Aims and objectives
Radiation safety awareness campaigns triggered several new initiatives in our cardiac catheterization laboratories.
One such project investigated whether a new working procedure that starts with low dose protocols rather than default standard dose setting would significantly reduce patient and personnel dose.
Five months after implementation,
a retrospective dose analysis was performed.
Methods and materials
Two Siemens cardiac imaging systems (Siemens Artis Q 'system A' and Siemens Axiom Artis dBC 'system B') were included in this study.
For the commonly used clinical protocols,
service technicians set the start-up defaults for both fluoroscopy and ciné (acquisition) to the low dose settings,
instead of the medium dose setting.
Additionally,
the program names were adjusted to be more understandable and uniform across the different systems.
Operators were instructed to switch to higher dose mode only when needed clinically.
Monthly average dose-area-product (DAP) and...
Results
Averaged over a 5 month period (July-November) following the changes,
DAP per exam decreased by 27% and 37% for systems A and B respectively,
compared to the 12 months prior the protocol change (System A:Fig. 1,
System B: Fig. 2).
Similarly,
looking at the median values instead of the mean values gave similar results,
with a decrease of 33% and 35% for both rooms.
Comparable results were found when looking at the PSD instead of the DAP values,
with a decrease of34% and 29% for...
Conclusion
Simple,
easily implemented steps,
made within the framework of radiation safety awareness,
can lead to large reductions in patient dose.Setting the default program to the low dose setting,
reduced the average patient DAP and PSD significantly,
without having any noticeable effect on the clinical workflow.
Personal information
Michiel Dehairs is a PhD student in medical physics in radiology at the KU Leuven.
His field of research is interventional radiology and cardiology and more particular how the choice of X-ray factors influences the overall system efficiency.
He is involved in the Horizon2020 P3 Stroke project,
where he is working on radiation protection,
X-ray image quality and system optimization for the Angio-MR system.
References
QAELUM NV,
Science Park Arenberg,
Gaston Geenslaan 9,
B-3001 Leuven – Heverlee,
Belgium: https://qaelum.com/ (Qaelum)