title: OPERATOR DEPENDENCY OF THE RADIATION EXPOSURE IN CARDIAC INTERVENTIONS: FEASIBILITY OF ULTRA LOW DOSE LEVELS.
abstract: BACKGROUND
  Mean radiation exposure in invasive cardiology varies greatly between different centres and interventionists. The International Commission on Radiological Protection and the EURATOM Council stipulate that, despite reference values, 'All medical exposure for radiodiagnostic purposes shall be kept as low as reasonably achievable' (ALARA). The purpose of this study is to establish the effects of the routine application of ALARA principles and to determine operator and procedure impact on radiation exposure in interventional cardiology.
  
  
  METHODS
  A total of 240 consecutive cardiac interventional procedures were analysed. Five operators performed the procedures, two of whom were working in accordance with ALARA principles (Group 1 operators) with the remaining three working in a standard manner (Group 2 operators). Radiation exposure levels of these two groups were compared.
  
  
  RESULTS
  Total fluoroscopy time and the number of radiographic runs were similar between groups. However, dose area product and cumulative dose were significantly lower in Group 1 when compared with Group 2. Radiation levels of Group 1 were far below even the reference levels in the literature, thus representing an ultra-low-dose radiation exposure in interventional cardiology.
  
  
  CONCLUSIONS
  By use of simple radiation reducing techniques, ultra-low-dose radiation exposure is feasible in interventional cardiology. Achievability of such levels depends greatly on operator awareness, desire, knowledge and experience of radiation protection.
authors.affiliation: Department of Cardiology, Izmir University, Izmir, Turkey.
authors.forename: Mehmet Emre
authors.initials: ME
authors.lastname: Ozpelit
authors.affiliation: Department of Cardiology, Izmir University, Izmir, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Ercan
authors.affiliation: Department of Cardiology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ozpelit
authors.affiliation: Department of Cardiology, Izmir University, Izmir, Turkey.
authors.forename: Nihat
authors.initials: N
authors.lastname: Pekel
authors.affiliation: Department of Cardiology, Izmir University, Izmir, Turkey.
authors.forename: Istemihan
authors.initials: I
authors.lastname: Tengiz
authors.affiliation: Department of Cardiology, Grand Medical Hospital, Manisa, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Ozyurtlu
authors.affiliation: Department of Cardiology, Izmir University, Izmir, Turkey.
authors.forename: Akar
authors.initials: A
authors.lastname: Yilmaz
mesh_terms: D005471:Fluoroscopy; D006801:Humans; D016273:Occupational Exposure; D011829:Radiation Dosage; D000069079:Radiation Exposure; D011835:Radiation Protection; D015641:Radiography, Interventional