A multicentre survey of patient exposure to ionising radiation during interventional cardiology procedures in France

Abstract

A tentative evaluation of doses received by patients undergoing international cardiolfgy (IC) procedures was carried out in France in June 2006 by the GACI. A pilot survey was performed aiming at: a) demonstrating the feasibility of the adopted approach towards estimating patient exposure; b) getting a first estimate of national diagnostic reference level (DRL) values; c) gathering experience on data collection in view of nationwide future studies. Nineteen catheterisation laboratories provided data on 813 IC procedures (496 coronarography (CA) and 317 PTCA) performed by 60 cardiologists on 29 different installations. Data gathered for each procedure were: patient characteristics, dosimetry indicators (DosexArea Product, fluoroscopy time, number of frames) and examination details (number of severe lesions, number of stents, etc.). In spite of their overall compliance with international DRL values, dosimetric indicators showed large variations. Maximum to minimum ratios ranged from 60 to 160 for the DAP, from 80 to 60 for the fluoroscopy time and from 25 to 30 for the number of images for CA and PTCA respectively. Findings highlighted key aspects of IC practice which should be improved from the radiation protection point of view: training of cardiologists, awareness of equipment performance and optimisation of procedures.