Evaluation of Procedure Doses and Staff Attitudes in Interventional Cardiology in Terms of Radiation Safety

BACKGROUND
Ionizing radiation has been used for years in the medical field. As one of the areas, the catheter laboratories (cath labs) have been accepted as a field where radiation exposure was reasonably high. This study aims to examine the radiation levels exposed during different interventional procedures to raise awareness of this issue in Türkiye.

METHODS
This study evaluated procedure radiation dose (n=2804) in the cath labs of four public hospitals with different characteristics. Radiation dose evaluation was conducted with Cumulative Air Kerma (CAK). The Kolmogorov-Smirnov, Kruskal Wallis H, the independent T-test, and The Pearson correlation coefficient were used to present the findings. p<0.05 was accepted as statistically significant. IBM® SPSS® STATISTIC Version 26.0.0.0 (Corporation, Armonk, New York, United States of America (USA) was used to analyze the data.

RESULTS
Procedure radiation doses in the cath labs were presented in this study. The findings were mainly consistent with the literature. Additionally, many outlier cases were determined with quite high radiation doses [CAK (min-max) = 0.12 – 9.9 Gy]. Chronic total occlusion (CTO) [Mean CAK: 3.8(±1.5) Gy] and percutaneous coronary interventions (PCI) [Mean CAK: 1.5(±1.4) Gy] were procedures with high doses. Moreover, personnel attitudes toward radiation optimization in the cath labs were insufficient.

CONCLUSION
The rates of high radiation exposure during interventional procedures may be higher than expected in Türkiye. Further studies are warranted to investigate the predictors and the preventive measures to reduce these rates. For this purpose, diagnostic radiation reference (DRL) levels can be established to monitor national radiation levels.