A1 Refereed original research article in a scientific journal

Contemporary radiation doses in interventional cardiology: a nationwide study of patient doses in Finland




AuthorsJukka Järvinen, Joanna Sierpowska, Teemu Siiskonen, Hannu Järvinen, Tuomas Kiviniemi, Tuomas T Rissanen, Hanna Matikka, Eini Niskanen, Saija Hurme, Heli R S Larjava, Timo J Mäkelä, Satu Strengell, Markku Eskola, Teuvo Parviainen, Elina Hallinen, Markku Pirinen, Antti Kivelä, Mika Teräs

PublisherOxford University Press

Publication year2019

JournalRadiation Protection Dosimetry

Journal name in sourceRadiation protection dosimetry

Volume185

Issue4

First page 483

Last page493

Number of pages11

ISSN1742-3406

eISSN1742-3406

DOIhttps://doi.org/10.1093/rpd/ncz041

Web address https://academic.oup.com/rpd/article/185/4/483/5466141

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/45522978


Abstract

The amount of interventional procedures such as percutaneous coronary intervention (PCI), transcatheter aortic valve implantation (TAVI), pacemaker implantation (PI) and ablations has increased within the previous decade. Simultaneously, novel fluoroscopy mainframes enable lower radiation doses for patients and operators. Therefore, there is a need to update the existing diagnostic reference levels (DRLs) and propose new ones for common or recently introduced procedures. We sought to assess patient radiation doses in interventional cardiology in a large sample from seven hospitals across Finland between 2014 and 2016. Data were used to set updated national DRLs for coronary angiographies (kerma-air product (KAP) 30 Gycm2) and PCIs (KAP 75 cm2), and novel levels for PIs (KAP 3.5 Gycm2), atrial fibrillation ablation procedures (KAP 25 Gycm2) and TAVI (KAP 90 Gycm2). Tentative KAP values were set for implantations of cardiac resynchronization therapy devices (CRT, KAP 22 Gycm2), electrophysiological treatment of atrioventricular nodal re-entry tachycardia (6 Gycm2) and atrial flutter procedures (KAP 16 Gycm2). The values for TAVI and CRT device implantation are published for the first time on national level. Dose from image acquisition (cine) constitutes the major part of the total dose in coronary and atrial fibrillation ablation procedures. For TAVI, patient weight is a good predictor of patient dose.


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