Effective-dose estimation in interventional radiological procedures

Abstract

Interventional radiology is based on minimally invasive procedures that allow diagnosis and percutaneous treatment of diseases in almost all organ systems. Such procedures have many benefits, but they also contribute significantly to collective radiation dose. In this regard, effective dose (E) is a convenient quantity to estimate patients' stochastic radiation risk. However, E cannot be accurately evaluated immediately. In the present study, we aimed to estimate the E value in 15 selected interventional procedures. The estimation was based on dose area product (DAP) measurements and used case-specific conversion coefficients. The E values ranged from 3.3 to 69.9 mSv, depending on the kind of procedure. This wide range was mainly due to the broad variation in DAP values, which in turn depend on the details of how the procedures are performed. This suggests that to ensure valid comparative studies and universal reference levels, all interventional procedures should be well classified.

Review of air kerma‐area product, effective dose and dose conversion coefficients for non‐cardiac interventional fluoroscopy procedures

“…Among others, Peruzzo Cornetto et al tabulated data for 23 procedures in an Italian hospital, Compagnone et al published data from a different Italian hospital for nine interventional procedures, Dauer et al published P KA data for 43 interventional fluoroscopy procedures at a single U.S. institution, Bundy et al did the same for 12 procedures at a different U.S. medical center, Erskine et al published P KA data for 32 interventional fluoroscopy procedures in Australia, Étard et al’s report contains data from France for 15 procedures, Pitton et al published data for 17 interventional vascular procedures at a German hospital, Schmitz et al reported data on biliary interventions at 23 different facilities, and Ruiz‐Cruces et al reported data for seven interventional procedures performed at eight hospitals in Spain. Many other published studies were also consulted to estimate one or more of P KA , E , and DC E …”

“…Table provides data for E and Table provides data for DC E . Data for E are provided in many recent publications . When only P KA data were provided, an estimated value for E was calculated by using the suggested DC E (Table ) appropriate for the procedure.…”

“…The “biliary” category includes biliary drainage, biliary stent placement and other unspecified biliary procedures. Relatively recent data are available for these procedures . Data from the last 10 yr are also available for nonvascular kidney interventions, and percutaneous intestinal access …”

“…On the other hand, thrombolysis of iliac veins and stenting of iliac arteries both involve irradiation of the same region; if P KA is the same for both cases, E will also be the same. Thus, for example, the “head and/or neck vascular interventions” category includes all types of interventions in this region, including embolization, thrombolysis, angioplasty and stenting . This approach has the advantage that these categories correspond more closely to the categorizations used in much of the published literature and avoids issues related to the relatively small amount of data available for many more specific procedures.…”

“…E may be calculated for interventional fluoroscopy examinations in different ways . In some publications, E is determined by using the irradiation geometry for the clinical protocol and radiation dose data for clinical procedures as inputs into a Monte Carlo radiation transport simulation that uses computational models of human anatomy .…”