Real-time measurement of radiation exposure to patients during diagnostic coronary angiography and percutaneous interventional procedures

AbstractObjectivesThe aim of this study was to accurately assess the radiation exposure received by patients during cardiac catheterization in a large sample representative of the current state of practice in cardiac angiography.BackgroundRadiation exposure to patients and laboratory staff has been recognized as a necessary hazard in coronary angiography. The effects on x-ray exposure of the increased complexity of coronary angiographic procedures and, in particular, the increasing use of coronary artery stenting, have not been adequately addressed in previous studies.MethodsX-ray exposure measurements were performed on a consecutive series of 972 patients undergoing 992 diagnostic and interventional studies in the Mayo Clinic catheterization laboratory within an eight week period in late 1997. Data were acquired from 706 diagnostic procedures and 286 interventional procedures using a real-time exposure measurement system to continuously calculate and record the exposure rate and total exposure, reflecting all parameters relevant to the specific patient and procedure situation.ResultsThe median exposure for all 992 procedures was 41.8 mC/kg (162.1 R); the corresponding values for diagnostic and interventional procedures were 34.9 and 95.6 mC/kg, respectively (135.3 vs. 370.5 R). There were significant differences in the fluoroscopy exposure time between diagnostic and interventional procedures: 4.7 min vs. 21.0 min. Heavier patients (>83 kg) received x-ray exposures at a significantly higher rate than did lighter patients (<83 kg) during both fluoroscopy and cine; 44.9 mC/kg/min (173.9 R/min) vs. 27.9 mC/kg/min (108.3 R/min) for cine exposure rate and 2.3 mC/kg/min (8.8 R/min) vs. 1.5 mC/kg/min (5.8 R/min) for fluoroscopy exposure rate.ConclusionsChanges in practice have led to higher values for patient x-ray radiation exposures during cardiac catheterization procedures. The real-time display and recording of x-ray exposure facilitates the reduction of exposure in the catheterization laboratory

Optimization of ATM and Legacy LAN for High Speed Satellite Communications

A high data rate (HDR) terrestrial and satellite network was implemented to transfer medical images and data. This paper describes the optimization of the workstations and networking equipment. Topics include tuning the network software configuration of Sun Microsystems workstations, Fore Systems ATM switches, and Cisco routers, as well as the transfer rate results of four distinct telemedicine experiments. The researchers were successful in achieving the transfer rates needed by the telemedicine software; particularly important was the proper determination of peak transfer rates and window sizes in making use of the resources available to the network interface cards (NICs) on the Sun Microsystems and Hewlett Packard workstations. 1. Introduction Telemedicine is a unique way to offer a medical service to a patient who would otherwise not have access to medical specialists. Globally, interest in telemedicine continues to increase, particularly in the store-and-forward form wherein com..