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PRELIMINARY INVESTIGATION OF RADIATION DOSE TO PATIENTS FROM CARDIOVASCULAR INTERVENTIONAL PROCEDURES IN TANZANIA.

J E Ngaile1, P K Msaki1, R Mvungi2

  • 1Department of Physics, University of Dar es Salaam, Dar es Salaam, Tanzania.

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Summary
This summary is machine-generated.

Radiation doses from cardiovascular interventional radiology (CVIR) procedures like coronary angiography (CA) and percutaneous coronary interventions (PCI) in Tanzania are higher than international benchmarks. Significant variations in patient radiation exposure (KAP, CAK, FT) highlight the need for dose optimization strategies.

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Area of Science:

  • Radiological Sciences
  • Cardiovascular Interventional Radiology
  • Medical Physics

Background:

  • Cardiovascular interventional radiological (CVIR) procedures, including coronary angiography (CA) and percutaneous coronary interventions (PCI), are increasingly complex, raising concerns about radiation exposure.
  • Patient radiation doses from these procedures can lead to tissue effects and stochastic effects, necessitating an investigation into factors influencing dose and opportunities for optimization.
  • Understanding patient radiation doses is crucial for ensuring the benefits of CVIR procedures outweigh the risks.

Purpose of the Study:

  • To investigate patient radiation doses, specifically air kerma area product (KAP), cumulative air kerma (CAK), and fluoroscopy time (FT), during CA and PCI procedures in Tanzania.
  • To identify factors contributing to variations in patient doses within and across hospitals.
  • To compare patient doses with international benchmarks and diagnostic reference levels.

Main Methods:

  • Patient radiation doses (KAP, CAK, FT) were collected for CA and PCI procedures from two major hospitals in Tanzania.
  • Ionization chambers equipped in angiographic units were used to determine CAK and KAP.
  • Data were analyzed to determine median and mean values, inter-hospital and intra-hospital variations, and comparisons with international data and reference levels.

Main Results:

  • Median KAP, CAK, and FT for CA were 37.8 Gy cm², 425.5 mGy, and 7.6 min; for PCI, they were 86.5 Gy cm², 1180.3 mGy, and 19.0 min, respectively.
  • Significant inter- and intra-hospital variations in KAP, CAK, and FT were observed, with differences up to 33.5, 58.7, and 26.3 for CA, and 10.9, 25.3, and 13.8 for PCI.
  • Mean KAP and FT values were generally higher than those reported in other countries, and third quartiles exceeded preliminary diagnostic reference levels.

Conclusions:

  • Substantial variations in patient radiation doses for CA and PCI procedures in Tanzania indicate a need for dose optimization.
  • Factors such as procedure complexity, patient characteristics, and variations in operator skill and protocols contribute to dose differences.
  • The higher-than-reported doses necessitate a review of procedural protocols and implementation of strategies to reduce patient radiation exposure in CVIR.