Radiation Dose Reduction in the Invasive Cardiovascular Laboratory

Abstract

This work demonstrates that a philosophy of radiation safety, implemented through a collection of sustained practice and x-ray system changes, can result in a significant decrease in the radiation dose administered to patients during invasive cardiovascular procedures.

Effect of Reduction of the Pulse Rates of Fluoroscopy and CINE-Acquisition on X-Ray Dose and Angiographic Image Quality During Invasive Cardiovascular Procedures

“…However specific recommendations for frame rates that balance reductions in total energy with adequate image quality are not made. Fetterly et al 10 examined the effect of several practice changes in their laboratory on the mean patient skin dose. Several x-ray system technical changes were introduced, including standardized imaging protocols, modulations to x-ray filter, and a reduction in the fluoroscopy frame rate from 15 FPS to 7.5 pulses per second; however, CINE were left unchanged at 15 pulses per second.…”

“…Reducing the rate at which the x-ray pulse is generated, particularly during fluoroscopy, is often part of comprehensive radiation reduction protocols. 10 Pulse rate reduction is an especially attractive technique to reduce patient and operator radiation exposure because it can usually be easily achieved by operators from the angiographic equipment control panels during the cases. The other important components of the quantitative x-ray dose, including the current and pulse width, are usually controlled by the x-ray equipment to maintain image quality and are not easily manipulated by the operating physician.…”

Fluoroscopy pulse rate reduction during diagnostic and therapeutic imaging in the cardiac catheterization laboratory: An evaluation of radiation dose, procedure complications and outcomes

“…One, it specifically evaluated reduction in fluoroscopy pulse rate in isolation. Several studies have also shown significant reductions in patient radiation dose by lowering pulse rate . The majority of these studies evaluated a reduction of fluoro pulse rate of 15 to 7.5 p/s, and many of these as part of a larger radiation reduction initiative or protocol.…”

Radiation exposure, the forgotten enemy: Toward implementation of national safety program

“…Mayo clinic 28 achieved a 40% radiation dose reduction (cumulative air kerma) over a 3-year period by implementing a culture and philosophy of radiation safety in the Cath lab.…”