Validação de níveis de referência de diagnóstico locais (LDRLs) e determinação de dose efetiva em procedimentos hemodinâmicos

Abstract

This study aimed to validate local diagnostic reference levels (LDRLs) and to establish Typical Values (TVs) adjusted for clinical and anthropometric variables in hemodynamic procedures, in addition to estimating the effective dose (E) using simulations with the PCXMC 2.0 software. We analyzed 2,200 retrospective interventional examinations (vascular and coronary angiography and angioplasty) performed at a large university hospital between 2022 and 2024. Clinical and dosimetric data were extracted from fluoroscopy system reports, supported by a semi-automated optical character recognition (OCR) pipeline. TVs and LDRLs were calculated for reference-point air kerma (K_a,r) and fluoroscopy time, stratified by procedure type, body mass index (BMI), and sex. Therapeutic procedures and patients with higher BMI showed significantly higher exposures. Effective dose was estimated from the LDRLs using actual examination technical parameters, with values ranging from 5.2 mSv to 89.3 mSv depending on procedure type. The results indicate that stratifying dose metrics by clinical and anthropometric characteristics improves the precision of radiological surveillance indicators. The adopted methodology—combining TVs, LDRLs, and effective-dose simulation—proved effective for optimizing clinical practice and strengthening radiological protection in hemodynamic procedures.