Updating national diagnostic reference levels for adult cardiac interventional procedures in Switzerland.

Authors

Eleni Theano Samara, Jonas Ekeberg, Gustavo S P Pamplona, Anja Stüssi, Reto Treier, Florian Riede, Florian Franzeck, Yves Bayard, Christian Steffen, Dominique Nüssli, Sacha Salzberg, Orso Pusterla, Hannah Eggimann, Alexander Schegerer, Pascal Meier, Gregoire Girod, Yolande Petegnief, Roman Menz, Christoph Aberle, Valon Spahiu, Stefan Stortecky, Matthias R Meyer, Marta Sans Merce, Anais Viry, Marie Nowak, Lucia Gallego-Manzano, Natalia Saltybaeva, Alexander Gotschy, Ardan M Saguner

Published in

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB). Volume 148. Pages 105869. Jun 30, 2026. Epub Jun 30, 2026.

Abstract

Diagnostic reference levels (DRLs) have been proven to be a useful tool for optimizing patient radiation exposure. National DRLs (NDRLs) are defined based on data from a representative sample of the healthcare facilities in a particular country. This project presents the survey to update the NDRLs for cardiac interventional procedures in Switzerland. Healthcare facilities performing cardiac procedures in Switzerland were asked to provide radiation dose data for adult cardiac interventional procedures performed over the course of one year. The dataset included the procedure name and the corresponding air kerma area product, air kerma at the reference point, fluoroscopy time and number of cine acquisitions. Thirty-five healthcare facilities (95% of the total) provided data. The procedures were grouped into 11 electrophysiology procedures, 4 cardiac catheterization procedures, and 3 structural heart procedures. For each healthcare facility and radiation quantity, the median values were calculated. Updated NDRLs were determined as the 75th percentile of the distribution of these median values. For example, the updated NDRL for air kerma area product was set at 24 Gy∙cm² for coronary angiography and at 2 Gy∙cm² for pacemaker implantation, reflecting a substantial reduction from the prior NDRL values of 50 and 30 Gy∙cm², respectively. These new NDRL values are substantially lower than the previous ones, highlighting the importance of conducting regular updates to accommodate continuous patient dose optimization of and technological advancements.

PMID:
42378754
Bibliographic data and abstract were imported from PubMed on 01 Jul 2026.

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