Background:
System optimization may improve the radiation safety of X-ray systems but has received limited study.
Methods:
We retrospectively reviewed 559 catheterization procedures performed in two cardiac catheterization laboratories during 2018 and compared patient radiation dose before and after X-ray system optimization.
Results:
Before and after optimization there was no significant difference in number of exposures (9 [6,16] vs 9 [6,15], p=0.546), total Dose Area Product (DAP) dose (2813 [1205, 5487] vs 2818 [1142, 4867] μGy/m
2, p=0.464), total air kerma (AK) dose (386 [172, 757] vs 367 [137, 725] mGy, p=0.450), cine DAP dose (1426 [672, 2587] vs 1556 [629, 2694] μGy/m
2, p=0.708), and cine AK dose (206 [104, 362] vs 216 [82.3, 399] mGy/m, p=0.693). Before and after optimization fluoroscopy DAP per minute dose (153 [96.1, 249] vs 154 [101, 237] μGy/m
2, p=0.935), fluoroscopy AK per minute dose (19.6 [11.5, 30.7] vs 19.8 [12.3, 29.9] mGy, p=0.904 and cine DAP per exposure dose (139 [82.2, 216] vs 158.48 [102, 231] μGy/m
2, p=0.079) were similar, however median patient cine mode AK dose per exposure was significantly lower (19.9 [13, 29.8] vs 23.8 [13.7, 33.2] mGy, p=0.035,
Figure 1).
Conclusions:
X-ray system optimization was associated in lower cine AK dose per exposure, but no difference in per minute fluoroscopy dose, suggesting that optimization improves the radiation of cine-angiography but not fluoroscopy.
