Related Experiment Video
Updated: Jul 5, 2026
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Interventional procedures for biliary drainage with bilioplasty in pediatric patients: dosimetric aspects
D Righi1, A Doriguzzi, O Rampado
1Radiologia Diagnostica Universitaria, Ospedale San Giovanni Battista, Via Genova 3, Turin, Italy.
Insights
This study optimized fluoroscopy parameters to minimize radiation dose for pediatric liver transplant patients undergoing biliary procedures. Findings indicate a low risk of deterministic effects and justified radiological risk for these interventions.
Area of Science:
- Radiology
- Pediatric Gastroenterology
- Transplant Surgery
Background:
- Percutaneous biliary interventions are crucial for pediatric liver transplant recipients.
- Accurate radiation dose assessment is vital for patient safety during these procedures.
Purpose of the Study:
- To evaluate and minimize patient radiation dose during percutaneous biliary drainage and bilioplasty in pediatric liver transplant recipients.
- To identify optimal fluoroscopic parameters for reducing radiation exposure.
Main Methods:
- Utilized a phantom model to test various fluoroscopy settings (pulsed modes, magnification, diaphragms).
- Performed in vivo measurements during actual interventional procedures.
- Measured effective dose rates and entrance skin-dose (ESD) rates.
Main Results:
- A specific pulsed fluoroscopy technique with maximum magnification and diaphragms yielded the lowest effective dose rate.
- Maximum in vivo ESD was approximately 50 mGy, well below the erythema threshold.
- Effective dose values ranged from 0.9-1.5 mSv.
Conclusions:
- Established optimized exposure parameters for low-dose, high-quality imaging in this specific interventional context.
- Confirmed that measured ESD values preclude the risk of deterministic skin effects.
- Concluded that the benefits of these procedures outweigh the justified radiological risks for patients.
Purpose:
This study was undertaken to evaluate patient dose in paediatric liver transplant recipients treated by percutaneous biliary drainage and bilioplasty procedures.
Materials And Methods:
Effective dose rates and entrance skin-dose (ESD) rates per minute of fluoroscopy were measured by using a plexiglas phantom (thickness 10 cm) simulating the patient and by varying the exposure parameters (type of pulsed fluoroscopy, image intensifier diameter, presence of diaphragms) to identify the technique delivering the lowest patient dose. In vivo measurements were performed during three interventional procedures.
Results:
The effective dose rate proved to be lowest for a particular type of pulsed fluoroscopy, with maximum magnification and with field-limiting diaphragms. The in vivo measurements showed a maximum ESD value of around 50 MGY (the threshold for transient erythema is 2,000 MGY, ICRP 60). The effective dose values were in the range of 0.9-1.5 MSV.
Conclusions:
We established exposure parameters providing the desired image quality with the lowest dose for the equipment used and for a specific type of interventional procedure. The measured ESD values allow us to exclude the risk of deterministic effects on the skin. The effective dose values and considerations regarding the likelihood of radiation-induced cancer led to the conclusion that the radiological risk for the patient is largely justified by the benefits of these kinds of procedure.
