Assessment of Patient Radiation Dose in Interventional Procedures at Shahid Madani Heart Center in Khorramabad, Iran

Document Type: Original Paper

Authors

1 Department of Medical Physics & Radiation Sciences, Lorestan University of Medical Sciences, Khorram Abad, Iran

2 Department of Medical physics and Radiation Sciences, School of Para Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran

3 Department of Public Health, Lorestan University of Medical Sciences, Khorramabad, Iran

4 Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran

5 Angiography and Angioplasty section, Shahid Madani Heart Center, Lorestan University of Medical Sciences, Khorramabad, Iran

Abstract

Introduction: Coronary angiography is the most common angiographic procedure for diagnosis and treatment of the heart diseases. Herein, we aimed to evaluate the entrance surface dose (ESD), dose area product (DAP), as well as cancer risk in interventional cardiology procedures.
Materials and Methods: This study was conducted during July-December 2015 at Shahid Madani Heart Center in Khorramabad, Iran. A total of 225 adult patients including 122 females and 103 males regardless of the risk factors for coronary diseases were participated. Of them, 199 and 26 patients underwent diagnostic coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), respectively. Each patient underwent CA or PTCA separately. All the procedures were carried out using Siemens angiography system with the pulsed fluoroscopy of 10-30 pulses/s and cine frame rate of 15 frames/s. DAP, ESD, fluoroscopy time (FT), as well as the number of sequences and frames per sequence were collected for each 199 CA and 26 PTCA procedures.
Results: The median values of DAP were 19.77±14.88 and 57.11±33.36 Gy.cm2 in CA and PTCA, respectively. In addition, the median values of ESD were 323.12±245.39 and 1145.22±594.42 mGy in CA and PTCA, respectively. FTs were 114.59±74.33 s in CA and 424.15±292.93 s in PTCA.
Conclusion: The average patient dose and cancer risk estimates in both CA and PTCA were consistent with the reference levels. However, in agreement with other interventional procedures, dose levels in the interventional cardiology are influenced by staff and clinical protocols, as well as the type of equipment. 

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Main Subjects

References

  1. Gray B, Klimis H,  Inam S, Ariyathna N, Kumar S, Bailey B, et al. Radiation Exposure During Cardiac Catheterisation is Similar for Both Femoral and Radial Approaches. Heart, Lung and Circulation. 2015; 24: 264–9. DOI: 10.1016/j.hlc.2014.09.022.
  2. Gerber T.C, Gibbons R.J. Weighing the Risks and Benefits of Cardiac Imaging with Ionizing Radiation. J A C C: Cardiovascular Imaging. 2010; 3(5): 528 – 35. DOI: 10.1016/j.jcmg.2010.03.003.
  3. Bor D, Sancak T, Olgar T, Elcim Y, Adanali A, Sanlidilek U ,et al. Comparison of effective doses obtained from dose–area product and air kerma measurements in interventional radiology. Br J Radiol. 2004; 77(916): 315–22. DOI: 10.1259/bjr/29942833.
  4. Tavakoli M.B, Monsef S, Hashemi M, Emami H. Assessment of patients skin dose undergoing coronary angiography and Percutaneous Transluminal Coronary Angioplasty (PTCA). Iran J Radiat Res. 2010; 8 (3): 155-60.
  5. Stratis A.I, Anthopoulos P.L, Gavaliatsis I.P, Ifantis G.P, Salahas A.I, Antonellis I.P, et al. Patient Dose in Cardiac Radiology. Hellenic J Cardiol. 2009; 50(1):17-25.
  6. Giordano C, D’Ercole L, Gobbi R, Bocchiola M, Passerini F. Coronary angiography and percutaneous transluminal coronary angioplasty procedures: Evaluation of patients’ maximum skin dose using Gafchromic films and a comparison of local levels with reference levels proposed in the literature. Physica Medica. 2010; 26: 224-32. DOI: 10.1016/j.ejmp.2010.01.001.
  7. Dogan Bor, Turan Olğar, Türkay Toklu, Ayça C¸ağlan, Elif önal, Renato Padovani. Patient doses and dosimetric evaluations in interventional cardiology. Physica Medica. 2009; 25(1):31-42. DOI:  10.1016/j.ejmp.2008.03.002.
  8. Castles AV, ul Haq MA, Barlis P, Ponnuthurai FA, Lim CC, Mehta N, et al.. Radiation Exposure with the Radial Approach for Diagnostic Coronary Angiography in a Centre Previously Performing Purely the Femoral Approach. Heart Lung and Circulation. 2014; 23: 751–7. DOI: 10.1016/j.hlc.2014.02.019.
  9. Gray B, Klimis H, Inam Sh, Ariyathna N, Kumar Sh, Bailey B, et al. Radiation Exposure during cardiac catheterization is similar for both femoral and radial approaches. Heart Lung and Circulation. 2016; 24: 264–9. DOI: 10.1016/j.hlc.2014.09.022.
  10. Wrixon A D. New ICRP Recommendations. J Radiol Prot. 2008; 28(2):161-8.
  11. Chida K, Saito H, Otani H, Kohzuki M, Takahashi Sh, Yamada Sh, et al. Relationship Between Fluoroscopic Time, Dose–Area Product, Body Weight, and Maximum Radiation Skin Dose in Cardiac Interventional Procedures. A J R. 2006; 186: 774–8. DOI: 10.2214/AJR.04.1653.
  12. Sources and effects of ionizing radiation. (UNSCEAR)United Nations. New York ;2010, 1. 53 p
  13. Smith I.R, and Rivers J.T. Measures of Radiation Exposure in Cardiac Imaging and the Impact of Case Complexity. Heart Lung and Circulation. 2008; 17: 224–31. DOI: 10.1016/j.hlc.2007.10.004.
  14. Khelassi-Toutaoui N, Toutaoui A,  Merad A, Sakhri-Brahimi Z, Baggoura B, Mansouri B. Assessment of radiation protection of patients and staff in interventional procedures in four algerian hospitals. Radiat Prot Dosimetry. 2016 ;168(1):55-60. DOI: 10.1093/rpd/ncv001.
  15. Bahreyni Toossi MT, Baradaran SF, Gholoobi A, Nademi H.. Evaluation of Maximum Patient Skin Dose Arising from Interventional Cardiology Using Thermoluminescence Dosimeter in Mashhad, Iran. Iranian Journal of Medical Physics. 2013; 10(3): 87-94. DOI: 10.22038/ijmp.2013.2176.
  16. Padovani R, Vano E, Trianni A, Bokou C, Bosmans H, Bor D, et al. Reference levels at European level for cardiac interventional procedures. Radiat Prot Dosimetry. 2008; 129: 104-7. DOI: 10.1093/rpd/ncn039.
  17. Bar O, Maccia C, Pages P. A multicenter survey of patient exposure to ionising radiation during interventional cardiology procedures in France. EuroIntervention. 2008;3(5):593-9. DOI: 10.4244/EIJV3I5A107.

 

Iranian Journal of Medical Physics

Volume 14, Issue 3
September and October 2017
Pages 128-134

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History

  • Receive Date: 25 March 2017
  • Revise Date: 26 May 2017
  • Accept Date: 03 June 2017

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