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Status of radiation protection in various interventional cardiology procedures in the Asia Pacific region
  1. Virginia Tsapaki1,
  2. Mohammed Faruque Ghulam2,
  3. Soo Teik Lim3,
  4. Hung Ngo Minh4,
  5. Nwe Nwe5,
  6. Anil Sharma6,
  7. Kui-Hian Sim7,
  8. Suphot Srimahachota8,
  9. Madan Mohan Rehani9
  1. 1Konstantopoulio Hospital, Athens, Attiki, Greece
  2. 2National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  3. 3National Heart Centre of Singapore, Singapore
  4. 4Choray University Hospital, Ho Chi Minh City, Vietnam
  5. 5Yangon General Hospital, Yangon, Myanmar
  6. 6Bombay Hospital, Mumbai, India
  7. 7Sarawak General Hospital, Kuching, Malaysia
  8. 8King Chulalongkorn Memorial Hospital, Bangkok, Thailand
  9. 9International Atomic Energy Agency, Vienna, Austria
  1. Correspondence to Dr Madan M Rehani, International Atomic Energy Agency, Vienna International Centre, PO Box 100, A-1400, Vienna, Austria; m.rehani{at}


Objective Increasing use of interventional procedures in cardiology with unknown levels of radiation protection in many countries of Asia-Pacific region necessitates the need for status assessment. The study was part of an International Atomic Energy Agency (IAEA) project for achieving improved radiation protection in interventional cardiology (IC) in developing countries.

Design The survey covers 18 cardiac catheterisation laboratories in seven countries (Bangladesh, India, Malaysia, Myanmar, Singapore, Thailand and Vietnam). An important step was the creation of the ‘Asian network of Cardiologists in Radiation Protection’ and a newsletter. Data were collected on: radiation protection tools, number of IC laboratories, and annual number of various IC paediatric and adult procedures in the hospital and in the country. Patient radiation dose data were collected in terms of Kerma Area Product (KAP) and cumulative dose (CD).

Results It is encouraging that protection devices for staff are largely used in the routine practice. Only 39% of the angiographic machines were equipped with a KAP meter. Operators' initial lack of awareness on radiation-protection optimisation improved significantly after participation in IAEA radiation-protection training. Only two out of five countries reporting patient percutaneous coronary intervention radiation-dose data were fully within the international guidance levels. Data from 51 patients who underwent multiple therapeutic procedures (median 2–3) indicated a total KAP reaching 995 Gy.cm2 (range 10.1–995) and CD 15.1 Gy (range 0.4–15.1), stressing the importance of dose monitoring and optimisation.

Conclusions There is a need for interventional cardiology societies to play an active role in training actions and implementation of radiation protection.

  • Interventional cardiology
  • developing countries
  • radiation dose
  • radiation protection
  • physics
  • PTCA

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  • Funding International Atomic Energy Agency, Vienna.

  • Competing interests None.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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