Occupational dose measurement in interventional cardiology practice.

Ensuring the safety of healthcare workers in interventional cardiology necessitates effective monitoring of occupational radiation exposure. This study aims to assess the accuracy of the over-apron single dosimetric approach compared with double dosimetric methods and explore the relationship between under-apron and over-apron doses. This investigation showed that the prescribed annual dose constraint of 20 mSv year-1 was not exceeded by the maximum annual occupational doses determined by dosimetric algorithms, which were 0.13 ± 0.02, 0.15 ± 0.02 and 0.27 ± 0.04 mSv, respectively. The study demonstrated excellent statistically significant correlations among single and double dosimetric algorithms and between direct under-apron and over-apron doses. Consequently, single dosimetric algorithms could effectively estimate doses for double dosimetric algorithms, highlighting the limited added value of under-apron measurements. These findings significantly impact the practice of interventional cardiology in Sri Lanka, playing a crucial role in enhancing radiation protection measures.

Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka.

Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.

Establishment of institutional diagnostic reference level for coronary angiography procedures in Sri Lanka.

Amongst many interventional procedures performed in a cardiac catheterisation laboratory, the coronary angiography (CAG) is the most frequently performed cardiac interventional procedure. A diagnostic reference level (DRL) is an effective tool to optimise the radiation exposure to patients and staff whilst maintaining the adequate diagnostic image quality. The aim of the study was to establish institutional DRLs for the CAG procedures performed at a selected private hospital in Colombo, Sri Lanka. A total of 325 CAG procedures were selected for this study from two C-arm machines. The institutional DRLs of cumulative dose length product (DAP) and fluoroscopic time for the CAG procedure were calculated. The established institutional DRL for accumulated DAP and fluoroscopic time are 10 610 mGycm2 and 2.31 min, respectively. As this study conducted at only one institute we recommend to develop national DRLs for mostly performing interventional procedures in Sri Lanka by considering all influencing factors to optimise the patient dose.

Current status and future prospects of radiation oncology in Sri Lanka.

PURPOSE: To investigate the current status of radiation treatment facilities in Sri Lanka and to explore future possibilities required to adequately address increasing cancer care. METHODS: Hospitals with radiation therapy facilities from across the country were identified. Data pertaining to the types of radiotherapy equipment, radiation oncology staffing, and radiotherapy education were collected by onsite visit, conversation over the phone, and from other available cancer resources in Sri Lanka. RESULTS: Seven government hospitals and two private sectors were identified with radiation therapy facilities over nine provinces in Sri Lanka for 21.4 million people. At present, there are twenty megavoltage machines (MVMs) operating. This is 0.93 MVMs per one million people. After completion of proposed radiotherapy facilities, it will be able to provide 1.21 MVMs per million people. In addition, multidisciplinary staffing has also been identified as inadequate. CONCLUSIONS: There is a significant shortfall in radiotherapy facilities and workforce in Sri Lanka. The current and future scope of radiation facilities is sub-optimal compared to internationally recognized guidelines.