Efficacy of radiation dose reduction due to real-time monitoring and visualization of peak skin dose during coronary angiography and percutaneous coronary intervention.

Abstract

This study assessed that the use of real-time monitoring and visualization of peak skin dose could reduce radiation dose during coronary angiography (CAG) and percutaneous coronary intervention (PCI). Exposure to ionizing radiation has dose related effects including skin damage. Reducing the radiation exposure is important during CAG and PCI. The skin dose-tracking system (DTS) has a real-time monitor of radiation peak skin dose. A total of 323 consecutive patients who underwent CAG and PCI between September 2014 and June 2015 were enrolled. Patients were classified into with DTS group (CAG alone in 104 and PCI in 57 patients) or without DTS group (CAG alone in 106 and PCI in 56 patients). There was no significant difference in reference air kerma between CAG alone with and without DTS groups. Reference air kerma with DTS group during PCI was lower than without DTS group (204.6 ± 141.1 mGy vs. 294.2 ± 237.4 mGy, P = 0.016). Moreover, kerma area product (17.8 ± 13.0 Gycm2 vs. 25.2 ± 19.3 Gycm2 , P = 0.019) and number of cine runs (12.8 ± 5.0 vs. 15.5 ± 6.5, P = 0.013) with DTS group were lower than without DTS group. Multiple regression analysis showed increased reference air kerma was associated with male gender, body mass index and type B2/C lesion. Conversely, DTS correlated with decreased reference air kerma. The use of DTS could reduce radiation dose during PCI. Real-time radiation monitoring and visualization of peak skin dose was effective for the patients with PCI.