A large-scale multicentre study in Belgium of dose area product values and effective doses in interventional cardiology using contemporary X-ray equipment.

In this paper, a large-scale multicentre patient dose study performed in eight Belgian interventional cardiology departments is presented. Effective dose (E) was calculated based on a detailed dose-area product (DAP)-registration during each procedure and by using conversion coefficients generated by the Monte Carlo-based computer program PCXMC. Conversion coefficients were found to be 0.177 mSv Gycm(-2) for systems that do not use any additional copper filtration in cineradiography and 0.207 mSv Gycm(-2) for systems that use additional copper filtration in cineradiography. Mean E values of 9.6 and 15.3 mSv for diagnostic and therapeutic procedures, respectively, were obtained. DAP distributions were investigated in order to derive dose reference levels: 71 and 106 Gycm2 for diagnostic and therapeutic procedures, respectively, are proposed. Significant differences were observed in DAP distributions taking into account whether additional copper filtration was used in the cineradiography mode. Apart from the skin, the organs most at risk are lungs and heart. The probability of fatal cancer for the studied population amounted to 1.1x10(-4) and 2.1x10(-4) for diagnostic and therapeutic procedures, respectively, for the age distribution of the patients considered in this multicentre study.

[1]  M. Tapiovaara,et al.  PCXMC. A PC-based Monte Carlo program for calculating patient doses in medical x-ray examinations , 1997 .

[2]  F. Verdun,et al.  Adult reference levels in diagnostic and interventional radiology for temporary use in Switzerland. , 2004, Radiation protection dosimetry.

[3]  G Panayiotakis,et al.  Patient radiation doses during cardiac catheterization procedures. , 1998, The British journal of radiology.

[4]  J. Karppinen,et al.  Radiation Risk and Exposure of Radiologists and Patients during Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (PTCA) , 1995 .

[5]  P. C. Johns,et al.  Radiation risk to patients from percutaneous transluminal coronary angioplasty. , 1993, Journal of the American College of Cardiology.

[6]  H. Thierens,et al.  Patient-Specific Dose and Radiation Risk Estimation in Pediatric Cardiac Catheterization , 2005, Circulation.

[7]  E. Vano,et al.  Preliminary reference levels in interventional cardiology , 2003, European Radiology.

[8]  伊沢 正実,et al.  Recommendations of the International Commission on Radiological Protection , 1961 .

[9]  V. Neofotistou Review of patient dosimetry in cardiology. , 2001, Radiation protection dosimetry.

[10]  K. Faulkner,et al.  Radiation doses and somatic risk to patients during cardiac radiological procedures. , 1986, The British journal of radiology.

[11]  K. Faulkner,et al.  A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients. , 1995, The British journal of radiology.

[12]  B. Wall,et al.  Estimation of effective dose in diagnostic radiology from entrance surface dose and dose-area product measurements , 1994 .

[13]  R. Sievert,et al.  Book Reviews : Recommendations of the International Commission on Radiological Protection (as amended 1959 and revised 1962). I.C.R.P. Publication 6. 70 pp. PERGAMON PRESS. Oxford, London and New York, 1964. £1 5s. 0d. [TB/54] , 1964 .

[14]  E. Vañó,et al.  Patient dose values in interventional radiology. , 1995, The British journal of radiology.

[15]  Chester L. Olson,et al.  Comparative Robustness of Six Tests in Multivariate Analysis of Variance , 1974 .

[16]  J Zoetelief,et al.  Dose conversion coefficients for interventional procedures. , 2005, Radiation protection dosimetry.

[17]  Stephen Balter,et al.  ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures. A report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task , 2004, Journal of the American College of Cardiology.

[18]  G. Giannoglou,et al.  Radiation doses to patients undergoing coronary angiography and percutaneous transluminal coronary angioplasty. , 2003, Radiation protection dosimetry.

[19]  B. Wall,et al.  Organ Doses from Medical X-Ray Examinations Calculated Using Monte Carlo Techniques , 1985 .

[20]  V. Štísová Effective dose to patient during cardiac interventional procedures (Prague workplaces). , 2004, Radiation protection dosimetry.