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Relationship Between Fluoroscopic Time, Dose–Area Product, Body Weight, and Maximum Radiation Skin Dose in Cardiac Interventional Procedures

Koichi Chida1, Haruo Saito2, Hiroki Otani3, Masahiro Kohzuki4, Shoki Takahashi2, Shogo Yamada2, Kunio Shirato3 and Masayuki Zuguchi1

1 Department of Radiological Technology, Tohoku University School of Health Sciences, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
2 Department of Radiology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
3 Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.
4 Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan.


Figure 1
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  		Fig. 1 —Graphical display of Caregraph (Siemens Medical Solutions). Example shows dose distribution at skin after cardiac radiofrequency catheter ablation. In this study, dose–area product (DAP) was measured using Caregraph, which consists of the Diamentor M4 system (PTW Freiburg). Caregraph algorithm uses several factors to calculate patient skin dose, including measured DAP, X-ray parameters (such as collimation size and angle view of image intensifier), and patient size and position. Maximum radiation dose, which is shown in red, received by right back skin was 2,098 mGy (total fluoroscopic time = 214.5 min, DAP = 28,115 cGy x cm2). Yellow shows areas of lesser radiation exposure.

 

Figure 2
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  		Fig. 2 —Graph shows correlation between maximum patient skin dose and fluoroscopic time in cardiac radiofrequency catheter ablation (r = 0.801, p < 0.0001).

 

Figure 3
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  		Fig. 3 —Graph shows correlation between maximum patient skin dose and dose–area product (DAP) in cardiac radiofrequency catheter ablation (r = 0.942, p < 0.0001).

 

Figure 4
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  		Fig. 4 —Graph shows correlation between maximum patient skin dose and fluoroscopic time in percutaneous coronary intervention (r = 0.628, p < 0.0001).

 

Figure 5
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  		Fig. 5 —Graph shows correlation between maximum patient skin dose and dose–area product (DAP) in percutaneous coronary intervention (r = 0.724, p < 0.0001).

 

Figure 6
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  		Fig. 6 —Graph shows correlation between maximum patient skin dose and double product (body weight x fluoroscopic time, or WFP [weight–fluoroscopic time product]) in percutaneous coronary intervention (r = 0.709, p < 0.0001).

 

Figure 7
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  		Fig. 7 —Graph shows correlation between dose–area product (DAP) and double product (body weight x fluoroscopic time, or WFP [weight–fluoroscopic time product]) in percutaneous coronary intervention (r = 0.736, p < 0.0001).

 

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