Establishment of diagnostic reference levels for selected interventional radiology procedures at Uganda Heart Institute, Mulago

Abstract

Interventional radiology (IR) has revolutionized the diagnosis and treatment of vascular and cardiac diseases, offering minimally invasive procedures with reduced hospitalization times. However, the increasing complexity of neuro-radiology procedures has raised concerns regarding radiation exposure for patients. This study aimed to establish dose reference levels (DRLs) for seven common IR procedures at the Uganda Heart Institute, Mulago Hospital, over a three-year period. Data on radiation doses received by adult patients undergoing vascular, diagnostic, and interventional procedures were systematically collected. The primary objective was to deter-mine DRLs using the 75th percentile approach, encompassing procedures such as Angiogra-phy, Percutaneous Coronary Intervention (PCI), Permanent Pacemaker Implantation (PPI), Biventricular Pacing, and Balloon Pulmonary Valvotomy. Analysis included parameters such as Dose-Area Product (DAP), Entrance Surface Dose (ESD), and Fluoroscopy Time (FT). Results revealed variations in radiation exposure among different procedures, with PCI involving three stents exhibiting the highest exposure, while PPI showed the lowest. Comparative analysis with international literature data demon-strated alignment with established DRLs, suggesting effective radiation protection practices at the institute. Establishing DRLs serves as a valuable benchmark for evaluating medical practices and ensuring patient safety. Furthermore, it facilitates the optimization of IR procedures, con-tributing to the enhancement of healthcare services provided at Uganda Heart Institute. This study emphasises the importance of continuous monitoring and adherence to DRLs to mitigate radiation risks and improve patient outcomes in interventional radiology.