Measures of radiation exposure in cardiac imaging and the impact of case complexity.
BACKGROUND
Although it is important for a patient's radiation related risks to be considered when recommending a cardiac imaging procedure, few clinicians appreciate the level of exposure involved. This paper provides a comprehensive set of radiation exposure metrics for common angiography procedures highlighting links to factors that influence radiation dose.


METHODS
Radiation use metrics and various clinical findings for diagnostic procedures and number of lesions treated, vessels treated and stents deployed for interventional cases were analysed.


RESULTS
Data relating to 1088 coronary angiography (CA), 256 angioplasty and 167 CA/angioplasty procedures were examined. The median effective dose (E) (mSv) for these procedures (including inter-quartile range) were, respectively, 3.3 (2.1-5.1), 7.5 (4.5-14.1) and 11.6 (6.9-16.1). For CA, E varied with the number of vessels (p<0.01) while for angioplasty E was linked to the number of vessels (p<0.01), lesions (p<0.01) and stents (p<0.01).


CONCLUSIONS
Radiation exposure metrics for common cardiac angiography imaging procedures have been documented and linked to procedure complexity. This has implications for performance monitoring when comparing radiation usage between users, facilities, times and technologies.
Smith
Ian R
IR
St. Andrew's Medical Institute, C/- St. Andrew's War Memorial Hospital, GPO Box 764, Brisbane, QLD 4001, Australia. ismith@sawmh.org.au
Rivers
John T
JT
D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D017023:Coronary Angiography / Q000009:adverse effects*; D005471:Fluoroscopy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods; D015641:Radiography, Interventional / Q000009:adverse effects* / Q000379:methods; D012016:Reference Values; D012189:Retrospective Studies