Establishing Diagnostic Reference Level for Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty – A Retrospective Study

This research aimed to establish radiation Diagnostic Reference Levels (DRLs) for two commonly performed cardiac catheterization procedures, coronary angiography (CAG) (diagnostic) and percutaneous transluminal coronary angioplasty (PTCA) (therapeutic) at a tertiary care hospital. The study focused on patients who underwent PTCA (200) and CAG (400) at our hospital between October 2024 and January 2025, on the advanced interventional radiological machines and the population is classified into two groups based on patient weight. Data collected are patient age, weight, dose surface product (PKA), skin surface entry dose (KAR) and fluoroscopic time. According to ICRP recommendations, the DRL was set for the entire population and was determined from the 75th percentile of the PKA value for the corresponding weight category in each procedure. In this study, the DRL established for the CAG and PTCA procedures is within the safety guidelines provided by the hospital and the regulatory board. The DRL for the CAG group is 2834 µGym² and for PTCA is 8963 µGym² which is within the limit. It was observed that DRL linearly responds to the patient's weight, concluding that patient weight is a factor affecting DRL. The DRL can serve as an audit tool for quality analysis and improvement.