Cardiac catheterization, whether for diagnostic procedures or cardiac interventions, will continue to be performed using ionizing radiation as a result of excellent temporal and spatial resolution afforded by fluoroscopy. It is probable that future improvements in detector sensitivity coupled with improved digitalization of the images will mean that radiation doses are reduced. It is apparent from the observations made concerning radiation doses following the introduction of flat-bed scanners that optimization of pulse frequency, filter settings, AEC management and collimation are also important when new technology is used.
Optimization of the system settings should be combined with the continued education of operators and ancillary staff.[12,65] The increasing complexity of digital imaging systems may distract staff from the importance of operator-dependent factors in controlling the levels of radiation during cardiac catheterization. In spite of the significant improvements in image quality and potential for radiation dose-lowering from digitalization and flat-bed panel systems, operator factors remain perhaps the most important determinants of radiation exposure during cardiac catheterization.
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