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Title: Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals

Abstract

Radiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals. Data were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (P{sub KA}), skin surface entrance dose (K{sub AR}), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the P{sub KA.} 2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median K{sub AR} = 581 mGy (374–876). Median P{sub KA} = 3908 uGym{sup 2} (2489–5865) DRL = 5865 uGym{sup 2}. 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median K{sub AR} = 1501 mGy (928–2224). Median P{sub KA} = 8736 uGym{sup 2} (5449–12,900) DRL = 12,900 uGym{sup 2}. This study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities.

Authors:
 [1];  [2];  [1];  [2];  [3];  [4];  [5];  [6];  [7];  [2]
  1. The Prince Charles Hospital, Chermside, Queensland (Australia)
  2. (Australia)
  3. Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland (Australia)
  4. Allied Health Professions' Office of Queensland, Brisbane, Queensland (Australia)
  5. Royal Brisbane and Women's Hospital, Herston, Queensland (Australia)
  6. Princess Alexandra Hospital, Woolloongabba, Queensland (Australia)
  7. Cardiac Clinical Informatics Unit - Queensland Health, Herston, Queensland (Australia)
Publication Date:
OSTI Identifier:
22402357
Resource Type:
Journal Article
Journal Name:
Journal of Medical Radiation Sciences (Print)
Additional Journal Information:
Journal Volume: 61; Journal Issue: 3; Other Information: PMCID: PMC4175852; PMID: 26229649; OAI: oai:pubmedcentral.nih.gov:4175852; Copyright (c) 2014 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 2051-3895
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BENCHMARKS; CONTAINERS; CORONARIES; FLUOROSCOPY; HOSPITALS; PATIENTS; QUEENSLAND; RADIATION DOSES; RECOMMENDATIONS; SKIN; SURFACES; WEIGHT

Citation Formats

Crowhurst, James A, E-mail: jimcrowhurst@hotmail.com, School of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland, Whitby, Mark, Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland, Thiele, David, Halligan, Toni, Westerink, Adam, Crown, Suzanne, Milne, Jillian, and The Prince Charles Hospital, Chermside, Queensland. Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals. Australia: N. p., 2014. Web. doi:10.1002/JMRS.67.
Crowhurst, James A, E-mail: jimcrowhurst@hotmail.com, School of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland, Whitby, Mark, Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland, Thiele, David, Halligan, Toni, Westerink, Adam, Crown, Suzanne, Milne, Jillian, & The Prince Charles Hospital, Chermside, Queensland. Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals. Australia. doi:10.1002/JMRS.67.
Crowhurst, James A, E-mail: jimcrowhurst@hotmail.com, School of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland, Whitby, Mark, Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland, Thiele, David, Halligan, Toni, Westerink, Adam, Crown, Suzanne, Milne, Jillian, and The Prince Charles Hospital, Chermside, Queensland. Mon . "Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals". Australia. doi:10.1002/JMRS.67.
@article{osti_22402357,
title = {Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals},
author = {Crowhurst, James A, E-mail: jimcrowhurst@hotmail.com and School of Medicine, University of Queensland, St. Lucia, Brisbane, Queensland and Whitby, Mark and Biomedical Technology Services, Health Services Support Agency, Queensland Health, Herston, Queensland and Thiele, David and Halligan, Toni and Westerink, Adam and Crown, Suzanne and Milne, Jillian and The Prince Charles Hospital, Chermside, Queensland},
abstractNote = {Radiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals. Data were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (P{sub KA}), skin surface entrance dose (K{sub AR}), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the P{sub KA.} 2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median K{sub AR} = 581 mGy (374–876). Median P{sub KA} = 3908 uGym{sup 2} (2489–5865) DRL = 5865 uGym{sup 2}. 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median K{sub AR} = 1501 mGy (928–2224). Median P{sub KA} = 8736 uGym{sup 2} (5449–12,900) DRL = 12,900 uGym{sup 2}. This study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities.},
doi = {10.1002/JMRS.67},
journal = {Journal of Medical Radiation Sciences (Print)},
issn = {2051-3895},
number = 3,
volume = 61,
place = {Australia},
year = {2014},
month = {9}
}