Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity |
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| Institution: | 1. Palindromo Consulting, W. de Croylaan 51 3000 Leuven, Belgium;2. CHU UCL Namur site Sainte Elisabeth, Department of Cardiology, 5000 Namur, Belgium;3. GE Healthcare, 283 Rue de la Minière, 78530 Buc, France;1. Department of Radiotherapy, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany;2. Department of Radiology, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany;3. Department of Physics, University of Osijek, Trg Ljudevita Gaja 6, 31000 Osijek, Croatia;4. Clinic and Polyclinic for Diagnostic and Interventional Radiology, University Hospital Leipzig, Liebigstraße 20, 04103 Leipzig, Germany;1. Department of Clinical Radiology, Kagawa University Hospital, Kagawa, Japan;2. Graduate School of Medicine, Kagawa University, Kagawa, Japan;3. Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan;1. Department of Medical Physics & Nuclear Medicine, Karolinska University Hospital, S-171 76 Stockholm, Sweden;2. Department of Radiation Physics, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden;1. Department of Cardiology, Hospital and University of Fribourg, Fribourg, Switzerland;2. Department of Radiology, Institute of Radiophysics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland;1. Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco;2. Unità Operativa di Fisica Medica “Fondazione Ca ''Granda - Ospedale Maggiore Policlinico”, Milano, Italy;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 |
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| Abstract: | PurposeThe aim of this study was to assess patient exposure data and operator dose in coronary interventional procedures, when considering patient body-mass index and procedure complexity.MethodsTotal air kerma area product (PKA), Air-Kerma (AK), Fluoroscopy time (FT), operator dose and patient body-mass index (BMI) from 97 patients’ procedures (62 coronary angiography (CA) and 35 Percutaneous Coronary Intervention (PCI) were collected for one year. For PCI procedures, also the complexity index-CI was collected. Continuous variables for each of the 2 groups procedures (CA and PCI) were compared as medians with interquartile range and using Mann-Whitney U test. Multiple group data were compared using Kruskal-Wallis test (significance: p < 0.05).ResultsMedian PKA was 63 and 125 Gy cm2 for CA and PCI respectively (p < 0.001); FT was 3 and 14 min, respectively (p < 0.001). PKA and FT significantly increased (p < 0.05) with BMI class for CA procedures. PKA and FT also increased in function of CI class for PCI, thought significantly only for FT (p < 0.001), possibly because of the low number of PCI procedures included; cine mode contributed most to PKA. Significant dose variability was observed among cardiologists for CA procedures (p < 0.001).ConclusionsDose references levels for PKA and FT in interventional cardiology should be defined - on a sufficient number of procedures- in function of CI and BMI classes. These could provide an additional tool for refining a facility’s quality assurance and optimization processes. Dose variability associated with cardiologists underlines the importance of continuous training. |
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| Keywords: | Coronary interventional procedures Operator dose Patient exposure data Complexity index Diagnostic reference levels |
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