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Factors contributing to radiation dose for patients and operators during diagnostic cardiac angiography

James A Crowhurst1,2,3, Mark Whitby1,2,4, Michael Savage1,2

  • 1Heart and Lung Program, The Prince Charles Hospital, Chermside, Queensland, Australia.

Journal of Medical Radiation Sciences
|November 30, 2018
PubMed

Insights

Obesity is the strongest predictor of high radiation dose during diagnostic coronary angiography (CA) for both patients and operators. Understanding these factors helps minimize radiation exposure in cardiac procedures.

Area of Science:

  • Interventional Cardiology
  • Medical Physics
  • Radiology

Background:

  • Diagnostic coronary angiography (CA) involves significant ionizing radiation exposure for patients and healthcare professionals.
  • Minimizing radiation dose is crucial for patient safety and occupational health in cardiac catheterization labs.

Purpose of the Study:

  • To identify patient and procedural factors that most significantly influence radiation dose to patients and operators during CA.
  • To establish predictors for high radiation doses in diagnostic coronary angiography.

Main Methods:

  • Collected patient and procedure data over 16 months, categorizing procedures into 10 types.
  • Measured patient dose using Kerma area product (PKA) and operator dose (OD) with an instantly downloadable dosimeter (IDD).
  • Utilized univariate and multivariate regression analysis to identify dose predictors, defining high dose based on the 75th percentile.

Main Results:

  • Obesity (BMI > 30) was the strongest predictor for high PKA (OR=19.1) and high OD (OR=3.3).
  • Other factors influencing PKA included male gender, biplane imaging, X-ray unit, operator experience, and procedure type.
  • Factors predicting high OD included radial access, male gender, biplane imaging, and procedure type.

Conclusions:

  • Radiation dose in CA is multifactorial, influenced by a combination of patient characteristics and procedural elements.
  • Obesity emerges as a critical, independent predictor for elevated radiation doses received by both patients and operators during CA.
  • These findings underscore the need for tailored strategies to mitigate radiation exposure based on identified risk factors.
Abstract

Keywords:
Body mass indexcoronary angiographyfluoroscopyquality assuranceradiation dose

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