Radiation Dose and Image Optimisation for Fluoroscopic Cardiac Interventional Procedures

Catherine D'helft, A. M. McGee, Louise Rainford, Sonyia McFadden, Ciara Hughes, J. R. Winder, Patrick Brennan

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Interventional radiological procedures are increasingly common because
of their cost-effectiveness compared with surgical procedures.
Prolonged fluoroscopic exposures, particularly cardiovascular studies
are responsible for some of the highest patient and staff radiation
doses. Such exposures increase the risk of stochastic effects and
regularly cross the threshold dose above which, deterministic effects
such as erythema, epilation and ulceration are experienced.
Radiation levels using dose area product and fluoroscopy time, are
being determined and compared for coronary angiograms (CA),
percutaneous coronary intervention (PCI) and permanent pacemaker
insertion procedures (PPI). Other factors such as grade of operater,
technique and equipment used are also recorded
To Date, the results demonstrate a mean dose for CA procedures
7,426cGycm2, for PCI procedures 10,744cGycm2, for PPI procedures
3,705cGycm2.However large intra and inter hospital variations were
noted. The time varied by a procedure specific extent and shows a
strong relationship with radiation dose delivered, other causal agents
for variation are being investigated.
Due to the risks associated with X-ray exposure radiation doses should
be kept as low as reasonably achievable, consistent with good image
quality. However significant variations in radiation dose and image
quality for coronary interventional procedures have been shown within
and between hospitals in Ireland for the first time. This all Ireland
study aims to explore radiation dose levels for cardiac interventional
procedures in 17 hospitals, possible areas pf standardisation and
potential Diagnostic Reference Levels will be proposed.
Original languageEnglish
Title of host publicationUKRC supplement to BJR
Publication statusPublished (in print/issue) - 27 Jun 2005


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