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Factors contributing to radiation dose for patients and operators during diagnostic cardiac angiography.

  • Crowhurst, James A1, 2, 3
  • Whitby, Mark1, 2, 4
  • Savage, Michael1, 2
  • Murdoch, Dale1, 2
  • Robinson, Brendan1, 3
  • Shaw, Elizabeth1
  • Gaikwad, Niranjan1
  • Saireddy, Ramkrishna1, 5
  • Hay, Karen6
  • Walters, Darren L1, 2
  • 1 Heart and Lung Program, The Prince Charles Hospital, Chermside, Queensland, Australia. , (Australia)
  • 2 University of Queensland, St Lucia, Queensland, Australia. , (Australia)
  • 3 Medical Imaging Department, The Prince Charles Hospital, Chermside, Queensland, Australia. , (Australia)
  • 4 Bio-Medical Technical Services, The Prince Charles Hospital, Chermside, Queensland, Australia. , (Australia)
  • 5 Cairns Base Hospital, Cairns, Queensland, Australia. , (Australia)
  • 6 QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. , (Australia)
Published Article
Journal of medical radiation sciences
Publication Date
Nov 28, 2018
DOI: 10.1002/jmrs.315
PMID: 30488575


Diagnostic coronary angiography (CA) uses ionising radiation with relatively high doses, which impact on both patients and staff. This study sought to identify which patient and procedural factors impact patient and operator dose the most during CA. Patient and procedure related variables impacting on Kerma area product (PKA ) and operator dose (OD) were collected for 16 months. Procedures were separated into 10 different procedure categories. PKA was used for patient dose and OD was measured with an instantly downloadable dosimeter (IDD) - downloaded at the end of each procedure. High and low radiation dose was defined by binary variables based on the 75th percentile of the continuous measures. Univariate and multivariate regression were used to identify predictors. Of 3860 patients included, the IDD was worn for 2591 (61.7%). Obesity (BMI > 30 compared to BMI < 25) was the strongest predictor for both a PKA (odds ratio (OR) = 19.1 (95% CI 13.5-26.9) P < 0.001) and OD (OR = 3.3 (2.4-4.4) P < 0.001) above the 75th percentile. Male gender, biplane imaging, the X-ray unit used, operator experience and procedure type also predicted a high PKA . Radial access, male gender, biplane imaging and procedure type also predicted a high OD. Radiation dose during CA is multifactorial and is dependent on patient and procedure related variables. Many factors impact on both PKA and OD but obesity is the strongest predictor for both patients and operators to receive a high radiation dose. © 2018 The Prince Charles Hospital. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

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