Radiation Exposure During Uterine Artery Embolization: Effective Measures to Minimize Dose to the Patient

Abstract

The use of modern angiographic units with flat panel detectors and strict application of methods of radiation reduction lead to a significantly lower radiation exposure. Target DAP for UAE should be kept below 5,000 cGy × cm(2).

Radiation Exposure During Uterine Fibroid Embolization (UFE): A Confounder-Controlled Comparison Between a State-of-the-Art Angiography Unit and a Conventional Angiography unit

“…In addition, substantial experience of radiologists performing UFE has been show to decrease the fluoroscopy time needed for uterine artery catheterization [24]. Moreover, strict adherence to protocols established to limit exposure as well as the use of modern angiographic units has been shown to reduce radiation dose during UFE [13,24]. In our study, UFE procedures in both groups followed the same protocol, and propensity score matching ensured comparability of patient characteristics and procedures.…”

“…Effective measures include optimized source-object, source-image, and object-image distances, the avoidance of magnification and oblique projections, tight collimation to the relevant anatomy, the use of pulsed fluoroscopy with decreased image frequency, and the use of low frame rates or even last-image-hold to document angiographic endpoints [9,13]. Flat panel detectors improve image quality while reducing radiation exposure, and pre-interventional optimization of the tube angle by 3D-reconstructed contrast-enhanced MR angiography helps to avoid conventional survey aortography [11,22,23].…”

“…Studies have therefore analyzed the radiation dose applied during UFE and measures to reduce exposure [9 -15]. Since most of these measures concern technical parameters, it has been hypothesized that state-of-the-art angiographic units are generally more appropriate than conventional units to reduce radiation exposure while maintaining image quality, low complication rates, and high clinical success [13].…”

Selective Embolisation of a Heavily Bleeding Cervical Fibroid in a Pregnant Woman

“…There are valuable measures that should be considered to reduce radiation dosage such as tight collimation, the use of road-mapping instead of angiographic runs, avoidance of magnification and oblique projections, angiographic runs in posterior-anterior direction with 0.5 frames per second, use of documentation of the angiographic endpoint using last-image-hold instead of an angiographic run and leave out survey angiography [10]. In addition, reduction of fluoroscopy time can be achieved by performing UFE with bilateral access and parallel instead of sequential embolisation [11,12].…”

Randomized comparison of long and short vascular sheaths in reduction of the operator radiation exposure during uterine artery embolization

“…1 However, radiation exposure of the operator during UAE has received little attention. 2,3 The use of the femoral approach for UAE puts the operator, and especially the left hand, close to the primary beam, one major reason being that the currently used sheath is only 11-cm long. Operator exposure can be reduced by increasing the distance from the radiation source (the inverse-square law).…”