This study has gathered data across Ireland to determine the range of radiation doses received during interventional cardiology (IC) investigations. Radiation doses for three common types of IC examinations where investigated: coronary angiography (CA), percutaneous coronary intervention (PCI) and pacemaker insertions (PPI). A total of 22 cardiac imaging suites participated in the study. Radiation dose was monitored for 1804 adult patients using dose area product (DAP) meters. Individual patient DAP values ranged from 136-23,101 cGy cm2, 475-41,038 cGy cm2 and 45-17,192 cGy cm2 for CA, PCI and PPI respectively, with third quartile values of 4654 cGy cm2, 10,650 cGy cm2 and 1686 cGy cm2. The importance of optimising radiation dose, while not compromising diagnostic efficacy is clear. Although setting reference levels for these complex procedures has some difficulties, it is important that some guideline values are available as a benchmark to guide the operators during these potentially high dose procedures. The third quartile values as described by this paper may offer such guidance.
Multiple published studies involving computed tomographic (CT) examinations of the equine head utilise a wide range of mAs parameters for image acquisition. This prospective, experimental study assessed the effects of lowering mAs during CT image acquisition on image quality and scatter radiation on 10 cadaver equine heads. Each head was scanned three times at 300, 225, and 150 mAs, with all other scanning parameters remaining constant between series. An anthropomorphic phantom was positioned adjacent to each equine head during image acquisition, mimicking a human bystander, with an ionization chamber attached to the phantom at eye level. Each series was reconstructed using filtered back projection, using medium (H30) and high (H80) frequency reconstruction algorithms. Quantitative image quality assessment was performed by calculating signal to noise ratio (SNR) and contrast to noise ratio (CNR). Two qualitative image quality assessments were performed independently by three blinded board certified veterinary radiologists with a 4 week interval, using a visual grade analysis model adapted from peer reviewed medical literature. Ionization chamber measurements, calculated volume CT dose index (CTDIvol), and dose‐length product (DLP) were recorded. Halving radiation dose during image acquisition from 300 to 150mAs resulted in comparable image quality between series. There was a statistically significant and linear relationship between mAs and scatter radiation to the bystander; halving mAs during image acquisition resulted in halving of scatter radiation. Results of this cadaveric study support the use of lower mAs settings during standing CT examinations of the equine head.
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