Patient Body Mass Index and Physician Radiation Dose During Coronary Angiography

Abstract

Background: Consistent with the increasing prevalence of obesity in the general population, obesity has become more prevalent among patients undergoing cardiac catheterization. This study evaluated the association between patient body mass index (BMI) and physician radiation dose during coronary angiography. Methods and Results: Real-time radiation exposure data were collected during consecutive coronary angiography procedures. Patient radiation dose was estimated using dose area product. Physician radiation dose in each case was recorded by a dosimeter worn by the physician and is reported as the personal dose equivalent (H p 10). Patient BMI was categorized as <25.0, 25.0 to 29.9, 30.0 to 34.9, 35.0 to 39.9, and ≥40. Among 1119 coronary angiography procedures, significant increases in dose area product and physician radiation dose were observed across increasing patient BMI categories ( P <0.001). Compared with a BMI <25, a patient BMI ≥40 was associated with a 2.1-fold increase in patient radiation dose (dose area product, 91.8 [59.6–149.2] versus 44.5 [25.7–70.3] Gy×cm 2 ; P <0.001) and a 7.0-fold increase in physician radiation dose (1.4 [0.2–7.1] versus 0.2 [0.0–2.9] μSv; P <0.001). By multiple regression analysis, patient BMI remained independently associated with physician radiation dose (dose increase, 5.2% per unit increase in BMI; 95% CI, 3.0%–7.5%; P <0.0001). Conclusions: Among coronary angiography procedures, increasing patient BMI was associated with a significant increase in physician radiation dose. Additional studies are needed to determine whether patient obesity might have adverse effects on physicians, in the form of increased radiation doses during coronary angiography.

Radiation exposure per thrombectomy attempt in modern endovascular stroke treatment in the anterior circulation

“…We also did not obtain the patients' body mass index as an influencing factor of radiation exposure, which is influencing the radiation exposure mainly in diagnostic and interventional imaging of the thorax and abdomen, but has a minor influence in head and neck procedures [23]. On the other hand, Miller et al suggested to establish reference levels in interventional neuroradiology without a weight correction [10].…”

“…Likewise, fluoroscopy time increased per each additional thrombectomy attempt and was significantly different when comparing EST with one or two thrombectomy attempts (median (IQR), in minutes; FT 1 , 16 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29) and FT 2 , 26 (21-41), p value 0.001). An additional third, fourth, or fifth thrombectomy attempt led to a significant increase (FT 3 , 35 min (25-45), p value 2vs3 0.008; FT 4 , 49 min (32-76), p value 3vs4 0.0003; and FT 5 , 67 min (57-98), p value 4vs5 0.005).…”

Semi-automatic positioning of the protective screen based on integration with C-arm X-ray device

“…3) the current angulation of the integrated system, which is consisted of the X-ray tube and the detector, in relation to the central axis of the patient's table -in multiple planes; 4) the current position of the patient table -which can be moved vertically (up and down) as standard, and depending on the model of the device -horizontally and angularly; 5) weight and height of the patient [51,52]; 6) geometric scheme that corresponds to the operator's room arrangement (the solution stipulates that it is necessary to have appropriate, clearly visible markings on the floor, in accordance with the scheme, which indicate where the staff should be positioned (several options, considering the type of procedure and mentioned internal planning decisions); 7) operator heights (correspond to the geometric scheme: the basic, minimum number of operators provided for certain medical procedure are processed) [53]. Information on the distribution of scattered radiation for all reference points and all angulations is defined before clinical work and the corresponding values are changed only in case of inconsistency, after off-schedule or regular dosimetric examinations, whereby a control set of measurements would determine the necessity to complete measuring process.…”

Radiation exposure in endovascular stroke treatment of acute basilar artery occlusions—a matched-pair analysis

“…RE in EST might differ between different stroke centers as angiography units and thrombectomy technique differ as well. Patient's anatomic variants and bodies (including body mass index; no-necked, short-necked, and long-necked patients) are not considered in this study [19,20]. If this plays a role in the differing EST of the anterior and posterior circulation remains uncertain until further investigation.…”