Establishing the European diagnostic reference levels for interventional cardiology |
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| Institution: | 1. STUK – Radiation and Nuclear Safety Authority, P.O. Box 14, FI-00881 Helsinki, Finland;2. University of Belgrade, Vinca Institute of Nuclear Sciences, P.O. Box 522, Belgrade, Serbia;3. Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, BE-2400 Mol, Belgium;4. Medical Physics Department, University Hospital Rijeka, Rijeka, Croatia;5. Nofer Institute of Occupational Medicine (NIOM), Sw. Teresy 8 Str, 91-348 ?ód?, Poland;6. Paris-Sud University Hospitals, Radiology and Nuclear Medicine Department, C.H.U. de Bicêtre, 78 Rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France;7. San Carlos Hospital and Complutense University, Madrid, Spain;8. St. James’s Hospital, James’s Street, Dublin 8, Ireland;9. EEAE – Greek Atomic Energy Commission, P.O. Box 60092, Agia Paraskevi, 15310 Attiki, Greece;10. Medical Physics Department, University Hospital Rijeka, Croatia;11. Department of Physics, Faculty of Medicine, University of Rijeka, Rijeka, Croatia;12. Turku Heart Centre, Turku University Hospital and University of Turku, Turku, Finland;13. Ru?er Bo?kovi? Institute (RBI), Bijeni?ka c. 54, 10000 Zagreb, Croatia;14. CAATS, 119 Grande Rue, 92310 Sevres, France;15. ZEPHYRA and Centre Hospitalier Universitaire de Liège (CHULg), Sart-Tilman, 4000 Liège, Belgium;p. Veneto Institute of Oncology IOV – IRCCS, Padua, Italy;q. Lebanese Atomic Energy Commission, National Council for Scientific Research, P.O. Box 11-8281, Airport Road, Beirut, Lebanon;r. Faculty of Sciences, Saint-Joseph University, P.O.Box.11-514 Riad El Solh, Beirut 1107 2050, Lebanon;s. Medical Radiation Physics, Department of Medical and Health Sciences and Center for Medical Image Science and Visualization, Linköping University, SE-58185 Linköping, Sweden;t. University Hospitals of Geneva (HUG), Rue Gabrielle-Perret.Gentil 4, 1205 Geneva, Switzerland;u. University Hospital of Lausanne (CHUV), Rue du Grand-Pré 1, 1007 Lausanne, Switzerland;v. Central Hospital of Northern Karelia, Joensuu, Finland;w. Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech Republic;1. National and Kapodistrian University of Athens, Faculty of Medicine, Medical Physics Laboratory, Athens, Greece;2. Onassis Cardiac Surgery Center, Athens, Greece;3. Konstantopoulio General Hospital, Nea Ionia, Athens, Greece;1. Department of Cardiology, University Health Network, Toronto, Canada;2. Department of Cardiology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, UK;3. Department of Cardiology, East Carolina University, Greenville, NC, USA;4. Department of Cardiology, Ysybty Gwynedd, Betsi Cadwaladr University Health Board, UK;1. Medical Physics, Azienda Ospedaliera Brotzu Cagliari, Italy;2. Interventional Cardiology, Azienda Ospedaliera Brotzu Cagliari, Italy;1. Neuroradiology, University Hospital of Brest, boulevard Tanguy Prigent, 29609 Brest cedex, France;2. Laboratory of medical information processing —LaTIM, INSERM UMR 1101, Université de Bretagne Occidentale, 22, avenue Camille Desmoulins, CS 93837, 29238 Brest cedex 3, France;3. Medical Physics Unit, University Hospital of Brest, boulevard Tanguy Prigent, 29609 Brest cedex, France;4. Neuroradiology, University Hospital of Nancy, 29, avenue du Maréchal de Lattre de Tassigny, 54035 Nancy, France;1. Department of Medical Physics, University of Crete, School of Medicine, Iraklion, Crete, Greece;2. Radiation Protection of Patients Unit, International Atomic Energy Agency, Vienna, Austria |
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| Abstract: | Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm2), percutaneous coronary intervention (PCI, 85 Gy cm2), transcatheter aortic valve implantation (TAVI, 130 Gy cm2), electrophysiological procedures (12 Gy cm2) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm2) and dual chamber (3.5 Gy cm2) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm2). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology. |
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| Keywords: | Diagnostic reference levels Interventional cardiology |
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