Current status of diagnostic reference levels in interventional cardiology.

J Radiol Prot

Radiology Department, Universidad Complutense de Madrid, Madrid, Spain.

Published: December 2022

AI Article Synopsis

  • Interventional cardiology offers significant benefits to patients but is associated with high levels of ionising radiation, prompting the need for Diagnostic Reference Levels (DRL) to optimize safety.
  • A review of studies since 2010 shows varying DRL values for procedures like coronary angiography, with Europe averaging around 35 Gy cm and North America around 83 Gy cm, highlighting the necessity for region-specific DRLs.
  • The complexity of the procedures, advancements in technology, and the challenge of collecting reliable data, especially in pediatric cases, point to a need for more comprehensive data analysis and standardized practices in monitoring radiation exposure.

Article Abstract

Interventional cardiology provides indisputable benefits for patients but uses a substantial amount of ionising radiation. The diagnostic reference level (DRL) is the tool recommended by the International Commission on Radiological Protection to optimise imaging procedures. In this work, a review of studies dealing with radiation dose or recommending DRL values for interventional cardiology since 2010 is presented, providing quantitative and qualitative results. There are many published papers on coronary angiography (CA) and percutaneous coronary intervention. The DRL values compiled for different continental regions are different: the DRL for CA is about 35 Gy cmfor Europe and 83 Gy cmfor North America. These differences emphasise the need to establish national DRLs considering different social and/or economic factors and the harmonisation of the survey methodology. Surveys with a large amount of data collected with the help of dose management systems provide more reliable information with less chance of statistical bias than those with a small amount of data. The complexity of procedures and improvements in technology are important factors that affect the radiation dose delivered to patients. There is a need for additional data on structural and electrophysiological procedures. The analysis of paediatric procedures is especially difficult because some studies present results split into age bands and others into weight bands. Diagnostic procedures are better described, but there is a great variety of therapeutic procedures with different DRL values (up to a factor of nine) and these require a dedicated review.

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http://dx.doi.org/10.1088/1361-6498/aca2b3DOI Listing

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