Patient radiation doses during cardiac angiography and implantations of cardiac resynchronization devices. Deriviation of local DRLs

Abstract

The Euratom directive 97/43 recommends the use of patient dose surveys in diagnostic and interventional cardiology and the establishment of diagnostic reference dose levels (DRLs).The objective of the present project was the determination of the dose received by patients during diagnostic coronary angiography (CA) and during cardiac resynchronization devises implantation in order to introduce local dose reference levels. Dose survey was performed during CA on 5900 patients since 2001, and on 955 patients since 2006 during cardiac resynchronization devises implantation. For the dose measurement a suitably calibrated dose-area product (DAP) meter was used. Mean value of DAP during CA was 50.01 Gycm2 and 14.87 Gycm2 during cardiac resynchronization devises implantation. The contribution of cinefluoro-graphy to the total DAP was 67.25% of the total DAP during CA.The mean duration of fluoroscopy during cardiac resynchronization devises implantation was 4.4 min. Mean values of effective dose equal to 10.1 mSv, for CA and 3 mSv for cardiac resynchronization devises implantation, were calculated applying conversation factors. A local DRLs was choosen to be 57.80 Gycm2 for CA and 19.4 Gycm2 for cardiac resynchronization devises implantation. A triggering level of 300 Gycm2 is introduced, in order to avoid any possible injury. The results of the present study, due to the large number of the sample, can be used in for the establishment of national or international DRLs. © 2009 Springer-Verlag.