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European Radiology

, Volume 13, Issue 7, pp 1522–1528 | Cite as

Radiogenic risks from hysterosalpingography

  • Kostas Perisinakis
  • John Damilakis
  • John Grammatikakis
  • Nicholas Theocharopoulos
  • Nicholas Gourtsoyiannis
Physics

Abstract

The aim of this study was to determine ovarian dose, effective dose and associated radiogenic risks from hysterosalpingography (HSG), and to provide data for the estimation of radiogenic risks related to HSG studies performed in any laboratory. The fluoroscopy time, number of radiographs taken and entrance surface dose were measured in a series of 78 consecutive patients undergoing HSG as part of their infertility work-up. Organ-dose values per radiograph and per minute of fluoroscopy were separately determined using an anthropomorphic phantom and thermoluminescence dosimetry. The radiogenic risk for deleterious effects on a possible future embryo and the radiogenic risk for cancer induction on the patient undergoing HSG were estimated. The average HSG procedure in our laboratory involves a mean fluoroscopic time of 0.3 min and a mean number of radiographs of 3.2. The dose to female gonads from an average HSG procedure was 2.7 mGy and the patient effective dose was 1.2 mSv. The risk for radiogenic anomalies in a future embryo of the woman undergoing an average HSG procedure and the risk for radiogenic fatal cancer induction in the exposed woman were estimated to be less than 10–3 of the correspondent nominal risks. Radiation risks from a typical HSG are low, but they may be elevated if fluoroscopic and/or radiographic exposures are prolonged for any reason. Present data allow the estimation of radiogenic risks associated with HSG procedures performed in other laboratories with use of different equipment, screening time and number of radiographs taken.

Keywords

Hysterosalpingography Gonadal dose Effective dose Radiation risks 

References

  1. 1.
    Collins JI, Woodward PJ (1995) Radiological evaluation of infertility. Semin Ultrasound CT 16:304–316CrossRefGoogle Scholar
  2. 2.
    Ubeda B, Paraira M, Alert E, Abuin RA (2001) Hysterosalpingography: spectrum of normal variants and nonpathologic findings. Am J Roentgenol 177:131–135CrossRefGoogle Scholar
  3. 3.
    Maubon AJ, Degraef M, Boncoeur-Martel MP, Rouanet JP (2001) Interventional radiology in female infertility: technique and role. Eur Radiol 11:771–778CrossRefPubMedGoogle Scholar
  4. 4.
    Ott DJ, Fayez JA (1991) Hysterosalpingography. Urban and Schwarzenberg, BaltimoreGoogle Scholar
  5. 5.
    Karande VC, Levrant SG, Pratt DE, Morris RS, Balin MS, Gleicher N (1997) What is the radiation exposure to patients during a gynaecoradiologic procedure? Fertil Steril 67:401–403CrossRefPubMedGoogle Scholar
  6. 6.
    Hedgpeth PL, Thurmond AS, Fry R, Schmidgall JR, Rosch J (1991) Radiographic fallopian tube recanalization: absorbed ovarian radiation dose. Radiology 180:121–122CrossRefPubMedGoogle Scholar
  7. 7.
    Fife IAJ, Wilson DJ, Lewis CA (1994) Entrance surface and ovarian doses in hysterosalpingography. Br J Radiol 67:860–863CrossRefPubMedGoogle Scholar
  8. 8.
    Fernandez JM, Vano E, Guibelalde E (1996) Patient doses in hysterosalpingography. Br J Radiol 69:751–754CrossRefPubMedGoogle Scholar
  9. 9.
    Nakamura K, Ishiguchi T, Maekoshi H, Ando Y, Tsuzaka M, Tamiya T, Suganuma N, Ishigaki T (1996) Selective fallopian tube catheterization in female infertility: clinical results and absorbed radiation dose. Eur Radiol 6:465–469CrossRefPubMedGoogle Scholar
  10. 10.
    Gregan ACM, Peach D, McHugo JM (1998) Patient dosimetry in hysterosalpingography: a comparative study. Br J Radiol 71:1058–1061CrossRefPubMedGoogle Scholar
  11. 11.
    Papaioannou S, Afnan M, Coomarasamy A, Ola B, Hammadieh N, Temperton DH, McHugo JM, Sharif K (2002) Long term safety of fluoroscopically guided selective salpingography and tubal catheterization. Hum Reprod 17:370–372CrossRefPubMedGoogle Scholar
  12. 12.
    Huda W, Sandison GA (1984) Estimation of mean organ doses in diagnostic radiology from rando phantom measurements. Health Phys 47:463–467PubMedGoogle Scholar
  13. 13.
    Czechowski J, Janeczek J, Kelly G, Johansen J (2001) Radiation dose to the lens in sequential and spiral CT of the facial bones and sinuses. Eur Radiol 11:711–713CrossRefPubMedGoogle Scholar
  14. 14.
    Marshall NW, Shehu G, Marsh D, Faulkner K, Malone J, Dewhurst K (2001) Effective dose in Albanian direct chest fluoroscopy. Eur Radiol 11:705–710CrossRefPubMedGoogle Scholar
  15. 15.
    Perisinakis K, Theocharopoulos N, Karkavitsas N, Damilakis J (2002) Patient effective radiation dose and associated detriment risk from transmission scans using153Gd line sources in cardiac SPECT studies. Health Phys 83:66–74CrossRefPubMedGoogle Scholar
  16. 16.
    Damilakis J, Perisinakis K, Prassopoulos P, Dimivasili E, Varveris H, Gourtsoyiannis N (2002) Conceptus radiation dose and risk from chest screen-film radiography. Eur Radiol DOI 10.1007/s00330–002–1352-zGoogle Scholar
  17. 17.
    ICRP 60 (1990) Recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP, vol 21, pp 1–3. Pergamon Press, OxfordGoogle Scholar
  18. 18.
    Bo WJ, Wolfman NT, Krueger WA, Carr JJ, Bowden RL, Meschan I (1998) Basic atlas of sectional anatomy with correlated imaging, 3rd edn. Saunders, PhiladelphiaGoogle Scholar
  19. 19.
    Hart D, Jones DG, Wall BF (1994) Estimation of effective dose in diagnostic radiology from entrance surface dose and dose-area product measurements. NRPB-R262, National Radiological Protection BoardGoogle Scholar
  20. 20.
    Le Heron JC (1995) XDOSE, Ministry of Health, National Radiation Laboratory, Christchurch, New ZealandGoogle Scholar
  21. 21.
    National Research Council (1990) Health effects exposure to low levels of ionizing radiation. BEIR V, National Academy Press, Washington DCGoogle Scholar
  22. 22.
    National Radiological Protection Board (NRPB) (1994) Estimates of radiation detriment in a UK population. NRPB R260. HMSO Publications center, Chilton, UKGoogle Scholar
  23. 23.
    National Council on Radiation Protection and Measurements (NCRP) (1987) Ionizing radiation exposure of the population in the United States. NCRP Report no. 93. NCRP publications, Bethesda, MarylandGoogle Scholar
  24. 24.
    National Radiological Protection Board (NRPB) (1999) Ionising radiation exposure of the UK population: 1999 review. NRPB R311. HMSO Publications Center, Chilton, UKGoogle Scholar
  25. 25.
    Hall EJ (1994) Hereditary effects of radiation. In: Hall EJ (ed) Radiobiology for the radiologist. Lippincott, PhiladelphiaGoogle Scholar
  26. 26.
    Jongen VHWM, Collins JMP, Lubbers JA, van Selm M (2001) Unsuspected early pregnancy at hysterosalpingography. Fertil Steril 76:610–611CrossRefPubMedGoogle Scholar
  27. 27.
    Wiesner W, Ruehm SG, Bongartz G, Kaim A, Reese E, De Geyter C (2001) Three-dimensional dynamic MR hysterosalpingography: a preliminary report. Eur Radiol 11:1439–1444CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Kostas Perisinakis
    • 1
  • John Damilakis
    • 1
  • John Grammatikakis
    • 2
  • Nicholas Theocharopoulos
    • 1
  • Nicholas Gourtsoyiannis
    • 2
  1. 1.Department of Medical Physics, Faculty of MedicineUniversity of CreteStavrakia, IraklionGreece
  2. 2.Department of Radiology, Faculty of MedicineUniversity of CreteStavrakia, IraklionGreece

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