A Study on the Establishment of Diagnostic Reference Levels for Cardiovascular Angiography and Interventional Procedures: Korean General Hospital
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background/Objectives: Cardiovascular interventions require prolonged fluoroscopy, which increases the risk of radiation. Diagnostic Reference Levels (DRLs), set at the 75th percentile of the dose distribution, are vital benchmarks for dose optimization. Following the release of national DRLs by the Korea Disease Control and Prevention Agency in March 2025, this study established institutional DRLs at a tertiary center to evaluate local optimization against national and international standards. Methods: This study analyzed radiation doses from 2022 to 2024 using DICOM Radiation Dose Structured Reports data from a single center’s angiography system. The total kerma-area product values and fluoroscopy times were evaluated across the categorized procedures. Following the International Commission on Radiological Protection guidelines, institutional DRLs were established at the 75th percentile of the dose distribution to benchmark against national and international DRLs. Results: Analysis of 1663 radiation dose structured reports established institutional DRLs, with the total kerma-area product ranging from 23.43 Gy·cm2 for coronary angiography to 329.45 Gy·cm2 for chronic total occlusion interventions. Complexity significantly increased the radiation burden; multivessel percutaneous coronary intervention and acute myocardial infarction nearly doubled the doses and fluoroscopy times in single-vessel interventions. Although the diagnostic procedures were cine image-driven, for moderate-complexity interventions, the contribution of fluoroscopy was greater. Conclusions: These findings support institutional optimization and development of safety guidelines to enhance patient protection during high-complexity cardiovascular procedures.
Source: Diagnostics
Authors: Daeho Kim, Jungsu Kim
Institutions: Daegu Health College, Daegu Fatima Hospital
Language: English
Topic: Radiation Dose and Imaging
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,137
OpenAlex ID: W7155108293
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