Patient dose in cardiac radiology.
BACKGROUND
In diagnostic and interventional cardiology procedures performed with the use of X-ray diagnostic imaging systems, the long fluoroscopy time and the large number of cine projections, as well as the repetition of the procedure due to the recurrence of the lesion--a common event--result in a high locally delivered skin dose, which may even lead to patient skin necrosis. The purpose of this study was to collect information in order to estimate the patient dose during coronary angiography and coronary angioplasty procedures, using the dose-area product measuring system of the X-ray angiographic machine.


METHODS
Dose-area product (DAP), fluoroscopy time, number of sequences and frames per sequence were collected for each of 108 coronary angiography and 101 coronary angioplasty procedures, using the dedicated X-ray machine of the hospital's haemodynamic department, where more than 3000 procedures are performed per year.


RESULTS
The median values of DAP were 19.96 and 40.17 Gy.cm(2) for coronary angiography and angioplasty, respectively; fluoroscopy times were 7.7 and 23.4 minutes; and the numbers of frames were 457 and 641, respectively. There was a strong correlation between DAP and fluoroscopy time, the number of frames per sequence, and hence the cine recording time.


CONCLUSIONS
The entrance skin dose delivered to the patient in the haemodynamic department was lower than that of other studies, although the mean fluoroscopy time per patient was longer. The practices in use satisfy the diagnostic reference levels as far as DAP values and number of frames per patient are concerned, but not with regard to fluoroscopy time. We did not find the correlation between doctors' experience and DAP values reported in other studies, as we did not take into account the complexity index of the lesion.
Stratis
Andreas I
AI
Medical Physics Laboratory, Evangelismos General Hospital, Athens, Greece.
Anthopoulos
Prodromos L
PL
Gavaliatsis
Isidoros P
IP
Ifantis
Georghios P
GP
Salahas
Anastasios I
AI
Antonellis
Ioannis P
IP
Tavernarakis
Antonios G
AG
Molfetas
Michael I
MI
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D015331:Cohort Studies; D017023:Coronary Angiography / Q000009:adverse effects; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D011829:Radiation Dosage; D011834:Radiation Monitoring; D018570:Risk Assessment; D012867:Skin / Q000528:radiation effects*; D013997:Time Factors