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Assessing Changes in Reference Point Air Kerma for Image Guided Interventions Following An X-Ray Angiography Equipment Upgrade

M Supanich*, H Ai , Rush University Medical Center, Chicago, IL


(Wednesday, 8/1/2018) 9:30 AM - 10:00 AM

Room: Exhibit Hall | Forum 8

Purpose: To evaluate changes in reference point air kerma (Kâ‚?,áµ£) used for image guided interventions following an upgrade of an X-ray Angiography (XA) suite and to evaluate trends in radiation dose across XA suites of different vintages.

Methods: Kâ‚?,áµ£ and other dose metrics were culled from RSDRs and dose pages sent to our Radiation Dose Index Monitoring software from 3 XA rooms of the same vendor but different vintages. One unit (Rm5) was upgraded in Early 2017. Dose metrics from 10 months on each side of the upgrade were evaluated for the 2 rooms (Rm3 and Rm6) that were not changed and for Rm5. Exams with Kâ‚?,áµ£ < 50 mGy were excluded from the bulk analysis as these exams were primarily line placements. Additionally, a specific exam type -Transjugular Liver Biopsies (TJs) - was compared across rooms as those cases are fairly consistent in complexity and imaging needs.

Results: The mean Kâ‚?,áµ£ from the bulk analysis of the exams for the two 10 month periods [before, after] were: Rm5 (the upgrade [1038 mGy (n=503), 644 mGy (n=342)], Rm3 [934 mGy (n=489), 936 mGy (n=402)], and Rm6 [742 mGy (n=413), 776 mGy (n=382)]. For TJs the mean Kâ‚?,áµ£ for the 2 periods [before, after] for each room were: Rm5 [162 mGy n=28, 77 mGy n=76], Rm3 [145 mGy n=64, 105 mGy n=46], Rm6 [112 mGy n=69, 137 mGy n=46].

Conclusion: Physician bias to put more complex cases in newer rooms may be a factor in the trends amongst rooms, as Rm3 is a newer room with more dose reduction features than Rm6, but shows higher average dose per exam. The significant decrease in dose across all exams and for TJs in Rm5 between the two periods supports hardware upgrades to minimize patient and operator radiation exposure.

Funding Support, Disclosures, and Conflict of Interest: Research Grant, Siemens AG


Dose, Fluoroscopy


IM- X-ray: Fluoroscopy, digital angiography, and DSA

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