Open AccessFactors contributing to radiation dose for patients and operators during diagnostic cardiac angiography
Author(s) -
Crowhurst James A.,
Whitby Mark,
Savage Michael,
Murdoch Dale,
Robinson Brendan,
Shaw Elizabeth,
Gaikwad Niranjan,
Saireddy Ramkrishna,
Hay Karen,
Walters Darren L.
Publication year - 2019
Publication title -
journal of medical radiation sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.484
H-Index - 18
eISSN - 2051-3909
pISSN - 2051-3895
DOI - 10.1002/jmrs.315
Subject(s) - medicine , kerma , percentile , univariate analysis , radiation dose , nuclear medicine , ionizing radiation , dosimeter , multivariate analysis , radiology , dosimetry , statistics , irradiation , physics , mathematics , nuclear physics
Diagnostic coronary angiography (CA) uses ionising radiation with relatively high doses, which impact on both patients and staff. This study sought to identify which patient and procedural factors impact patient and operator dose the most during CA. Methods Patient and procedure related variables impacting on Kerma area product (P KA ) and operator dose (OD) were collected for 16 months. Procedures were separated into 10 different procedure categories. P KA was used for patient dose and OD was measured with an instantly downloadable dosimeter (IDD) – downloaded at the end of each procedure. High and low radiation dose was defined by binary variables based on the 75th percentile of the continuous measures. Univariate and multivariate regression were used to identify predictors. Results Of 3860 patients included, the IDD was worn for 2591 (61.7%). Obesity (BMI > 30 compared to BMI < 25) was the strongest predictor for both a P KA (odds ratio (OR) = 19.1 (95% CI 13.5–26.9) P < 0.001) and OD (OR = 3.3 (2.4–4.4) P < 0.001) above the 75th percentile. Male gender, biplane imaging, the X‐ray unit used, operator experience and procedure type also predicted a high P KA . Radial access, male gender, biplane imaging and procedure type also predicted a high OD. Conclusion Radiation dose during CA is multifactorial and is dependent on patient and procedure related variables. Many factors impact on both P KA and OD but obesity is the strongest predictor for both patients and operators to receive a high radiation dose.