scholarly journals Cathlab department diagnostic reference levels and trigger values analysis

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Angela Cortez ◽  
Joana Santos ◽  
João Costa ◽  
Graciano Paulo
Keyword(s):  
Diagnostic Procedures ◽  
Interventional Cardiology ◽  
Patient Characteristics ◽  
Fluoroscopy Time ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Area Product ◽  
The Right ◽  
Operator Identification

Abstract Background This study aims to assess the examination dose values in interventional cardiology procedures to establish diagnostic reference levels and analyse number of procedures that exceed trigger values. Methods Data about the procedure type, operator identification, procedure access, patient characteristics (gender, age and weight), fluoroscopy time (min), Kerma Area Product - PKA (Gy.cm2), was retrospectively collected, for a period of 12 months. Patients were categorised in three weight groups: low ( < 65 kg), standard (65–75kg) and high ( > 75 kg). Results he majority of the 2540 examinations were diagnostic procedures (65%) and the more common access was via the right radial artery (92%). Significant differences (P < 0.05) in fluoroscopy time and PKA values, between procedure access, patient weight group and type of procedure were found. The trigger level of PKA ( > 300Gy.cm2) value was exceeded in 0.5% of the procedures, lower than the incidence found in the literature. The local DRL values for diagnostic and therapeutical procedures were respectively 39 and 111 Gy.cm2, in line with values published in the literature. Conclusions The dose distribution is in line with the ones found in the literature. The percentage of patients that exceed one of trigger levels is lower when compared with the literature, however a patient follow-up plan should be established.

A MULTICENTRE SURVEY OF LOCAL DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSE FOR CORONARY ANGIOGRAPHY AND PERCUTANEOUS TRANSLUMINAL CORONARY INTERVENTION PROCEDURES IN KOREA

2019 ◽  
Vol 187 (3) ◽  
pp. 378-382
Author(s):  
Jung Su Kim ◽  
Bong-Ki Lee ◽  
Dong Ryeol Ryu ◽  
Kwang Jin Chun ◽  
Hyun-Hee Choi ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
High Radiation ◽  
Exposure Data ◽  
Area Product ◽  
Percutaneous Transluminal

Abstract Interventional cardiology procedures can involve relatively high radiation doses compared to general radiography. During coronary angiography (CAG) and percutaneous transluminal coronary intervention (PCI), the same area is exposed to radiation for a long period. In this study, radiation exposure data of 1071 examinations in Korean hospitals were collected, and the achievable dose (AD) and diagnostic reference levels (DRLs) in actual medical practice for two types of interventional cardiology procedures in Korea were established. In CAG, 75th percentile DRLs and AD of the total kerma-area product were 47.0 and 33.1 Gy·cm 2, respectively. In PCI, those values were 171.3 and 102.6 Gy·cm2, respectively. This is the first study to introduce the DRLs for cardiovascular interventional procedures in Korea. These results will help optimise the interventional cardiology procedures for Korean cardiac centres.

scholarly journals Multicentric survey of patient doses in fluoroscopy guided diagnostic and interventional cardiac procedures: comparison with Diagnostic Reference Levels and follow-up levels for patients at risk for radiation induced skin effects

2020 ◽  
Vol 26 (1) ◽  
pp. 44-52
Author(s):  
Anna Zagorska ◽  
Desislava Ivanova ◽  
Dessislava Kostova-Lefterova ◽  
Filip Simeonov ◽  
Valeri Gelev ◽  
...  
Keyword(s):  
At Risk ◽  
Coronary Intervention ◽  
Fluoroscopy Time ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Cardiac Procedures ◽  
Patients At Risk ◽  
Radiation Induced ◽  
Patient Doses

Introduction. Interventional cardiac procedures are often associated with high patient exposure and therefore require special care in protecting patients from radiation-induced effects. Materials and methods. A retrospective study of typical patients’doses was performed in nine hospitals, with a total number of fourteen angiography systems. The typical values for kerma-area product (KAP), cumulative dose (CD) and fluoroscopy time (FT) for two of the most commonly performed procedures - percutaneous coronary intervention (PCI) and coronary arteriography (CA), were calculated and compared with the Bulgarian National Diagnostic Reference Levels (NDRL). Data analysis, regarding the risk of radiation-induced skin effects due to interventional cardiac procedures, was performed. Aim. 1) to present and analyze the typical KAP values for PCI and CA procedures in cardiology departments with high workload and to compare them with the NDRL; 2) to compare the patient doses with the follow-up levels published in Ordinance 2, to identify patients at risk for radiation-induced effects. Results. The results show that typical values for PCI and CA procedures for some of the angiography systems are higher than the NDRL. In all investigated departments there are patients with at least one exceeded follow-up level for PCI. Conclusions. The results show a potential for optimization in the departments with both high or very low typical dose or FT values. No radiation-induced effect was observed in the followed-up group of patients. The introduction of procedure with "Instruction to the patient after an interventional cardiac procedure(s) with greater complexity and a long fluoroscopy time" for patient follow-up and its regular implementation into the routine clinical practice will help for timely diagnosis and treatment of radiation-induced skin effects after cardiac procedures under fluoroscopy control.

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

scholarly journals Establishing local diagnostic reference levels for common orthopaedic procedures using the mini C-arm fluoroscope

2021 ◽  
Vol 94 (1117) ◽  
pp. 20190878
Author(s):  
Anna Kropelnicki ◽  
Rosemary Eaton ◽  
Alexandra Adamczyk ◽  
Jacqueline Waterman ◽  
Pegah Mohaghegh
Keyword(s):  
Radiation Exposure ◽  
Best Practice ◽  
District General Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Data Set ◽  
Dose Area Product ◽  
The Third ◽  
Retrospective Audit ◽  
Area Product

Objective: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years. Methods: This retrospective audit evaluates the end dose–area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital. We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope. Results: For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures. Advances in knowledge: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.

NATIONAL DIAGNOSTIC REFERENCE LEVELS IN INTERVENTIONAL RADIOLOGY SUITES IN LEBANON: A MULTICENTER SURVEY

2019 ◽  
Vol 187 (1) ◽  
pp. 50-60 ◽  
Author(s):  
C Rizk ◽  
J Farah ◽  
F Vanhavere ◽  
G Fares
Keyword(s):  
Radiation Protection ◽  
Pacemaker Implantation ◽  
High Dose ◽  
National Council ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Transcatheter Aortic Valve ◽  
Multicenter Survey ◽  
Area Product

ABSTRACT Air kerma-area product (PKA), cumulative air kerma at patient entrance reference point, fluoroscopy time and number of images were retrospectively collected from 15 hospitals in Lebanon for 11282 fluoroscopically-guided interventional (FGI) procedures between March 2016 and November 2018. National diagnostic reference levels (NDRLs) were established based on the third quartile of the distribution of median values of exposure parameters per department for 27 types of FGI procedures. NDRLs were in line with international DRLs except for coronary angiography (CA), percutaneous coronary interventions (PCI) and transcatheter aortic valve implantation (TAVI) which require optimisation. Additionally, following the National Council on Radiation Protection and Measurements report 168, PCI, TAVI, triple chamber pacemaker implantation, endovascular aortic repair, nephrostomy, kyphoplasty and percutaneous transhepatic biliary drainage were classified as potentially high-dose procedures with >5% of the patients with PKA exceeding 300 Gycm2. The established NDRLs will promote dose optimisation and patient radiation protection.

Establishing the European diagnostic reference levels for interventional cardiology

2018 ◽  
Vol 54 ◽  
pp. 42-48 ◽  
Author(s):  
T. Siiskonen ◽  
O. Ciraj-Bjelac ◽  
J. Dabin ◽  
A. Diklic ◽  
J. Domienik-Andrzejewska ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Diagnostic Reference Levels ◽  
Reference Levels

The establishment of local diagnostic reference levels for paediatric interventional cardiology

Radiography ◽  
2013 ◽  
Vol 19 (4) ◽  
pp. 295-301 ◽  
Author(s):  
S. McFadden ◽  
C. Hughes ◽  
C.I. D'Helft ◽  
A. McGee ◽  
L. Rainford ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Diagnostic Reference Levels ◽  
Reference Levels

Transcatheter pulmonary valve insertion, expanded use (beyond large conduits from the right ventricle to pulmonary artery), and future directions

2014 ◽  
Vol 24 (6) ◽  
pp. 1095-1100 ◽  
Author(s):  
Jeremy M. Ringewald ◽  
Elsa J. Suh
Keyword(s):  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Interventional Cardiology ◽  
Ventricular Outflow Tract ◽  
Future Directions ◽  
United States Food ◽  
History Of ◽  
States Food ◽  
The Right

AbstractTranscatheter pulmonary valve insertion is the most important advance in congenital interventional cardiology since atrial septal defect devices became commonly available 15 years ago. It has changed the way we look at a number of diverse diagnoses and changes how we plan, diagnose, operate, and follow-up patients. It has changed how we counsel families expecting a child that may benefit from it. Expanded use of the Melody® valve, outside its United States Food and Drug Administration approved indications, has helped numerous additional patients. The use of transcatheter pulmonary valve insertion in selected patients following surgical Gore-tex® bileaflet in valve right ventricular outflow tract reconstruction and those with a history of prior small homograft conduits will be discussed.

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