Abstract

Purpose: To audit radiation doses imparted to patients from interventional procedures performed in image intensifier and flat panel based interventional systems in a tertiary referral center in India. Methods: Forty cerebral angiographies were performed using Siemens Multistar top Image intensifier (II) and nine using Artis Zee flat panel detector (FPD) based angiographic systems. Dose area product (DAP) meter was used to measure dose imparted to patients during interventional procedures. Dose audit involved assessment of radiation dose, exposure parameters and image quality relevant to the examination. Copper filtration of 0.2mm was selected in the II based system, whereas 0.6mm copper filters were selected in FPD system. Subjective evaluation of image quality was performed by the interventionalists performing the procedure. Results: The mean DAP values for cerebral angiography using II and FPD systems were 127.5 (32.96 to 366.47) and 94.6 (26.31 to 228.68) Gy cm2 respectively. Dose reduction of about 26 % without sacrificing diagnostic information was achieved using FPD compared to the II system. Conclusion: It is necessary to orient the interventional staff to strictly adhere to low dose protocols so that inadvertent selection of preset protocols may impart high doses to patients. Further data collection on several other interventions is necessary in order set reference levels for Indian adult. At present using low dose protocols involving high filtration does not degrade image quality and are suggestive for use in FPD systems for the Indian adult.

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