In recognition of the increased use of ionizing radiation-based cardiovascular imaging, the American College of Cardiology released a new expert document outlining best practices for minimizing exposure to patients and clinicians.
In addition to recommending practitioners use non-radiation techniques when appropriate, along with equipment set for minimal radiation exposure, the document, published online May 2 in the Journal of the American College of Cardiology offered many dose-minimizing strategies broken down by modality.
- In x-ray fluoroscopy: make sure of optimal system positioning, choose the lowest dose per frame and slowest frame rate and utilize personal protective equipment.
- In x-ray CT: appropriate case selection is key, but also use the lowest-dose scan for producing necessary correlating image-quality. Confine the body area relevant to diagnostic purpose when possible.
- In nuclear cardiology: use stress-rest protocol when appropriate, small radionuclide dosing, position camera head as close to the patient as possible and avoid Thallium-201 when possible.
The recommendations were approved by the Heart Rhythm Society, North American Society for Cardiovascular Imaging, Society for Cardiovascular Angiography and Interventions and Society of Cardiovascular Computed Tomography.
“By applying this knowledge base, cardiovascular practitioners will be able to select and perform procedures optimally, and, accordingly, minimize radiation exposure to patients and to personnel,” wrote John Hirshfeld, Jr., MD, and Victor A. Ferrari, MD, both chairs of the writing committee which authored the document.