xu
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - B Zhao
- Department of Cardiology, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - L Zhou
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - F Wang
- Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu, China.
| | - C Li
- Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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Manicardi M, Nocetti L, Brigidi A, Cadioli C, Sgreccia D, Valenti AC, Vitolo M, Arrotti S, Monopoli DE, Sgura F, Rossi R, Guidi G, Boriani G. Anthropometric parameters and radiation doses during percutaneous coronary procedures. Phys Med 2022; 100:164-175. [PMID: 35901630 DOI: 10.1016/j.ejmp.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/24/2022] [Accepted: 06/27/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Body size is a major determinant of patient's dose during percutaneous coronary interventions (PCI). Body mass index, body surface area (BSA), lean body mass and weight are commonly used estimates for body size. We aim to identify which of these measures and which procedural/clinical characteristics can better predict received dose. METHODS Dose area product (DAP, Gycm2), fluoroscopy DAP rate (Gycm2/min), fluoroscopy DAP (Gycm2), cine-angiography DAP (Gycm2), Air Kerma (mGy) were selected as indices of patient radiation dose. Different clinical/procedural variables were analysed in multiple linear regression models with previously mentioned patient radiation dose parameters as end points. The best model for each of them was identified. RESULTS Overall 6623 PCI were analysed, median fluoroscopy DAP rate was 35 [IQR 2.7,4.4] Gycm2, median total DAP was 62.7 [IQR 38.1,107] Gycm2. Among all anthropometric variables, BSA showed the best correlation with all radiation dose parameters considered. Every 1 m2 increment in BSA added 4.861 Gycm2/min (95% CI [4.656, 5.067]) to fluoroscopy DAP rate and 164 Gycm2 (95% CI [145.3, 182.8]) to total DAP. Height and female sex were significantly associated to a reduction in fluoroscopy DAP rate and total DAP. Coronary angioplasty, diabetes, basal creatinine and the number of treated vessels were associated to higher values. CONCLUSIONS Main determinants of patient radiation dose are: BSA, female sex, height and number of treated vessels. In an era of increasing PCI complexity and obesity prevalence, these results can help clinicians tailoring X-ray administration to patient's size.
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Affiliation(s)
- Marcella Manicardi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Luca Nocetti
- Medical Physics Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Alessio Brigidi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Cecilia Cadioli
- Medical Physics Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Daria Sgreccia
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Anna Chiara Valenti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Marco Vitolo
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Salvatore Arrotti
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Daniel Enrique Monopoli
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Fabio Sgura
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Rosario Rossi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Gabriele Guidi
- Medical Physics Unit, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
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