Radiation dose of cardiac IVR x-ray systems: A comparison of present and past

Objective Although many patients benefit greatly from fluoroscopically guided intervention (IVR) procedures such as percutaneous coronary intervention (PCI), one of the major disadvantages associated with these procedures, such as cardiac IVR, is the increased patient radiation dose. This study compared the entrance surface doses of x-ray equipment for cardiac IVR at the same seven cardiac catheterization laboratories between today and the past to determine the radiation doses of current cardiac IVR x-ray systems. Methods and results This study was conducted in 2001, 2007, and 2014 at the same seven cardiac catheterization laboratories in and around Sendai City, Japan. The entrance surface doses with cineangiography and fluoroscopy were compared in 2001 (11 x-ray systems), 2007, and 2014 (12 x-ray systems) using a 20-cm-thick acrylic plate and skin dose monitor. The x-ray conditions used in the measurements, including the image receptor field magnification mode and the recording speed for cineangiography and fluoroscopy, were those normally used in the facilities performing PCI. Although presently, the entrance doses of x-ray equipment used for cardiac IVR tend to be lower than previously (fluoroscopy dose in 2001, 19.3 ± 6.3 mGy/min; in 2014, 13.2 ± 6.5 mGy/min), some equipment has a high radiation dose. In addition, the dose diff erences of the x-ray systems in 2014 were greater than those in the past (fluoroscopy dose in 2001, 3.4-fold; in 2014, 10.5-fold). Conclusions In IVR procedures, managing the radiation dose of cardiac IVR x-ray systems is a very important issue. Periodical measurement of the radiation dose of the x-ray equipment used for both cineangiography and fluoroscopy for cardiac IVR is necessary.