{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:44:18Z","timestamp":1777041858484,"version":"3.51.4"},"reference-count":21,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Cardiovascular interventions require prolonged fluoroscopy, which increases the risk of radiation. Diagnostic Reference Levels (DRLs), set at the 75th percentile of the dose distribution, are vital benchmarks for dose optimization. Following the release of national DRLs by the Korea Disease Control and Prevention Agency in March 2025, this study established institutional DRLs at a tertiary center to evaluate local optimization against national and international standards. Methods: This study analyzed radiation doses from 2022 to 2024 using DICOM Radiation Dose Structured Reports data from a single center\u2019s angiography system. The total kerma-area product values and fluoroscopy times were evaluated across the categorized procedures. Following the International Commission on Radiological Protection guidelines, institutional DRLs were established at the 75th percentile of the dose distribution to benchmark against national and international DRLs. Results: Analysis of 1663 radiation dose structured reports established institutional DRLs, with the total kerma-area product ranging from 23.43 Gy\u00b7cm2 for coronary angiography to 329.45 Gy\u00b7cm2 for chronic total occlusion interventions. Complexity significantly increased the radiation burden; multivessel percutaneous coronary intervention and acute myocardial infarction nearly doubled the doses and fluoroscopy times in single-vessel interventions. Although the diagnostic procedures were cine image-driven, for moderate-complexity interventions, the contribution of fluoroscopy was greater. Conclusions: These findings support institutional optimization and development of safety guidelines to enhance patient protection during high-complexity cardiovascular procedures.<\/jats:p>","DOI":"10.3390\/diagnostics16081243","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T16:10:44Z","timestamp":1776787844000},"page":"1243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Study on the Establishment of Diagnostic Reference Levels for Cardiovascular Angiography and Interventional Procedures: Korean General Hospital"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2273-4577","authenticated-orcid":false,"given":"Daeho","family":"Kim","sequence":"first","affiliation":[{"name":"Medical Convergence Radiologic-Technology, Department of Bio-Health Convergence, Graduate School of Health Technology, Daegu Health College, Daegu 41453, Republic of Korea"},{"name":"Department of Radiology, Daegu Fatima Hospital, Daegu 41199, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jungsu","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiological-Technology, Daegu Health College, Daegu 41453, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.ihj.2021.09.012","article-title":"Establishing a diagnostic reference level of radiation dose in coronary angiography and intervention: A prospective evaluation","volume":"73","author":"Kataria","year":"2021","journal-title":"Indian Heart J."},{"key":"ref_2","unstructured":"Korea Disease Control and Prevention Agency (2026, March 17). 2023 National Medical Radiation Evaluation Yearbook, Available online: https:\/\/www.kdca.go.kr\/preview\/doc.html?fn=172489079241700&rs=\/atchmnfl\/preview\/result\/."},{"key":"ref_3","first-page":"2","article-title":"The 2007 recommendations of the international commission on radiological protection","volume":"103","author":"Valentin","year":"2008","journal-title":"ICRP Publ."},{"key":"ref_4","first-page":"1","article-title":"Diagnostic reference levels in medical imaging","volume":"46","author":"Miller","year":"2017","journal-title":"ICRP Publ."},{"key":"ref_5","unstructured":"Bosmans, H., Damilakis, J., Ducou le Pointe, H., and Foley, S.J. (2018). Radiation Protection no. 185 European Guidelines on Diagnostic Reference Levels for Paediatric Imaging, European Commission."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1259\/bjr.71.846.9849387","article-title":"Patient radiation doses during cardiac catheterization procedures","volume":"71","author":"Betsou","year":"1998","journal-title":"Br. J. Radiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"138","DOI":"10.2214\/AJR.11.8455","article-title":"Occupational dose in interventional radiology procedures","volume":"200","author":"Chida","year":"2013","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.3390\/ijerph6061882","article-title":"Health risk and biological effects of cardiac ionising imaging: From epidemiology to genes","volume":"6","author":"Foffa","year":"2009","journal-title":"Int. J. Environ. Res. 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Dosim."},{"key":"ref_21","unstructured":"Japan Network for Research and Information on Medical Exposures (J-RIME) (2025, December 20). National Diagnostic Reference Levels in Japan 2025\u2014Japan DRLs 2025. Available online: https:\/\/j-rime.qst.go.jp\/report\/JapanDRLs2025_en.pdf."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/8\/1243\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T12:45:08Z","timestamp":1777034708000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/8\/1243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,21]]},"references-count":21,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16081243"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16081243","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,21]]}}}