Measurement of patient skin dose and establishment of local diagnostic reference levels for interventional cardiology procedures

Abstract

Use of diagnostic reference levels (DRLs) is an important tool for patient dose optimization in interventional radiology. DRLs are normally expressed in terms of kerma-area product (Pka). However, no direct method is available to estimate the probability of skin reactions using system displayed quantities. The aim of this work was to measure skin entrance doses (SEDs) in patients undergoing coronary angiography (CA) and percutaneous coronary interventions (PCI) using Gafchromic films and establish DRLs. The details of patients, exposure parameters, and dose quantities were recorded for 572 patients. Out of these, skin doses were measured for selected 64 patients using Gafchromic film. Measured SEDs are in the range of 48.2–740 mGy and 84–1242 mGy for CA and PCI, respectively. The data of 572 patients were analyzed, and 75th percentile of Pkawas calculated. DRLs for CA and PCI in terms of Pkaare found to be 34 and 134 Gy.cm2, respectively. DRLs for CA and PCI in terms of cumulative air kerma (Ka) at reference point are found to be 590 mGy and 1930 mGy, respectively. SED has a good correlation with Ka, however, it does not correlate well with Pka.

Keywords

• Diagnostic reference level
• dosimetry
• Gafchromic film
• interventional cardiology
• skin dose