Measures of radiation exposure in cardiac imaging and the impact of case complexity.

BACKGROUND

Although it is important for a patient's radiation related risks to be considered when recommending a cardiac imaging procedure, few clinicians appreciate the level of exposure involved. This paper provides a comprehensive set of radiation exposure metrics for common angiography procedures highlighting links to factors that influence radiation dose.

METHODS

Radiation use metrics and various clinical findings for diagnostic procedures and number of lesions treated, vessels treated and stents deployed for interventional cases were analysed.

RESULTS

Data relating to 1088 coronary angiography (CA), 256 angioplasty and 167 CA/angioplasty procedures were examined. The median effective dose (E) (mSv) for these procedures (including inter-quartile range) were, respectively, 3.3 (2.1-5.1), 7.5 (4.5-14.1) and 11.6 (6.9-16.1). For CA, E varied with the number of vessels (p<0.01) while for angioplasty E was linked to the number of vessels (p<0.01), lesions (p<0.01) and stents (p<0.01).

CONCLUSION

Radiation exposure metrics for common cardiac angiography imaging procedures have been documented and linked to procedure complexity. This has implications for performance monitoring when comparing radiation usage between users, facilities, times and technologies.