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. 2020 Jul;6(1):25-33.
doi: 10.4244/AIJ-D-18-00044. Epub 2020 Jul 20.

Radiation doses during cardiac catheterisation procedures in India: a multicentre study: Radiation dose study

Vijayakumar Subban  1 , Sophie Amelot  2 , Suma M Victor  1 , Anil Potdar  3 , Vishawanath Yadav  3 , Tejas Patel  4 , Sanjay Shah  4 , Thomas Alexander  5 , Balakumaran Jeyakumaran  5 , Juno Angel  1 , Mullasari S Ajit  1
Affiliations

Radiation doses during cardiac catheterisation procedures in India: a multicentre study: Radiation dose study

Vijayakumar Subban et al. AsiaIntervention. 2020 Jul.

Abstract

Aims: Established, evidence-based measures of radiation are required to minimise its hazards, while maintaining adequate image quality. The aim of this study is to evaluate radiation data and generate reference radiation levels for commonly performed coronary catheterisation procedures in India.

Methods and results: In this prospective, observational study, all procedures were performed in accordance with the established standards using Innova IGS 520/2100-IQ catheterisation laboratories. Demographic, procedural and radiation data were collected. Dose reference limits (DRL) were established as the 75th percentile of the total distribution. There were 2,906 coronary angiograms (CAG), 750 percutaneous coronary interventions (PCI) and 715 CAG+PCI. DRLs for dose area product were: 19.6 Gy·cm2 for CAG, 49.8 Gy·cm2 for PCI and 72.0 Gy·cm2 for CAG+PCI, respectively. Median cumulative air kerma levels were: 185 mGy for CAG, 533mGy for PCI, and 891 mGy for CAG+PCI. Male gender, higher BMI, combining CAG+PCI, fluoroscopy time, number of cine frames, and image acquisition settings were significant contributors to increased radiation dose.

Conclusions: This study established reference radiation dose levels for diagnostic and interventional coronary procedures in India, which were comparable to and in the lower range of international standards.

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Conflict of interest statement

V. Subban has received an institutional research grant from GE Healthcare. S. Amelot is a GE Healthcare employee. The other authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
Impact of BMI on patient radiation dose. BMI: body mass index, DAP: dose area product
Figure 2.
Figure 2.
75th percentile DAP data by institutions. CAG: coronary angiography; CAG+PCI: coronary angiography followed by percutaneous coronary intervention; DAP: dose area product; PCI: percutaneous coronary intervention
Figure 3.
Figure 3.
Cumulative air kerma distribution for all procedures, (CAG, PCI, CAG+PCI) – Log scale. CAG: coronary angiography; CAG+PCI: coronary angiography followed by percutaneous coronary intervention; PCI: percutaneous coronary intervention
Figure 4.
Figure 4.
Cumulative DAP (Gy.cm²) in comparison with international references for CAG and PCI categories. Median and interquartile range are given, unless otherwise indicated. CAG: coronary angiography; DAP: dose area product; PCI: percutaneous coronary intervention
See this image and copyright information in PMC

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