OPTIMISASI DOSIS DAN KUALITAS CITRA PADA PEMERIKSAAN PULMONARY ARTERY CATHETER (PAC) DAN PERCUTANEUS CORONARY INTERVENTION (PCI) SEBAGAI UPAYA PROTEKSI RADIASI PASIEN DI CATHLAB RSUP ADAM MALIK MEDAN

Abstract

The radiation exposure a patient receives during diagnosis and treatment cannot be fully avoided. However, it is crucial to optimize the radiation dose to ensure it is only as much as needed. The purpose of this study is to minimize the patient's radiation exposure during interventions and produce optimal image quality. To accomplish this, dose optimization and image quality were evaluated during PAC and PCI procedures in the Cathlab room at Adam Malik Hospital using Philips Allura Xper FD20. The study was retrospective, using patient dose audits from January 2020 to February 2023, with 250 PACs and 139 PCI mature patients. The median dose value (Q2) was compared to the National diagnostic reference level (NDRL) third quartile (Q3) value to determine optimal patient dose levels. We used a 28 cm PMMA phantom and a 2 cm imaging quality in-house phantom to represent the patient and a solid-state detector to measure surface dose. Medical physicists, radiographers, cardiologists, and nurses worked together in optimization cycles to ensure dose levels were kept to a minimum. Image quality was assessed by calculating the signal difference-to-noise ratio (SDNR), and images were recorded in DICOM format and analyzed using Image J software. Entrance Surface Air Kerma (ESAK) values were recorded to calculate Figure of Merit (FOM) values for each change in physical parameters. The study showed that the distance between the image detector and the object significantly affects the patient's dose. A distance of 14 cm resulted in a higher dose than a distance of 2 cm. The SDNR value varied with the object image distance (OID) factor, and increasing the object's distance to the image detector did not increase the SDNR value. Setting the OID spacing to a minimum is recommended for PAC and PCI procedures to minimize the patient's radiation exposure. The FOM values were affected by both the ESAK and SDNR values. Keywords: Dose Optimization, Image Quality, objek to image distance (OID), Pulmonary Artery Catheter, Percutaneous Coronary Intervention, Cathlab.