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Cumulative Effective Dose During Fluoroscopically Guided Interventions (FGI): Analysis of More Than 5000 FGIs in a Single European Center

  • Clinical Investigation
  • Radiation Protection
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Background

The number of fluoroscopically guided interventions (FGI) has increased significantly over time. However, little attention has been paid to possible stochastic radiation effects. The aim of this retrospective study was to investigate the number of patients who received cumulative effective doses over 100 mSv during FGI procedures.

Material and Methods

Five thousand five hundred and fifty four classified FGI procedures were included. Radiation dose data, retrieved from an in-house-dose-management system, was analysed. Effective doses and cumulative effective doses (CED) were calculated. Patients who received a CED > 100 mSv were identified. Radiology reports, patient age, imaging and clinical data of these patients were used to identify reasons for CED ≥ 100 mSv.

Results

One Hundred and thirty two (41.1% female) of 3981 patients received a CED > 100 mSy, with a mean CED of 173.5 ± 84.5 mSv. Mean age at first intervention was 66.1 ± 11.7 years. 81 (61.4%) of 132 were older than 64 years, one patient was < 30 years. 110 patients received ≥ 100 mSv within one year (83.4%), through FGIs: EVAR, pelvic/mesenteric interventions (stent or embolization), hepatic interventions (chemoembolization, TIPSS), embolization of cerebral aneurysms or arterio-venous-malformations.

Conclusions

Substantial CED may occur in a small but not ignorable fraction of patients (~ 3%) undergoing FGIs. Approximately 2/3rd of patients may most likely not encounter radiation-related stochastic effects due to life-threatening diseases and age at first treatment > 65 years but 1/3rd may. Patients undergoing more than one FGI (77%) carry a higher risk of accumulating effective doses > 100 mSv. Remarkably, 23% received a mean CED 162.2 ± 72.3 mSv in a single procedure.

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Funding

This study was not supported by any funding. The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria

    Elke R. Gizewski

  2. Department of Radiology, Medical University Innsbruck, Anichstrasse. 35, 6020, Innsbruck, Austria

    Elke R. Gizewski, Michael Verius & Werner Jaschke

  3. Global Outreach for Radiation Protection Program; Chair, Radiation Safety Committee, Massachusetts General Hospital, 175 Cambridge Street, Suite 244, Boston, MA, 02114, USA

    Madan M. Rehani

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  1. Elke R. Gizewski
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Correspondence to Michael Verius.

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Gizewski, E.R., Verius, M., Rehani, M.M. et al. Cumulative Effective Dose During Fluoroscopically Guided Interventions (FGI): Analysis of More Than 5000 FGIs in a Single European Center. Cardiovasc Intervent Radiol 47, 101–108 (2024). https://doi.org/10.1007/s00270-023-03604-w

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