Overall measurements of dose to patients in common interventional cardiology procedures

This study was designed to measure peak skin dose (PSD), dose-area product (DAP), cumulative dose (CD) and fluoroscopy time (FT) for interventional cardiology procedures and to evaluate whether patient doses were higher than that in other published data. Three cardiac procedure types, including coronary angiography (CAG), percutaneous transluminal coronary angioplasty (PTCA) and radio frequency (RF) ablation, were entered into the study. Data of four special metrics (PSD, DAP, CD and FT) for these procedures were collected and measured. A total of 238 patients who underwent interventional radiology procedures participated in this study. For every procedure, data about PSD were resulted from six TLD arrays and DAP, CD and FT were collected from the displayed monitor. The mean, standard deviation (SD), range and third quartile of the distribution of PSD, DAP, CD and FT recorded and measured on spot were calculated for all procedures. High-dose cases were specifically recorded. There was wide variation in the doses observed for different instances of the same procedure. PSD for PTCA and RF ablation ranged from 0.1 Gy to more than 3 Gy. Of 238 instances, there were 22 (9.2 %) with PSDs greater than 2 Gy and 4 (1.7 %) than 3 Gy. The third quartile of the distribution for PTCA had exceeded the DIMOND preliminary reference levels by 41.1 % in DAP and 25.0 % in FT. Mean DAP was in the range of reported values for CAG procedure, but higher than all data obtained in literatures for PTCA. Data from this study are in the range of most reported values for CAG and RF ablation procedure, while higher than that obtained in some literatures for PTCA. In case of a constant delivering of high doses to patient and physician himself, thorough training of interventionalists and staff is necessary, and the legislation has to be revised and set dose constrains especially for the interventional high-dose procedures.