Reference levels for patient radiation doses in interventional radiology: proposed initial values for U.S. practice

Area of Science:

• Medical Imaging
• Radiology
• Radiation Safety

Background:

• Fluoroscopically guided procedures are common in interventional radiology.
• Establishing patient reference levels is crucial for optimizing radiation dose.
• Existing data from the RAD-IR study provide a basis for proposing these levels.

Purpose of the Study:

• To propose initial patient reference levels for fluoroscopically guided procedures in the United States.
• To evaluate methods for normalizing radiation dose data based on patient characteristics.

Main Methods:

• Secondary analysis of data from the Radiation Doses in Interventional Radiology Procedures (RAD-IR) study.
• Calculation of dose distributions (percentiles) for procedures with at least 30 cases.
• Testing of weight banding and size correction methods for dose normalization.

Main Results:

• Methods for normalizing patient radiation dose by weight were not significantly different.
• The 75th percentile doses, with or without weight banding, showed no significant difference.
• Initial reference levels are proposed for reference air kerma, kerma-area product, fluoroscopy time, and image count.

Conclusions:

• Sufficient data exist to propose initial reference levels for US interventional radiology procedures.
• Reference levels uncorrected for body habitus are recommended for ease of use.
• A national registry for radiation dose data is needed to refine these reference levels.