Evaluating the maximum patient radiation dose in cardiac interventional procedures

Area of Science:

• Medical Physics
• Radiology
• Cardiovascular Interventions

Background:

• X-ray systems in cardiac interventional radiology often lack methods to assess patient maximum skin dose (MSD).
• Accurate MSD evaluation is crucial for patient safety during interventional procedures.

Purpose of the Study:

• To develop and validate a novel method for estimating MSD during percutaneous coronary intervention (PCI).
• To correlate cumulative entrance skin dose (ESD) with cineangiography parameters for MSD estimation.

Main Methods:

• A retrospective study of 400 consecutive PCI patients.
• Utilized cumulative patient entrance skin dose (ESD) with back-scatter factor and cineangiography frame count.
• Employed dose-mapping software to verify irradiation and overlapping fields.

Main Results:

• A strong correlation was identified between cumulative ESD and the number of cineangiography frames.
• Developed a formula to estimate MSD using the proportion of main view cineangiography frames and cumulative ESD.
• The average estimated MSD (3.0 ± 1.9 Gy) was found to be lower than the average cumulative ESD (4.6 ± 2.6 Gy).

Conclusions:

• The proposed method offers a straightforward approach to estimate MSD in PCI procedures.
• This technique enhances patient dose monitoring in cardiac interventional radiology.
• Facilitates better risk management for radiation-induced skin injuries.