Radiation dose in coronary angiography and intervention: initial results from the establishment of a multi-centre diagnostic reference level in Queensland public hospitals

INTRODUCTION: Radiation dose to patients undergoing invasive coronary angiography (ICA) is relatively high. Guidelines suggest that a local benchmark or diagnostic reference level (DRL) be established for these procedures. This study sought to create a DRL for ICA procedures in Queensland public hospitals. METHODS: Data were collected for all Cardiac Catheter Laboratories in Queensland public hospitals. Data were collected for diagnostic coronary angiography (CA) and single-vessel percutaneous intervention (PCI) procedures. Dose area product (P(KA)), skin surface entrance dose (K(AR)), fluoroscopy time (FT), and patient height and weight were collected for 3 months. The DRL was set from the 75th percentile of the P(KA.) RESULTS: 2590 patients were included in the CA group where the median FT was 3.5 min (inter-quartile range = 2.3–6.1). Median K(AR) = 581 mGy (374–876). Median P(KA) = 3908 uGym(2) (2489–5865) DRL = 5865 uGym(2). 947 patients were included in the PCI group where median FT was 11.2 min (7.7–17.4). Median K(AR) = 1501 mGy (928–2224). Median P(KA) = 8736 uGym(2) (5449–12,900) DRL = 12,900 uGym(2). CONCLUSION: This study established a benchmark for radiation dose for diagnostic and interventional coronary angiography in Queensland public facilities.