Gerenciamento e otimização de doses de radiação em equipamentos de hemodinâmica

Abstract

This study evaluated strategies for managing and optimizing radiation doses in hemodynamic procedures, covering aspects from imaging system characterization to the impact of optimization on exposure levels. Initially, equipment parameters were analyzed, including the accuracy of dose indicators and the behavior of AEC, as well as the influence of image processing on noise reduction without compromising diagnostic quality. Dosimetric parameters, including time, PKA, and dose, were systematically recorded for angioplasty, catheterization, vascular exams, and other high-exposure or more frequent procedures, expanding the reference base in the literature. The optimization of clinical protocols resulted in significant reductions in exposure levels. In catheterization, the median PKA was reduced by 16.3%, while in angioplasty, the reduction was 18,6%. The parameters were compared with 17 other national and international studies. For catheterization, the facility’s PKA remained above 63,16% of the analyzed studies, whereas for angioplasty, by the end of the study, it was above only 24%. Occupational analysis indicated a decrease of 64,6% in recording events and 64,8% in investigation events, reflecting greater adherence to radioprotection practices. The high-exposure study revealed that, despite the association with complex anatomical characteristics, no statistical correlation was established with the Complexity Index. The findings highlight the importance of continuous monitoring, automated recording, and active dose management, providing a replicable methodology for optimization in different centers.