Does a flat panel detector reduce the patient radiation dose in interventional cardiology?

An internal audit has been performed to evaluate the patient radiation dose in the clinical use of X-ray cardiac flat panel detector (FPD) systems. Fluoroscopy and image acquisition (cine mode) programs are optimised for low-dose settings. The diagnostic and therapeutic interventional cardiac procedures are performed at 6 pulse s(-1) for fluoroscopy and 15 frames s(-1) for image acquisition. The FPD entrance dose is configured for 29 nGy pulse(-1) in the fluoroscopy mode and 0.10 microGy frame(-1) in the cine mode. From the data collected, the following local reference levels for coronary angiography and angioplasty have been obtained: kerma-area products 23 and 44 Gy cm(2), cumulative doses 376 and 776 mGy, fluoroscopy times 5 and 15.5 min and cine images 617 and 1163 images.