OA102] Correlation between cumulative dose and peak skin dose using gafchromic films for patients undergoing interventional cardiology procedures

Abstract

Purpose During last years Interventional Cardiology (IC) procedures have increased in number and complexity thus the concern about radiation dose to patients and radiation damages is increasing too. The aim of the work is to examine the radiation exposure of patients undergoing IC procedures and evaluating the deterministic risk in terms of Peak Skin Dose (PSD). Methods 40 procedures involving adult patients undergoing Coronary Angiography (CA) and Percutaneous Transluminal Coronary Angioplasty (PTCA) were involved. The procedures were performed at our institution by means of an Allura Clarity and Axiom Artis angiographic system. PSD was measured in vivo using calibrated radiochromic GafChromic XR-RV3 films and Cumulative Dose at the Interventional Reference Point (CD), reported in the Radiation Dose Structured Reports (RDSR), was collected. Linear regression between measured PSD and CD was investigated for both the angiographic systems. Results The CD values are generally higher and more variable for PTCA than for CA, due to the different procedure complexity. Mean PSD was found (103 ± 64) Gy for CA, (526 ± 436) Gy for PTCA, respectively. For the same type of procedure, values result lower on Allura Clarity system, due to his powerful dose-reduction strategies. The correlation obtained between PSD and CD was found to be good (R2 = 0.76 for Axiom Artis, R2 = 0.83 for Allura Clarity). The CD values corresponding to a PSD of 2 Gy (threshold for deterministic skin effects) are 6.0 Gy for Axiom Artis and 3.5 Gy for Allura Clarity system, respectively. Conclusions The study confirmed that IC procedures can deliver high levels of radiation dose to patients, dose increases with the complexity of procedures and can significantly depend on the X-Rays system. The correlation between PSD and CD can effectively support clinicians in identifying and managing patients at risk for deterministic effects.