Patients’ organ dose and risk assessment in interventional cardiology procedures

Abstract

Interventional cardiology (IC) procedures can be complex, leading to long exposure times to ionizing radiation (IR) that may cause deterministic effects and an increased risk of stochastic effects. Hence, there is a growing need, for studies such as the ones reported in this work, correlating the patient effective dose and the radiological cancer risk.A female voxel phantom, LAURA, was implemented using a Monte Carlo program, PENELOPE, to assess organ doses per unit kerma-area-product (KAP). The demographic and exposure data, from 27 female patients, were used to assess the radiological risk associated to typical IC examinations.For organs, such as lungs and thyroid, the higher values of dose per unit KAP are observed for RAO30 projection, with an exception for breast and stomach. For coronariography (CA), an effective dose ranging from 15.3 ± 0.2 to 44.8 ± 0.4 mSv was found, whereas for percutaneous transluminal coronary angioplasty (PTCA) was 109.8 ± 0.9 mSv. The lung is the main organ at risk (OAR), with lung cancer risk incidence and mortality as high as 1/196 and 1/182, respectively. The calculated lifetime attributable risk (LAR) for stochastic effects varies from 0.064% (CA) to 0.461% (PTCA).The effective doses calculated highlight the importance of accurately assessing the risk of cancer incidence and mortality. Furthermore, for the sake of reducing the risk of stochastic effects, as low as possible, lower peak voltages of the X-ray equipment should be used, as long as the resulting image quality does not jeopardize the clinical result of the intended IC procedure.