Effect of fluoroscopic X‐ray beam spectrum on air‐kerma measurement accuracy: implications for establishing correction coefficients on interventional fluoroscopes with KAP meters

The first goal of this study was to investigate the accuracy of the displayed reference plane air kerma (Ka,r) or air kerma‐area product (Pk,a) over a broad spectrum of X‐ray beam qualities on clinically used interventional fluoroscopes incorporating air kerma‐area product meters (KAP meters) to measure X‐ray output. The second goal was to investigate the accuracy of a correction coefficient (CC) determined at a single beam quality and applied to the measured Ka,r over a broad spectrum of beam qualities. Eleven state‐of‐the‐art interventional fluoroscopes were evaluated, consisting of eight Siemens Artis zee and Artis Q systems and three Philips Allura FD systems. A separate calibrated 60 cc ionization chamber (external chamber) was used to determine the accuracy of the KAP meter over a broad range of clinically used beam qualities. For typical adult beam qualities, applying a single CC determined at 100 kVp with copper (Cu) in the beam resulted in a deviation of