Article

Impact of collimation on radiation exposure during interventional electrophysiology

Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
Europace (Impact Factor: 3.67). 04/2012; 14(11). DOI: 10.1093/europace/eus095
Source: PubMed

ABSTRACT

AIMS: Fluoroscopy remains a cornerstone imaging technique in contemporary electrophysiology practice. We evaluated the impact of collimation to the 'minimal required field size' on clinically significant parameters of radiation exposure.METHODS AND RESULTS: Radiation dose measured by dose area product (DAP) and radiation dose rate measured by DAP per minute of fluoroscopy were determined for all 571 electrophysiology procedures performed in a single electrophysiology laboratory from January 2010 to December 2010. Data from 205 procedures performed by one interventional electrophysiologist, who instituted a practice of routinely collimating to the minimum required visual fluoroscopy field on a case-by-case basis, were compared with data from 366 procedures performed by the three other experienced interventional electrophysiologists using the laboratory who continued their existing practice of ad hoc collimation. Significant reductions in radiation exposure were seen with the practice of routine maximal collimation. The largest reductions were seen during 'simple' ablation procedures.CONCLUSION: A practice of routinely collimating to the minimum required visual fluoroscopy field results in significant reductions in radiation exposure when compared with a usual approach to collimation. This may have important implications for risk of malignancy in patients and operators.

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    • "e l s e v i e r . c o m / i j c -h e a r t -a n d -v a s c u l a t u r e principles in terms of patient radiation safety, such as short imaging time, avoidance of field overlap in repeated acquisitions, low SID, tight collimation, use of intra-procedural echocardiography, and a frame rate for fluoroscopy acquisitions of maximum 15 frames/s [19] [20] [21] [22] [23] [24]. Moreover, our cath lab has been recently upgraded to a novel X-ray imaging technology (AlluraClarity; Philips Healthcare, Best, Netherlands) developed for fluoroscopy and cine exposure for interventional cardiology for the entire patient size population, including pediatric. "
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    • "Walters et al. evaluated the impact of collimation of the "minimal required field size" on the clinically significant parameters of radiation exposure. There was a significant 60% reduction in the total radiation dose with collimation of the minimum required visual field [13]. In this study, we used a 14.5 cm width of collimation because the width easily permitted physicians to see the target point in the L3, 4 and 5 MBBs as shown in Fig. 1A. "
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