Overlap of radiation field and radiation field shape in cardiac catheterization

The radiation field shape for cardiac catheterization has changed from being circular to being rectangular with the spread of flat-panel detector systems. A rectangular radiation field provides a wide fluoroscopy field to the four corners of a subject area; however, in cardiac catheterization, there is not much usable information around the four corners at several angles, and this tends to be regarded as a meaningless radiation exposure. Hence, overlap of radiation fields has been of concern recently. The authors changed field sizes/fluoroscopy angles and examined entrance dose rates to study radiation field shapes and configurations of radiation exposure to patients, and they discussed a radiation exposure reduction method. In measurements of phantom entrance dose rates, we considered right anterior oblique (RAO) directions, cranial (CRA) directions and RAO-CRA directions and found that entrance dose rates rose considerably, particularly at the RAO-CRA. In the study of radiation field overlap, we discuss radiation field shapes (rectangular/circular) as well as angles. In the RAO-CRA directions, differences occurred in angles of non-overlapping radiation field by differences in radiation field shapes. For RAO-CRA, compared with the RAO and CRA directions, entrance dose rates increased with an increase in angle. When convenience in clinics is considered, the utilization frequency of the four corners of a rectangular field is low. When one considers the increases in radiation exposure caused by radiation field overlap, it is more effective to use circular radiation fields.