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Irradiator Commissioning and Dosimetry for Assessment of LQ α and β Parameters, Radiation Dosing Schema, and in vivo Dose Deposition
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CONTEMPORARY RADIATION DOSES IN INTERVENTIONAL CARDIOLOGY: A NATIONWIDE STUDY OF PATIENT DOSES IN FINLAND
Jukka Järvinen1,2,3, Joanna Sierpowska4, Teemu Siiskonen5
1Department of Cardiology, Turku Heart Centre, Turku University Hospital and University of Turku, Turku, Finland.
Radiation Protection Dosimetry
|April 17, 2019
Summary
New diagnostic reference levels (DRLs) for radiation dose in interventional cardiology procedures like PCI and TAVI were established in Finland. These updated DRLs reflect advancements in fluoroscopy technology and ensure patient safety during cardiac interventions.
Area of Science:
- Medical Physics
- Interventional Cardiology
- Radiology
Background:
- Interventional cardiology procedures have increased, necessitating updated radiation dose guidelines.
- Advancements in fluoroscopy technology allow for lower radiation exposure.
- Existing diagnostic reference levels (DRLs) require revision to reflect current practices.
Purpose of the Study:
- To assess patient radiation doses in interventional cardiology across seven Finnish hospitals.
- To establish updated and novel national DRLs for various interventional cardiology procedures.
- To provide updated radiation dose benchmarks for common and emerging cardiac interventions.
Main Methods:
- Analysis of patient radiation dose data (kerma-air product, KAP) from seven Finnish hospitals between 2014 and 2016.
- Calculation of DRLs for coronary angiography, percutaneous coronary intervention (PCI), pacemaker implantation (PI), atrial fibrillation ablation, and transcatheter aortic valve implantation (TAVI).
- Determination of tentative KAP values for cardiac resynchronization therapy (CRT) device implantation, atrioventricular nodal re-entry tachycardia ablation, and atrial flutter ablation.
Main Results:
- Updated DRLs set for coronary angiography (30 Gycm²) and PCI (75 Gycm²).
- Novel DRLs established for PI (3.5 Gycm²), atrial fibrillation ablation (25 Gycm²), and TAVI (90 Gycm²).
- First-time national DRLs proposed for TAVI and CRT device implantation (22 Gycm²).
- Image acquisition (cine) is the primary dose contributor in coronary and atrial fibrillation ablation procedures.
- Patient weight is a significant predictor of radiation dose in TAVI procedures.
Conclusions:
- Updated and new national DRLs for interventional cardiology procedures in Finland have been proposed.
- These DRLs provide essential benchmarks for radiation dose optimization in line with technological advancements.
- The findings support efforts to minimize patient and operator radiation exposure while maintaining diagnostic image quality.
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