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Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France

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Abstract

Objectives

A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom.

Methods

Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions.

Results

Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm2 and 11 mins for cerebral angiography, 35 Gy.cm2 and 16 mins for biliary drainage, 75 Gy.cm2 and 6 mins for lower limbs arteriography and 70 Gy.cm2 and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published.

Conclusions

This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs.

Key Points

• Delivered dose in interventional radiology depends on procedure, practice and patient.

• National RLs are proposed for 15 interventional procedures.

• Reference levels (RLs) are useful to benchmark practices and optimize protocols.

• RLs are proposed for kerma area product, air kerma, fluoroscopy time and number of images.

• RLs should be adapted to the procedure complexity and updated regularly.

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Acknowledgements

The authors are very grateful to the staff of the 36 imaging departments (medical physicists and radiologists) who took the time to collect and check the data.

Author information

Authors and Affiliations

  1. Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France

    Cécile Etard

  2. French Society of Medical Physicists (SFPM), Paris, France

    Cécile Etard, Emeline Bigand, Cécile Salvat, Amaury Hornbeck & Joël Greffier

  3. Department of Radiology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex, France

    Emeline Bigand & Vincent Vidal

  4. Department of Medical Physics and Radiation Protection, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, 75010, Paris, France

    Cécile Salvat

  5. French Society of Radiology (SFR) – Interventional Radiology Federation (FRI), Paris, France

    Vincent Vidal & Jean Paul Beregi

  6. Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France

    Jean Paul Beregi & Joël Greffier

  7. Department of Pediatric Radiology, Trousseau University Hospital, AP-HP, 26 rue du Dr Arnold Netter, 75012, Paris, France

    Amaury Hornbeck

Authors
  1. Cécile Etard
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  2. Emeline Bigand
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  3. Cécile Salvat
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  4. Vincent Vidal
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  5. Jean Paul Beregi
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  6. Amaury Hornbeck
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  7. Joël Greffier
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Corresponding author

Correspondence to Joël Greffier.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Jean Paul Beregi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

The authors state that this work has not received any funding.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional review board approval was not required because this study is a retrospective survey on patient doses to assess reference levels in interventional radiology.

Informed consent

Written informed consent was not required for this study because this study is a retrospective survey on patient doses to assess reference levels in interventional radiology.

Study subjects or cohorts overlap

None of the study subjects or cohorts have been previously reported.

Methodology

• Retrospective

• Not applicable

• Multicentre study

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Etard, C., Bigand, E., Salvat, C. et al. Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France. Eur Radiol 27, 4281–4290 (2017). https://doi.org/10.1007/s00330-017-4780-5

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  • DOI: https://doi.org/10.1007/s00330-017-4780-5

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