Impact of the Ceiling-Mounted Radiation Shielding Position on the Physician’s Dose from Scatter Radiation during Interventional Procedures

The effect of the ceiling-mounted radiation shielding on the amount of the scatter radiation was assessed under conditions simulating obese patients for clinically relevant exposure parameters. Measurements were performed in different projections and with different positions of the ceiling-mounted shielding: without shielding; shielding closest to the patient; and shielding closest to the physician performing the procedure. The protection provided by the shielding was assessed for cardiology when the femoral access is used and for radiology when the physician performs the procedure in the abdominal area. The results show that the use of the ceiling-mounted shielding can decrease the dose from the scatter radiation by 95% at the position of the performing physician. In cardiology, the impact is more pronounced when the left oblique projection is used. In radiology, a large decrease was observed for right oblique projections, compared to cardiology. The ceiling-mounted shielding should be placed as close to the physician as possible. The idea of creating the largest radiation shadow by placing the radiation shielding as close to the patient as possible does not provide as effective radiation protection of the operator as it might be thought

Establishing the European diagnostic reference levels for interventional cardiology.

Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm <sup>2</sup> ), percutaneous coronary intervention (PCI, 85 Gy cm <sup>2</sup> ), transcatheter aortic valve implantation (TAVI, 130 Gy cm <sup>2</sup> ), electrophysiological procedures (12 Gy cm <sup>2</sup> ) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm <sup>2</sup> ) and dual chamber (3.5 Gy cm <sup>2</sup> ) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm <sup>2</sup> ). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology

Establishing the European diagnostic reference levels for interventional cardiology

Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm(2)), percutaneous coronary intervention (PCI, 85 Gy cm(2)), transcatheter aortic valve implantation (TAVI, 130 Gy cm(2)), electrophysiological procedures (12 Gy cm(2)) and pacemaker implantations Pacemaker implantations were further divided into single-chamber (2.5 Gy cm(2)) and dual chamber (3.5 Gy cm(2)) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm(2)). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology