Feasibility study of using fluoroscopy time as warning indicator for radiation dose in cardiovascular interventions

Objective To collect the date of radiation dose in reference air kerma(AK) and dose-area product (DAP) values in order to evaluate the feasibility of fluoroscopy time as a monitoring and warning indicator of radiation exposure in cardiovascular interventions. Methods The study conducted a retrospective analysis of 736 patients who underwent coronary angiography(CAG)and percutaneous coronary intervention(PCI)from November 2016 to January 2018 in Shanghai Changhai Hospital. Based on the imaging equipments(a Siemens Ceiling system and a Siemens Biplane system)and cardiovascular interventions(CAG and PCI), the fluoroscopy time, AK values and DAP values were collected. The correlation of the radiation dose and fluoroscopy time was analyzed using Spearman correlation statistics. Results The mean values of fluoroscopy time, fluoroscopy AK, total AK, fluoroscopy DAP and total DAP were(8.9±7.8)min, (472±474), (703±595)mGy, (4 578±4 085)and(6 253±4 938)μGy·m2 for Ceiling system and(8.6±7.3)min, (510±509), (733±614)mGy, (4 255±3 781)and (5 681±4 432)μGy·m2 for Biplane system, respectively. The mean values of CAG and PCI fluoroscopy time were(2.4±0.9)and(15.7±4.9)min, respectively.The ratio of fluoroscopy radiation dose (AK and DAP) to total dose was 74% and 78% in PCI procedures. There was a strongly correlation between fluoroscopy time and total AK (r=0.822) or total DAP (r=0.844) in cardiovascular interventions (P<0.001). Conclusions The radiation dose of fluoroscopy acquisition is the main source of overall radiation dose in cardiovascular interventions. Radiation dose is expected to increase as fluoroscopy time increases.The fluoroscopy timer as a protective tool of radiation exposure has a good reference and warning value in the clinical application of cardiovascular interventions. Key words: Cardiovascular intervention; Radiation dose; Fluoroscopy time