Patient radiation dose in percutaneous biliary interventions: recommendations for DRLs on the basis of a multicentre study

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

“…Recent data for P KA are available in the international literature for 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 …”

“…Clinical experience was used to interpret the procedure types and anatomic locations of the procedures for which radiation dose data were provided. The values reported for average E and suggested [5,7,9,10,13,16,23,24,27,28,30,31,61] 0.03-620.9 [5,9,13,16,23,[29][30][31] Percutaneous intestinal access 2.2-44.1 [5][6][7]9,13,24] 0.02-308.8 [5,9,13] Head and/or neck diagnostic angiography 21-242 [6,9,10,12,15,17,19,22,30,31] 13-4131 [9,12,17,19,22,30,31] Head…”

“…Achievable dose values of appropriate dose metrics, such as P KA and cumulative air kerma, can be used to compare relative patient radiation doses among fluoroscopically guided procedures where imaging is limited to the same area of the body, for example, liver. These dose metrics are the preferred method for these comparisons in fluoroscopy, 67 but such comparisons are valid only when the Head and/or neck diagnostic angiography 9.0 2.3-16.9 [9,12,17,30,31] 0.07-45.12 [9,12,17,19,30] Head and/or neck vascular interventions 16 imaging modality and body part being imaged are identical. Neither DRLs nor ADs are useful when comparing patient radiation doses from different imaging modalities (e.g., fluoroscopy vs. CT) or when different parts of the body are exposed (e.g., chest vs. pelvis).…”

“…There is no consistent method used in the literature for categorizing interventional fluoroscopy procedures. Some of the literature uses very specific categories, based on the specific type and anatomic location of procedures, and sometimes on the indication for the procedure . Other literature uses more general categories .…”

“…Some of the literature uses very specific categories, based on the specific type and anatomic location of procedures, and sometimes on the indication for the procedure. 3,[6][7][8][9][10][11][12][13][14][15][16] Other literature uses more general categories. [17][18][19][20][21][22] Some of the literature uses both specific and general categories, depending on the procedure.…”