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Reference levels at European level for cardiac interventional procedures

R Padovani1, E Vano, A Trianni

  • 1Medical Physics Department, Udine Hospital, Italy. padovani.renato@aoud.sanita.fvg.it

Radiation Protection Dosimetry
|March 4, 2008
PubMed

Insights

Patient radiation doses in interventional cardiology vary widely. The SENTINEL study established new European reference levels (RLs) for procedures like coronary angiography and electrophysiology to reduce dose variability.

Area of Science:

  • Interventional Cardiology
  • Medical Radiation Physics
  • Radiological Protection

Background:

  • Significant patient dose variation exists for similar interventional cardiology procedures.
  • Factors contributing to dose variability include procedure complexity, equipment, protocols, and operator skill.

Purpose of the Study:

  • To assess and propose new European reference levels (RLs) for patient radiation dose in common interventional cardiology procedures.
  • To identify key factors influencing dose variability and propose related dose metrics.

Main Methods:

  • A survey conducted by the SENTINEL consortium across nine European centers.
  • Collected data on nearly 2000 procedures, including coronary angiography, angioplasty, and diagnostic electrophysiology.
  • Analyzed dose metrics such as air kerma-area product, effective dose, cumulative dose, fluoroscopy time, and cine frames.

Main Results:

  • New reference levels (RLs) were established for air kerma-area product (45, 85, 35 Gy cm2), effective dose (8, 15, 6 mSv), cumulative dose (650, 1500 mGy), fluoroscopy time (6.5, 15.5, 21 min), and cine frames (700, 1000 images).
  • Entrance surface air kerma for fluoroscopy (13 mGy/min) and image acquisition (0.10 mGy/frame) were proposed, highlighting equipment performance as a key factor.

Conclusions:

  • The established RLs provide benchmarks for optimizing patient radiation doses in interventional cardiology.
  • Addressing equipment performance and setup is crucial for reducing patient dose variability and ensuring consistent radiological protection.

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