P1. A survey of initial patient diagnostic reference levels from selected fluoroscopically guided interventional procedures at Groote Schuur hospital

Abstract

Introduction Fluoroscopy units must comply with the minimum requirements set up by the Department of Health: Radiation Control, which require a license holder to establish a program to ensure that the radiation dose that a patient receives for diagnostic and interventional procedures is optimised. The approach of optimisation involves several aspects, including quality control, establishment of diagnostic reference levels (DRLs) and conducting dose surveys. Of relevance to this study are the DRLs. The aim of the study is to analyse the initial Dose-Area Product (DAP) records of three fluoroscopically guided procedures performed at Groote Schuur Hospital, to determine a baseline local DRL for each examination and compare the obtained values with reference values from literature. Materials and methods Active tracking of DAP records on the cardiac catheterization laboratories (Cathlabs) began in August 2015. DAP records collected over the period from August 2015 to May 2016 from the two Cathlabs were retrieved and analysed. The third quartile of the DAP distribution for coronary angiography (CA), coronary angiography plus left ventriculography (CA + LV) and permanent pacemaker placement were determined and were set as initial local DRLs. Results In the ten month time period in question, DAP data was recorded for 224 coronary angiographies, 144 coronary angiography plus left ventriculography studies and 90 pacemaker placements. These numbers are adequate to set initial local DRLs. Baseline local DRLs were set as follows: CA: 67 Gy·cm2, CA + LV: 72 Gy·cm2 and pacemaker placement: 10 Gy·cm2. Conclusion DRL values from these selected studies are in line with values reported in literature, but there is definite room for dose optimisation and the enhancement of radiation protection principles.