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A national patient dose survey and setting of reference levels for interventional radiology in Bulgaria

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Abstract

Objectives

A national study on patient dose values in interventional radiology and cardiology was performed in order to assess current practice in Bulgaria, to estimate the typical patient doses and to propose reference levels for the most common procedures.

Methods

Fifteen units and more than 1,000 cases were included. Average values of the measured parameters for three procedures—coronary angiography (CA), combined procedure (CA + PCI) and lower limb arteriography (LLA)—were compared with data published in the literature.

Results

Substantial variations were observed in equipment and procedure protocols used. This resulted in variations in patient dose: air-kerma area product ranges were 4–339, 6–1,003 and 0.2–288 Gy cm2 for CA, CA + PCI and LLA respectively. Reference levels for air kerma-area product were proposed: 40 Gy cm2 for CA, 140 Gy cm2 for CA + PCI and 45 Gy cm2 for LLA. Auxiliary reference intervals were proposed for other dose-related parameters: fluoroscopy time, number of images and entrance surface air kerma rate in fluoroscopy and cine mode.

Conclusions

There is an apparent necessity for improvement in the classification of peripheral procedures and for standardisation of the protocols applied. It is important that patient doses are routinely recorded and compared with reference levels.

Key Points

• Patient doses in interventional radiology are high and vary greatly

• Better standardisation of procedures and techniques is needed to improve practice

• Dose reference levels for most common procedures are proposed

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Acknowledgements

The study was partially conducted under the SENTINEL EU Coordinated Action Project, IAEA Regional Project R9/093 and Finland–Bulgaria PHARE Twinning Project BG 2006/IB/SO 01.

The authors would like to thank the medical staff at all the departments visited for their cooperation in the data collection for the study.

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Authors and Affiliations

  1. National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria

    R. Zotova, J. Vassileva & J. Hristova

  2. Radiation and Nuclear Safety Authority (STUK), Helsinki, Finland

    M. Pirinen & H. Järvinen

Authors
  1. R. Zotova
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  2. J. Vassileva
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  3. J. Hristova
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  4. M. Pirinen
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  5. H. Järvinen
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Corresponding author

Correspondence to R. Zotova.

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Zotova, R., Vassileva, J., Hristova, J. et al. A national patient dose survey and setting of reference levels for interventional radiology in Bulgaria. Eur Radiol 22, 1240–1249 (2012). https://doi.org/10.1007/s00330-012-2386-5

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  • DOI: https://doi.org/10.1007/s00330-012-2386-5

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