Local diagnostic reference levels and effective doses: single institution levels for interventional cardiology procedures for adult patients

• Autorzy: Kidoń Joanna , Polaczek-Grelik Kinga , Wojciuch Leszek

Identyfikatory

DOI

10.2478/pjmpe-2022-0009

• Języki publikacji: EN

Abstrakty

EN

Introduction: The current regulations in Poland in the field of interventional radiology only include diagnostic reference levels (DRL) for five procedures, containing only two for cardiological (hemodynamic) procedures, and only for adults. Given the insufficient number of DRLs, the need to introduce local levels based on the intervention procedures performed was identified. The purpose of this research was the evaluation of radiation doses (DRL, effective dose) received by patients in cardiological interventional procedures. Material and methods: The DRL level was defined as the 75th percentile of the distribution of dosimetric parameters KAP and Kair, ref for each type of cardiological procedure. Data include three different X-ray units and 27 interventional cardiologists, derived from February 2019 to June 2019 and from August 2021 to December 2021. In order to estimate the effective dose, the appropriate conversion factors for cardiological procedures were used. The total number of analyzed procedures was 3818. Results: The proposed local DRL levels were found to be mostly lower than data found in literature and in the current Polish national requirements (60%-70% lower for coronary angiography (CA) and percutaneous coronary angioplasty (PCI) procedures). Median equivalent doses for cardiological procedures were estimated at 2.66 mSv, 6.11 mSv and 7.22 mSv for CA, PCI and combined PCI with CA procedure, respectively. Conclusions: The proposed local/institutional DRLs seem to be suitable for use and could be utilized by other centers for comparison purposes.

Słowa kluczowe

EN

effective dose; interventional cardiology; Diagnostic Reference Levels; DRL

• Wydawca: Polskie Towarzystwo Fizyki Medycznej ; De Gruyter
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2022
• Tom: Vol. 28, Iss. 2
• Strony: 77--83
• Opis fizyczny: Bibliogr. 23 poz., tab.

Twórcy

autor

Kidoń Joanna

• Invasive Cardiology and Electrocardiology Department, 3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland
• Department of Medical Physics, Upper Silesian Medical Center, Katowice, Poland

• https://orcid.org/0000-0003-0941-2514

autor

Polaczek-Grelik Kinga

• Prof. K. Gibiński Memorial University Clinical Centre, Medical University of Silesia, Poland

autor

Wojciuch Leszek

• Department of Medical Physics, Upper Silesian Medical Center, Katowice, Poland

Bibliografia

• 1. European Union. Medical Radiation Exposure of the European Population Part 1/2. Radiat Prot N° 180 2014:1-181.
• 2. Jaschke W., Schmuth M., Trianni A., Bartal G. Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know. Cardiovasc Intervent Radiol 2017;40:1131-40. https://doi.org/10.1007/s00270-017-1674-5.
• 3. Lin P.J.P., Schueler B.A., Balter S., Strauss K.J., Wunderle K.A., Lafrance M.T. et al. Accuracy and calibration of integrated radiation output indicators in diagnostic radiology: A report of the AAPM Imaging Physics Committee Task Group 190. Med Phys 2015;42:6815-29. https://doi.org/10.1118/1.4934831.
• 4. Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures. IAEA-TECDOC-1641. Vienna: International Atomic Energy Agency; 2010.
• 5. Announcement of the Minister of Health of 3 April 2017 on the publication of the uniform text of the Regulation of the Minister of Health on the conditions for the safety use of ionizing radiation for all types of medical exposure. Poland: 2017.
• 6. Siiskonen T., Ciraj-Bjelac O., Dabin J., Diklic A., Domienik-Andrzejewska J., Farah J., et al. Establishing the European diagnostic reference levels for interventional cardiology. Physica Medica. 2018;54:42-8. https://doi.org/10.1016/j.ejmp.2018.09.012.
• 7. Hirshfeld J.W.J., Ferrari V.A., Bengel F.M., Bergersen L., Chambers C.E., Einstein A.J., et al. 2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging: Best Practices for Safety and Effectiveness: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pat. J Am Coll Cardiol. 2018;71:e283-351. https://doi.org/10.1016/j.jacc.2018.02.016.
• 8. Whitby M., Martin C.J. Radiation doses to the legs of radiologists performing interventional procedures: are they a cause for concern? Br J Radiol 2003;76:321-7. https://doi.org/10.1259/bjr/65778215.
• 9. Edwards A.A., Lloyd D.C. Risks from ionising radiation: deterministic effects. J Radiol Prot. 1998;18:175-83. https://doi.org/10.1088/0952-4746/18/3/004.
• 10. National Research Council. Health Risks from Exposure to Low Levels of Ionizing Radiation: BEIR VII Phase 2. Washington, DC: The National Academies Press; 2006. https://doi.org/10.17226/11340.
• 11. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP 2007;37:1-332. https://doi.org/10.1016/j.icrp.2007.10.003.
• 12. Dosimetry in Diagnostic Radiology: An International Code of Practice. IAEA Technical Reports Series No. 457. Vienna: International Atomic Energy Agency; 2007.
• 13. Wood E.J. Review of NCRP report No 116: Limitation of Exposure to Ionising Radiation. Occup Environ Med. 1994;51:216.
• 14. Dance D.R., Christofides S., Maidment A.D.A., McLean I.D., Ng K.H. Diagnostic radiology physics: A handbook for teachers and students. International Atomic Energy Agency (IAEA): IAEA; 2014.
• 15. Patient dosimetry for x rays used in medical imaging. J ICRU. 2005;5:iv–vi. https://doi.org/10.1093/jicru/ndi018.
• 16. Brambilla M., Cannillo B., Matheoud R., Compagnone G., Rognoni A., Bongo A.S., et al. Conversion factors of effective and equivalent organ doses with the air kerma area product in patients undergoing coronary angiography and percutaneous coronary interventions. Physica Medica. 2017;42:189-96. https://doi.org/10.1016/j.ejmp.2017.09.131.
• 17. Damilakis J., Frija G., Jaschke W., Repussard J., Schegerer A.A., Tsapaki V., et al. European Study on Clinical Diagnostic Reference Levels for X-ray Medical Imaging. (EUCLID). Radiation Protection N° 195. 2021. https://doi.org/10.2833/452154.
• 18. Stratis A.I., Anthopoulos PL, Gavaliatsis IP, Ifantis GP, Salahas AI, Antonellis IP, et al. Patient dose in cardiac radiology. Hellenic J Cardiol 2009;50:17-25.
• 19. Chaikh A., Gaudu A., Balosso J. Monitoring methods for skin dose in interventional radiology. Int J Cancer Ther Oncol. 2014;3:03011. https://doi.org/10.14319/ijcto.0301.1.
• 20. Stecker M.S., Balter S., Towbin R.B., Miller D.L., Vañó E., Bartal G., et al. Guidelines for patient radiation dose management. J Vasc Interv Radiol. 2009;20:S263-73. https://doi.org/10.1016/j.jvir.2009.04.037.
• 21. Aly A.E., Duhaini I.M., Manaa S.M., Tarique S.M., Kuniyil S.E., Naemi H.M. Al. Patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures. Int J Med Physics, Clin Eng Radiat Oncol. 2015;04:7-12. https://doi.org/10.4236/ijmpcero.2015.41002.
• 22. Hansson B., Karambatsakidou A.. Relationships Between Entrance Skin Dose, Effective Dose and Dose Area Product for Patients in Diagnostic and Interventional Cardiac Procedures. Radiat Prot Dosimetry. 2000;90:141-4. https://doi.org/10.1093/oxfordjournals.rpd.a033104.
• 23. Basic anatomical and physiological data for use in radiological protection: reference values. A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP Publication 89. Ann ICRP 2002;32:5-265.

Uwagi

Opracowanie rekordu ze środków MEiN, umowa nr SONP/SP/546092/2022 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2022-2023).