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Six years experience in intracoronary brachytherapy procedures: patient doses from fluoroscopy

¹ Medical Physics Service, ² Radiotherapy Service and, ³ Interventional Cardiology Service, San Carlos University Hospital, 28040 Madrid, ⁴ Radiology Department, Medicine School, Complutense University, 28040 Madrid, Spain

Typical patient dose levels during intracoronary brachytherapy (ICB) procedures using beta sources were determined across a sample of 221 treatments. Dose–area product values, fluoroscopy time and number of frames per procedure, with median values of 62 Gy cm², 17.0 min and 1493 images, respectively, resulted in a 20% to 50% increase in the values measured for percutaneous transluminal coronary angioplasty procedures in the same medical centre (median values 41 Gy cm², 14.3 min and 1078 images). Likely reasons for this increase include the additional complexity of ICB, the need for recording and reporting every step of the treatment, getting the essential parameters for the volume determination of the lesion and therapeutic radiation dose calculation and, finally, the learning curve for this kind of procedure. A high concentration skin dose distribution during ICB procedures was measured and in 12% of the patients peak skin doses higher than 1.5 Gy were confirmed. 10 patients were submitted to clinical follow-up and skin injuries were not identified.