Conversion factors of effective and equivalent organ doses with the air kerma area product in patients undergoing coronary angiography and percutaneous coronary interventions

To derive effective dose (E), organ dose (H_T) and conversion factors with the air kerma area product (KAP) in coronary angiography (CA) and percutaneous coronary intervention (PCI) by the radial route, using the ICRP 103 tissue weighting factors. The study included 34 patients referred for CA and 31 for PCI. E and H_T were derived from in-the-field KAP measurements using Montecarlo methods. Median KAP of 23.2 and 56.8 Gy cm² and E of 6.9 and 20.0 mSv were found for CA and PCI, respectively. Mean KAP and E were significantly higher in males than in females (52.4 ± 40.0 vs 32.3 ± 16.6 Gy cm²; p = 0.02) and (16.8 ± 13.6 vs 10.7 ± 5.8 mSv; p = 0.04). KAP (r = 0.39; p = 0.001) and E (r = 0.34; p = 0.005) showed a significant correlation with the patient's weight. Conversion factors between KAP and E (E/KAP) were 0.30 ± 0.04 mSv Gy⁻¹ cm⁻² for CA and 0.33 ± 0.05 mSv Gy⁻¹ cm⁻² for PCI. No significant differences in the E/KAP between males and females were found (0.31 ± 0.05 vs 0.33 ± 0.05; p = 0.08). Again, no significant correlation was found between E/KAP and patient's weight (r = 0.23; p = 0.07). The correlation between E and KAP was excellent for CA (r = 0.99) and PCI (r = 0.96). The correlation between H_T and KAP ranged from r = 0.87 to r = 1 and from r = 0.71 to r = 0.98 for CA and PCI, respectively. A single factor, the total KAP, could be used for a specific acquisition protocol to reliably estimate E and H_T without the need of a patient's specific analysis. Conversion factors might be installation, X-ray beam quality or protocol dependent.