Efficacy of a minicourse in radiation-reducing techniques in invasive cardiology: a multicenter field study.

Objectives Our goal was to validate an educational 90-min minicourse in lower-irradiating cardiac invasive techniques. Background Despite comprehensive radiation safety programs, patient radiation exposure in invasive cardiology remains considerable. Methods Before and at a median period of 3.7 months after the minicourse at 32 German cardiac centers, 177 interventionalists consistently documented radiation parameters for 10 coronary angiographies: dose area product (DAP), radiographic and fluoroscopic fractions, fluoroscopy time, and number of radiographic frames and runs. Results A total of 154 cardiologists attended the minicourse and achieved significant (p 2 . They reduced fluoroscopy times (–20.8%), radiographic runs (–9.1%), frames/run (–18.6%) and frames (–29.6%), and both radiographic DAP/frame (–27.4%) and fluoroscopic DAP/s (–39.3%), which indicate improved collimation, reduced-irradiation angulations, or adequate image quality. Dose-related parameters for the remaining 23 invited cardiologists unable to attend the workshop did not change significantly in univariate comparison. Multilevel analysis (p 2 ) and revealed higher DAP for increasing body mass index (+1.5 Gy × cm 2 per kg/m 2 ), male sex (+5.8 Gy × cm 2 ), age (+1.5 Gy × cm 2 /decade), and—owing to different settings during image acquisition—for advanced flat-panel detector systems (+9.0 Gy × cm 2 ) versus older, traditional image intensifier systems. Conclusions Despite significant required training in radiation safety for all interventional cardiologists, the presented additional 90-min minicourse significantly reduced patient dose.