Radiation doses to patients in coronary interventions in a hospital in Thailand

Background: Radiation dose is best estimated by the Dose Area Product (DAP), the absorbed dose to air, multiplied by the X-ray beam cross-sectional area at the point of measurement. Interventional cardiologists should be made aware of the exposures to patients and how they compare to established norms. Objective: We assessed patient doses during coronary diagnostic and interventions then compared doses between two angiocardiographic systems in our center and through these actions. Methods and Results: In total, 308 (44.4%) diagnostic CAs, 229 (33.0%) one-vessel PCIs, 53 (7.6%) two or threevessel PCIs, and 15 (2.2%) PCIs to CTO were carried out. The mean DAP value for diagnostic CAs in room No. 1 (Siemens Axiom Artis dBC) was 45.2±28.7 Gy.cm ², compared with room No. 2 (Philips Allura Xper biplane FD 20/10) where mean DAP value was 78.6±58.4 Gy.cm² ( p < 0.001). The mean DAP value for one-vessel PCIs in room No. 1 was 97.8±67.5 Gy.cm², compared with room No. 2, mean DAP value of 159.4±82.4 Gy.cm² (p = 0.030). The mean DAP value for two or three-vessel PCIs in room No. 1 was 153.1±65.6 Gy.cm², compared with room No. 2, mean DAP value of 168.0±94.7 Gy.cm² (p = 0.070). DAP values per procedure in diagnostic CAs, one-vessel PCIs, and two or three-vessel PCIs in room No. 2 were higher than in room No. 1 after multivariable correction for weight and fluoroscopy time. Conclusions: Regular measurement of patient doses is an essential step to optimize exposure. It makes operators aware their own performance and allows comparisons with generally accepted practice.

Duke Scholars

Author Madan Mohan Rehani Radiology