Decadal Changes in Institutional Diagnostic Reference Levels for X-Ray Angiography: A Retrospective Comparative Study

Area of Science:

• Medical Imaging
• Radiology
• Interventional Cardiology

Background:

• Angiography is crucial for diagnosing and treating vascular diseases.
• Interventional procedures necessitate radiation dose optimization.
• Diagnostic Reference Levels (DRLs) are vital for monitoring patient exposure and adhering to the ALARA principle.

Purpose of the Study:

• To compare radiation dose metrics of a new angiographic system with a previous one and published literature.
• To establish updated institutional DRLs for radiation dose optimization.

Main Methods:

• Retrospective collection of radiation dose and procedural parameters for various angiography procedures.
• Analysis of Dose Area Product (DAP), fluoroscopy-related DAP, patient entrance dose indicators, and fluoroscopy time.
• Comparison of current data with historical data from approximately a decade prior.

Main Results:

• Median DAP values varied significantly by procedure, ranging from 5.72 to 349.60 Gy·cm².
• DAP values increased by an average of 96.4% compared to data from a decade ago.
• Fluoroscopy times remained relatively unchanged, and overall dose levels were lower than international literature values.

Conclusions:

• Updated institutional DRLs provide a benchmark for radiation dose optimization and quality assurance.
• The findings support future multicenter studies for national DRL establishment.
• Observed dose increases may be influenced by technological advancements and evolving clinical practices, though not directly assessed.