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Published on: March 11, 2021
Local Diagnostic Reference Levels in Interventional Radiology
Imane Ou-Saada1, Soumaya Boujemaa1, Mauro Campoleoni2
1Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco.
Insights
This study establishes local diagnostic reference levels (DRLs) for interventional cardiology procedures in Morocco. The findings aim to optimize radiation doses and improve radiological practices for coronary angiography and angioplasty.
Area of Science:
- Medical Imaging
- Radiological Protection
- Interventional Cardiology
Background:
- Interventional cardiology procedures utilize fluoroscopy, leading to significant radiation exposure for patients and operators.
- Managing radiation doses during these procedures is a critical challenge for healthcare professionals and regulatory bodies.
- Establishing local diagnostic reference levels (DRLs) is essential for optimizing radiological practices.
Purpose of the Study:
- To establish local diagnostic reference levels (DRLs) for interventional cardiology procedures in Morocco.
- To optimize radiation doses and enhance radiological practices within the study's scope.
- To provide benchmarks for radiation exposure in coronary angiography and percutaneous transluminal coronary angioplasty.
Main Methods:
- The study analyzed 657 interventional cardiology procedures (coronary angiography and percutaneous transluminal coronary angioplasty) in Rabat, Morocco (2017-2018).
- Data collected included patient demographics, dose area product (PKA), air kerma (Kar), fluoroscopy time (FT), and beam parameters (kV, mAs).
- Local DRLs were determined using the 75th percentile of PKA and FT for each procedure type.
Main Results:
- Mean PKA values were 29.2 Gy*cm² for CA and 70.4 Gy*cm² for PTCA.
- Mean fluoroscopy times were 4.0 min for CA and 12.17 min for PTCA.
- Local DRLs were established at 37.3 Gy*cm² (PKA) and 4.48 min (FT) for CA, and 87.1 Gy*cm² (PKA) and 16.15 min (FT) for PTCA.
Conclusions:
- This study successfully proposed local DRLs for coronary angiography and percutaneous transluminal coronary angioplasty in Morocco.
- The established DRLs align with findings from international studies, indicating comparable radiation dose levels.
- The proposed DRLs serve as a valuable tool for optimizing radiation safety in Moroccan interventional cardiology.
Purpose:
Interventional cardiology procedures, during which live images are acquired, involve exposure to x-rays. The use of fluoroscopy can cause high radiation doses to patients and operators because of the prolonged duration of x-ray emission. For this reason, special attention and constant vigilance represent challenges for commissions and groups of experts in the field. The purpose of this study is to establish local diagnostic reference levels (DRLs) for these procedures, to improve radiological practice, and to optimize radiation doses.
Methods:
This work was carried out in two university hospitals and two private medical facilities in Rabat, the capital of Morocco, during the period 2017-2018. The study concerns 657 interventional cardiology procedures (457 coronary angiography [CA] and 200 percutaneous transluminal coronary angioplasty [PTCA]), performed by 11 cardiologists on different installations in 5 catheterization rooms. The data collected for each procedure were patient age, height and weight, dosimeter indicators in terms of dose area product (PKA), total air kerma at the reference point (Kar), fluoroscopy time (FT), and the number of frames, together with the primary beam parameters as kV and total mAs. The proposed DRLs were set from the 75th percentile of the PKA and FT.
Results:
The mean of PKA for CA and PTCA procedures were 29.2 Gy∗cm2 and 70.4 Gy∗cm2, respectively, the mean of fluoroscopy time were 4.0 min and 12.17 min for 334 and 685 frames, respectively. Results for the local DRLs were 37.3 and 87.1 Gy cm2 for PKA and 4.48 and 16.15 min for FT, corresponding to CA and PTCA procedures.
Conclusion:
This work focuses on proposing local DRLs in Morocco for CA and PTCA procedures. The results show that the values found conform with those of international studies.
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