Optimization of radiation dose and risk assessment during interventional cardiology procedures: A case study at The National Cardiothoracic Centre, Korle-Bu teaching hospital-Ghana

Abstract

Cardiac intervention procedures involve high radiation doses, hence the need to protect patients and staff from deterministic and stochastic effects. Patients’ weight, height, age, and radiation exposure values were measured at the National Cardiothoracic Centre (NCTC), where a number of different interventional cardiology procedures were performed. Body Mass Index (BMI) was calculated from measured weight and height results. Dose data were collected for a total of 498 patients: comprising of 309 males and 189 females. The values for Dose Area Product (DAP) were measured using DAP meter for four cardiovascular examinations namely, Coronary Angiography (CA), Percutaneous Coronary Intervention (PCI), combine Coronary Angiography and Percutaneous Coronary Intervention (CAPCI) and Right Heart Catheterization (RHC). Occupational doses (staff effective doses) were calculated using three different double dosimetry algorithms with two dosimeters (TLDs) that were placed above and below the lead protective apron. Staff total detriment to radiation was estimated using risk coefficients for stochastic effect and the results obtained are 1.76 ∗ 10−3 for surgeons 7.96 ∗ 10−4 for nurses and 1.29 ∗ 10−4 for operators. BMI obtained for females and males were (29.92±5.51) kg/m2 and (27.14±4.03) kg/m2, respectively. Male dose values obtained were [(17.34±12.62), (74.77±11.20), (87.17±10.72), (34.87±37.48)] µGycm2 and female dose values were [(69.44±76.15), (133.49±94.37), (80.90±10.78), (34.27±35.02)] µGycm2 for CA, PCI, CAPCI and RHC, respectively. Effective doses obtained ranged between [0.54-2.20), (0.45-1.61), (0.52-1.04)] mSv for cardiologists, nurses, and operators, respectively.