Radiation dose and risk from fluoroscopically guided percutaneous transhepatic biliary procedures

Area of Science:

• Medical Imaging
• Radiation Oncology
• Interventional Radiology

Background:

• Percutaneous transhepatic biliary (PTB) procedures are essential for biliary drainage and stent implantation.
• Fluoroscopy is integral to these minimally invasive interventions.
• Accurate estimation of radiation dose and associated risks is crucial for patient safety.

Purpose of the Study:

• To quantify radiation doses delivered during fluoroscopically guided PTB procedures.
• To assess the cancer and genetic risks associated with these doses.
• To provide data for optimizing radiation protection strategies.

Main Methods:

• Utilized Monte Carlo transport code and an adult mathematical phantom to estimate organ and effective doses.
• Normalized doses to dose-area product (DAP) for broad applicability.
• Validated calculations using thermoluminescent dosimeters in an anthropomorphic phantom.

Main Results:

• Estimated average effective doses ranged from 1.8 to 5.4 mSv, varying by access approach and procedure type.
• A maximum effective dose of 13 mSv was observed for 30 minutes of fluoroscopy.
• Calculated doses are comparable to those from computed tomography (CT) protocols.

Conclusions:

• Patient radiation doses from PTB procedures are significant and comparable to CT scans.
• The potential for radiation-induced cancer risk, particularly in younger individuals, warrants careful consideration.
• Findings emphasize the need for radiation dose optimization in interventional radiology.