Audit of radiation dose to patients during coronary angiography

Livingstone, Roshan S; Chandy, Sunil; Peace, T; George, Paul V; John, Bobby; Pati, P.

doi:10.4103/0019-5359.30348

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…Selection of 0.4 mm Cu filtration did not suffer significant loss of image quality; however, tube potentials were increased from 80 kVp to 103 kVp during fluoroscopy. [1516] In the FPD system, tube potentials ranged from 90 kVp–110 kVp when 0.4 mm Cu filtration was selected with low dose settings during fluoroscopy. Having adhered to the same optimization strategies in both systems, doses were similar owing to the fact that further optimization is warranted in FPD system.…”

Section: Resultsmentioning

confidence: 99%

“…The PTCA procedure was invariably performed by a senior interventionalist assisted by two junior cardiologists, while the CAG was performed either by the senior interventionalist or by junior cardiologists. For a similar comparison of clinical protocols adopted in the institution, DAP values from CAG and PTCA performed using Philips Integris H3000 and H5000 II-based systems (Netherlands) reported earlier[1516] were compared to those from FPD system currently studied. All the X-ray systems were on periodic QA programs and conformed to the manufacturer's specifications.…”

Section: Methodsmentioning

confidence: 99%

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Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

Livingstone¹,

Chase²,

Varghese³

et al. 2015

J Med Phys

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Flat panel detector (FPD) technology in interventional cardiology is on the increase due to its varied advantages compared to the conventional image intensifier (II) systems. It is not clear whether FPD imparts lower radiation doses compared to II systems though a few studies support this finding. This study intends to compare radiation doses from II and FPD systems for coronaryangiography (CAG) and Percutaneous Transluminal Coronary Angioplasty (PTCA) performed in a tertiary referral center. Radiation doses were measured using dose area product (DAP) meter from patients who underwent CAG (n = 222) and PTCA (n = 75) performed using FPD angiography system. The DAP values from FPD were compared with earlier reported data using II systems from the same referral center where the study was conducted. The mean DAP values from FPD system for CAG and PTCA were 24.35 and 63.64 Gycm2 and those from II system were 27.71 and 65.44 Gycm2. Transition from II to FPD system requires stringent dose optimization strategies right from the initial period of installation.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

Livingstone¹,

Chase²,

Varghese³

et al. 2015

J Med Phys

Self Cite

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“…In a separate study conducted earlier, the mean DAP value for CA procedure was 27.71 Gy cm 2 . [15] Adding the DAP value after the optimization for corresponding patients for both CA and PTCA would therefore give 76.38 and 93.15 Gy cm 2 for single stent and multiple stent placement respectively. No ill effects of radiation, such as deterministic or stochastic, were reported for any patient during the course of the study.…”

Section: Discussionmentioning

confidence: 99%

Optimization and audit of radiation dose during percutaneous transluminal coronary angioplasty

et al. 2007

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The percutaneous transluminal coronary angioplasty (PTCA) is one of the interventional procedures which impart high radiation doses to patients compared to the other cardiologic procedures. This study intends to audit and optimize radiation dose imparted to patients undergoing PTCA. Forty-four patients who underwent PTCA involving single or multiple stent placement guided under cardiovascular X-ray machine were included in the study. Radiation doses were measured using dose area product (DAP) meter for patients undergoing single and multiple stent placements during PTCA. A dose reduction of 27-47% was achieved using copper filters and optimal exposure parameters. The mean DAP values before optimization were 66.16 and 122.68 Gy cm2 for single and multiple stent placement respectively. These values were 48.67 and 65.44 Gy cm2 respectively after optimization. In the present scenario, due to the increase in the number of PTCAs performed and the associated risk from radiation, periodical audit of radiation doses for interventional procedures are recommended.

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“…[19][20][21][22] Investigations into the use of filtration suggest increasing filter thickness, though the advantage gained from filtration can saturate quickly, with increased thickness having reduced impact. 18,22 Copper x-ray beam filtration has been demonstrated to reduce patient dose in fluoroscopy 23 at the cost of losing image quality. 18,24,25 Copper has more recently been used for image acquisition, 26,27 and has been shown to have minimal impact on high quality patient images.…”

Section: Introductionmentioning

confidence: 99%

Dose optimization in cardiac x‐ray imaging

et al. 2013

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These settings, adjusted for x-ray tube loading limits and clinically acceptable image quality, should provide a useful option for optimizing patient dose to image quality in cardiac x-ray imaging. The same optimal x-ray beam spectra were found for both the tin and copper details, suggesting that iodine contrast based imaging and visualization of interventional devices could potentially be optimized for dose using similar x-ray beam spectra.

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Audit of radiation dose to patients during coronary angiography

Abstract: Dose area product is particularly useful for machines. In the initial stages of the dose ANGIOGRAPHY assessing and comparing radiation dose from auditing, tabletop dose rates were same in fluoroscopy procedures as it provides an both the systems. The dose rates for low

Cited by 6 publications

References 2 publications

Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

Transition from image intensifier to flat panel detector in interventional cardiology: Impact of radiation dose

Optimization and audit of radiation dose during percutaneous transluminal coronary angioplasty

Dose optimization in cardiac x‐ray imaging

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