Patient dose in interventional radiology: a European survey

Vañó, Eliseo; Järvinen, H; Kosunen, A; Bly, Ritva; Malone, Jim; Dowling, A.; Larkin, A.; Padovani, R.; Bosmans, Hilde; Dragusin, Octavian; Jaschke, Werner; Torbica, Pavle; Back, Carlo; Schreiner, A.; Bokou, C.; Kottou, Sofia; Tsapaki, Virginia; Jankowski, J; Papierz, Sylwia; Domienik, J.; Werduch, A.; Nikodémová, D.; Salát, D.; Kepler, Kalle; Bor, Mustafa; Vassileva, J.; Borisova, R.; Pellet, S.; Corbett, R H

doi:10.1093/rpd/ncn024

Cited by 69 publications

(51 citation statements)

References 5 publications

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“…To provide adequate radiation dose data, due the large individual variability of patient dose in fluoroscopically guided interventional procedures, Vano et al [22] recommended to collect the radiation data of >50 patients within the same type of procedure for a single center. In this study, the number of cases per type of procedures was >50 for all categories, except for AVF/AVM.…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience

Hassan¹,

Amelot²

2017

Intervent Neurol

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Background and Purpose: Per the ALARA principle, reducing the dose delivered to both patients and staff must be a priority for endovascular therapists, who should monitor their own practice. We evaluated patient exposure to radiation during common neurointerventions performed with a recent flat-panel detector angiographic system and compared our results with those of recently published studies. Methods: All consecutive patients who underwent a diagnostic cerebral angiography or intervention on 2 modern flat-panel detector angiographic biplane systems (Innova IGS 630, GE Healthcare, Chalfont St Giles, UK) from February to November 2015 were retrospectively analyzed. Dose-area product (DAP), cumulative air kerma (CAK) per plane, fluoroscopy time (FT), and total number of digital subtraction angiography (DSA) frames were collected, reported as median (interquartile range), and compared with the previously published literature. Results: A total of 755 consecutive cases were assessed in our institution during the study period, including 398 diagnostic cerebral angiographies and 357 interventions. The DAP (Gy × cm 2 ), fontal and lateral CAK (Gy), FT (min), and total number of DSA frames were as follows: 43 (33-60), 0.26 (0.19-0.33), 0.09 (0.07-0.13), 5.6 (4.2-7.5), and 245 (193-314) for diagnostic cerebral angiographies, and 66 (41-110), 0.46 (0.25-0.80), 0.18 (0.10-0.30), 18.3 (9.1-30.2), and 281 (184-427) for interventions. Conclusion: Our diagnostic cerebral angiography group had a lower median and was in the 75th percentile of DAP and FT when compared with the published literature. For interventions, both DAP and number of DSA frames were significantly lower than the values reported in the literature, despite a higher FT. Subgroup analysis by procedure type also revealed a lower or comparable DAP.

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Section: Discussionmentioning

confidence: 99%

Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience

Hassan¹,

Amelot²

2017

Intervent Neurol

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“…Vano et al [16] found 3 rd quartile values of P KA and fluoroscopy time for the diagnostic procedure cerebral angiography of 107 Gycm 2 and 12 minutes. They also suggest preliminary reference levels for this procedure of 120 Gycm 2 and 15 minutes based also on the other five references quoted in their publication.…”

Section: Tablementioning

confidence: 98%

“…But is has also been suggested for use in interventional cardiology [15]. Others [16][17][18] have also suggested using P KA as an indicator for high skin doses.…”

Section: Introductionmentioning

confidence: 99%

Local skin and eye lens equivalent doses in interventional neuroradiology

2009

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Abstract:The aim of this work was to assess patient skin and eye lens doses in interventional neuroradiology and to assess both stochastic and deterministic radiation risks. Kerma-area product, P KA was recorded and skin doses measured using thermoluminescence dosimeters. Estimated dose at interventional reference point, IRP, was compared with measured absorbed doses. The average and maximum fluoroscopy times were 32 and 189 min for coiling and 40 and 144min for embolisation. The average and maximum P KA for coiling were 121 and 436 Gycm 2 respectively and 189 and 677 Gycm 2 for embolisation. The average and maximum values of the measured maximum absorbed skin doses were 0.72 and 3.0Sv respectively for coiling and 0.79 and 2.1Sv for embolisation. Two out of the 52 patients received skin doses in excess of 2Sv. The average and maximum doses to the eye lens (left eye) were 51 and 51mSv (coiling) and 71 and 289mSv (embolisation). The ratio between the measured dose and the dose at the IRP was 0.44±0.18mSv/mGy indicating that the dose displayed by the x-ray unit overestimates the maximum skin dose but is still a valuable indication of the dose. The risk in our hospital skin erythema and lens cataract is therefore small.

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“…The DAP is measured through an ionization chamber located in the front of the collimator, and the measured values are transferred via DICOM. In Europe, The DAP is considered the reference value and is compared with the measured radiation exposures of patients undergoing interventional radiological procedures [12].…”

Section: Radiation Dose Monitoringmentioning

confidence: 99%

Development of Diagnostic Reference Levels Using a Real-Time Radiation Dose Monitoring System at a Cardiovascular Center in Korea

Kim

Seo²,

Choi³

et al. 2015

J Digit Imaging

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Digital cardiovascular angiography accounts for a major portion of the radiation dose among the examinations performed at cardiovascular centres. However, dose-related information is neither monitored nor recorded systemically. This report concerns the construction of a radiation dose monitoring system based on digital imaging and communications in medicine (DICOM) data and its use at the cardiovascular centre of the University Hospitals in Korea. The dose information was analysed according to DICOM standards for a series of procedures, and the formulation of diagnostic reference levels (DRLs) at our cardiovascular centre represents the first of its kind in Korea. We determined a dose area product J Digit Imaging (2015) 28:684-694 DOI 10.1007 (DAP) DRL for coronary angiography of 75.6 Gy cm 2 and a fluoroscopic time DRL of 318.0 s. The DAP DRL for percutaneous transluminal coronary intervention was 213.3 Gy cm 2 , and the DRL for fluoroscopic time was 1207.5 s.

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Patient dose in interventional radiology: a European survey

Cited by 69 publications

References 5 publications

Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience

Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience

Local skin and eye lens equivalent doses in interventional neuroradiology

Development of Diagnostic Reference Levels Using a Real-Time Radiation Dose Monitoring System at a Cardiovascular Center in Korea

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