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Changes to imaging lab practices reduced patient radiation exposure
Changes to practices in the imaging lab decreased the radiation dose administered to patients during invasive CV procedures by 40%, reported a team from one center.
A CV invasive labs radiation safety committee at Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minn., implemented such practice changes as intraprocedure radiation dose announcements; reporting of procedures for which the air-kerma exceeded 6,000 mGy, including procedure air-kerma in the clinical report; and establishing compulsory radiation safety training for fellows. Technical changes included establishing standard X-ray imaging protocols, increasing use of X-ray beam spectral filters, reducing the detector target dose for fluoroscopy and acquisition imaging, and reducing the fluoroscopy frame rate to 7.5 s-1.
The team calculated patient- and procedure-specific cumulative skin dose from air-kerma values and evaluated retrospectively during 3 years.
A total of 18,115 procedures were performed by staff cardiologists and fellows-in-training. Overall, the mean cumulative skin dose decreased from 969 mGy to 568 mGy (40% reduction) in 3 years. This overall dose reduction resulted from a combination of reduced acquisition skin dose (46%) and fluoroscopy skin dose (33%).
The researchers wrote, “This reduction was accomplished in a clinical environment with several X-ray systems, 27 physician operators, and 65 fellows-in-training while performing a wide variety of CV procedures. Because radiation scatter that results in occupational dose is directly proportional to patient dose, reductions in patient dose can be expected to have a complementary effect on radiation dose to staff.”
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