Increases in patient doses need to be avoided when upgrading interventional cardiology systems to flat detectors

The aim of this study was to evaluate patient doses in two interventional cardiology laboratories over a period of 1 y in which the imaging devices were changed from image intensifier (II) to flat detector (FD). Dosimetric data from a total of 1040 coronary angiography (CA) procedures and 1087 percutaneous transluminal coronary angioplasty (PTCA) procedures were gathered. During the period studied with II imaging, median values of dose area product were 28 Gy cm(2) for CA and 57 Gy cm(2) for PTCA. In the first half of the year with FD imaging, median values were 37 Gy cm(2) for CA and 89 Gy cm(2) for PTCA. A significant increase in patient doses was noticed in the early stages of use of FD technology for imaging IC procedures, while fluoroscopy time and number of images remained similar. A careful setting of the X-ray systems, after upgrading the imaging system, is essential to avoid unjustified increases in patient doses.