Medical personnel and patient dosimetry during coronary angiography and intervention.
Percutaneous coronary interventions are associated with increased radiation exposure compared to most radiological examinations. This prospective study aimed at (1) measuring entrance doses for all in-room personnel, (2) performing an assessment of patient effective dose and intracoronary doses, (3) investigating the contribution of each projection to kerma-area product (KAP) and irradiation time, (4) comparing results with established DRL values in this clinical setting and (5) estimating the risk for fatal cancer to patients and operators. Measurements were performed during 40 consecutive procedures of coronary angiography (CA), half of which were followed by ad hoc coronary angioplasty (PTCA). KAP measurements were used for patients and thermoluminescent dosimetry for the in-room personnel. The mean KAP value per procedure for CA was 29 +/- 9 Gy cm2. Thirty four per cent of KAP was due to fluoroscopy, whereas the remainder (66%) was due to digital cine. Accordingly, the mean KAP value per PTCA procedure was 75 +/- 30 Gy cm2, and contribution of fluoroscopy is 57%. Effective dose per year was estimated to be 0.04-0.05 mSv y(-1) for the primary operator, and 0.03-0.04 mSv y(-1) for those assisting. Corresponding measurements for radiographer and nurse were below detectable level, implying minimal radiation hazards for them. Regarding radiation exposure, coronary intervention is considered a quite safe procedure for both patients and personnel in laboratories with modern equipment and experienced operators as long as standard safety precautions are considered. Exposure optimization though should be constantly sought through continuous review of procedures.
Efstathopoulos
Efstathios P
EP
2nd Department of Radiology, University of Athens, 20 Papadiamantopoulou Str., 11828 Athens, Greece. stathise@cc.uoa.gr
Makrygiannis
Stamatis S
SS
Kottou
Sofia
S
Karvouni
Evangelia
E
Giazitzoglou
Eleftherios
E
Korovesis
Socrates
S
Tzanalaridou
Efthalia
E
Raptou
Panagiota D
PD
Katritsis
Demosthenes G
DG
D001822:Body Burden; D017023:Coronary Angiography / Q000009:adverse effects*; D003331:Coronary Vessels / Q000601:surgery; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005260:Female; D006115:Greece / Q000453:epidemiology; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis*; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D011872:Radiology Department, Hospital; D011874:Radiometry / Q000379:methods*; D018570:Risk Assessment / Q000379:methods*