Patient radiation doses in interventional cardiology in the U.S.: Advisory data sets and possible initial values for U.S. reference levels

Journal Article · Mon Oct 15 00:00:00 EDT 2012 · Medical Physics

DOI:https://doi.org/10.1118/1.4754300· OSTI ID:22099047

Miller, Donald L.; Hilohi, C. Michael; Spelic, David C. ^[1]

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1. Center for Devices and Radiological Health, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, Maryland 20993 (United States)

Purpose: To determine patient radiation doses from interventional cardiology procedures in the U.S and to suggest possible initial values for U.S. benchmarks for patient radiation dose from selected interventional cardiology procedures [fluoroscopically guided diagnostic cardiac catheterization and percutaneous coronary intervention (PCI)]. Methods: Patient radiation dose metrics were derived from analysis of data from the 2008 to 2009 Nationwide Evaluation of X-ray Trends (NEXT) survey of cardiac catheterization. This analysis used deidentified data and did not require review by an IRB. Data from 171 facilities in 30 states were analyzed. The distributions (percentiles) of radiation dose metrics were determined for diagnostic cardiac catheterizations, PCI, and combined diagnostic and PCI procedures. Confidence intervals for these dose distributions were determined using bootstrap resampling. Results: Percentile distributions (advisory data sets) and possible preliminary U.S. reference levels (based on the 75th percentile of the dose distributions) are provided for cumulative air kerma at the reference point (K{sub a,r}), cumulative air kerma-area product (P{sub KA}), fluoroscopy time, and number of cine runs. Dose distributions are sufficiently detailed to permit dose audits as described in National Council on Radiation Protection and Measurements Report No. 168. Fluoroscopy times are consistent with those observed in European studies, but P{sub KA} is higher in the U.S. Conclusions: Sufficient data exist to suggest possible initial benchmarks for patient radiation dose for certain interventional cardiology procedures in the U.S. Our data suggest that patient radiation dose in these procedures is not optimized in U.S. practice.

• OSTI ID: 22099047
• Journal Information: Medical Physics, Vol. 39, Issue 10; Other Information: (c) 2012 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-2405
• Country of Publication: United States
• Language: English

Related Subjects

07 ISOTOPES AND RADIATION SOURCES
60 APPLIED LIFE SCIENCES
71 CLASSICAL AND QUANTUM MECHANICS
GENERAL PHYSICS
BENCHMARKS
CORONARIES
DATA ANALYSIS
DISTRIBUTION
EVALUATION
FLUOROSCOPY
KERMA
METRICS
PATIENTS
QUALITY ASSURANCE
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIATION PROTECTION
X RADIATION