Patient dose reference levels for interventional radiology: a national approach

Area of Science:

• Medical Physics
• Radiology
• Interventional Radiology

Background:

• Patient dose reference levels (RLs) are crucial for optimizing radiation protection in fluoroscopically guided interventional procedures.
• The European Medical Exposures Directive recommends establishing national RLs.

Purpose of the Study:

• To establish national patient dose reference levels (RLs) for common fluoroscopically guided interventional procedures.
• To compare these RLs with previously established values.

Main Methods:

• A national survey collected 1391 kerma area product (KAP) values from 10 public hospitals for seven frequent interventional radiology procedures.
• Third quartiles of KAP distributions were used to set the RLs.
• Quality control of X-ray systems and dosemeters, along with analysis of fluoroscopy time and imaging parameters, were performed.

Main Results:

• Provisional national RL values were proposed for fistulography (12 Gy cm²), lower limb arteriography (73 Gy cm²), renal arteriography (89 Gy cm²), biliary drainage (80 Gy cm²), hepatic chemoembolization (289 Gy cm²), iliac stent (94 Gy cm²), and uterine embolization (236 Gy cm²).
• These proposed RL values are generally lower than those from a similar US survey (2002-2004).

Conclusions:

• The established RLs can serve as benchmarks to identify and improve practices in centers with consistently higher patient doses.
• The survey raised awareness among interventional radiology professionals regarding patient dose values and radiation protection programs.