Status of radiation protection in various interventional cardiology procedures in the Asia Pacific region.
OBJECTIVE
Increasing use of interventional procedures in cardiology with unknown levels of radiation protection in many countries of Asia-Pacific region necessitates the need for status assessment. The study was part of an International Atomic Energy Agency (IAEA) project for achieving improved radiation protection in interventional cardiology (IC) in developing countries.


METHODS
The survey covers 18 cardiac catheterisation laboratories in seven countries (Bangladesh, India, Malaysia, Myanmar, Singapore, Thailand and Vietnam). An important step was the creation of the 'Asian network of Cardiologists in Radiation Protection' and a newsletter. Data were collected on: radiation protection tools, number of IC laboratories, and annual number of various IC paediatric and adult procedures in the hospital and in the country. Patient radiation dose data were collected in terms of Kerma Area Product (KAP) and cumulative dose (CD).


RESULTS
It is encouraging that protection devices for staff are largely used in the routine practice. Only 39% of the angiographic machines were equipped with a KAP meter. Operators' initial lack of awareness on radiation-protection optimisation improved significantly after participation in IAEA radiation-protection training. Only two out of five countries reporting patient percutaneous coronary intervention radiation-dose data were fully within the international guidance levels. Data from 51 patients who underwent multiple therapeutic procedures (median 2-3) indicated a total KAP reaching 995 Gy.cm(2) (range 10.1-995) and CD 15.1 Gy (range 0.4-15.1), stressing the importance of dose monitoring and optimisation.


CONCLUSIONS
There is a need for interventional cardiology societies to play an active role in training actions and implementation of radiation protection.
Konstantopoulio Hospital, Athens, Attiki, Greece.
Virginia
V
Tsapaki
National Institute of Cardiovascular Diseases, Dhaka, Bangladesh.
Mohammed
M
Faruque Ghulam
National Heart Centre of Singapore, Singapore.
Soo Teik
ST
Lim
Choray University Hospital, Ho Chi Minh City, Vietnam.
Hung
H
Ngo Minh
Yangon General Hospital, Yangon, Myanmar.
Nwe
N
Nwe
Bombay Hospital, Mumbai, India.
Anil
A
Sharma
Sarawak General Hospital, Kuching, Malaysia.
Kui-Hian
KH
Sim
King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Suphot
S
Srimahachota
International Atomic Energy Agency, Vienna, Austria.
Madan Mohan
MM
Rehani
Interventional cardiology; PTCA; developing countries; physics; radiation dose; radiation protection