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Exposure to patient during interventional endourological procedures.

J Hristova-Popova1, I Saltirov, J Vassileva

  • 1National Centre of Radiobiology and Radiation Protection, Sofia, Bulgaria. yulia.hp@gmail.com

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Summary

Patient radiation doses during endourological procedures vary significantly. This study highlights the need for optimized X-ray protocols to minimize patient exposure in interventional urology.

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Area of Science:

  • Medical Physics
  • Radiology
  • Urology

Background:

  • Interventional endourological procedures utilize X-ray imaging, necessitating an understanding of patient radiation doses.
  • Variability in radiation exposure can impact patient safety and diagnostic quality.

Purpose of the Study:

  • To investigate and quantify patient doses in air kerma-area product (P(KA)) during various interventional endourological procedures.
  • To identify factors contributing to dose variations in a clinical setting.

Main Methods:

  • Data collection from 429 patients undergoing 11 different endourological procedures.
  • Measurement of patient dose using integrated KAP-meters on dedicated X-ray systems.
  • Recording of procedure type, patient age, fluoroscopy time, and number of images acquired.

Main Results:

  • Mean fluoroscopy times ranged from 0.2 to 4 minutes across procedures.
  • Highest mean P(KA) values were observed in percutaneous nephrolithotripsy (457 cGy cm(2)) and ureteroscopy (590 cGy cm(2)).
  • Individual patient doses varied widely (2–2440 cGy cm(2)), influenced by procedure type, complexity, and operator experience.

Conclusions:

  • Significant variations in patient radiation doses exist in interventional endourology.
  • Procedure type, complexity, operator experience, and exposure settings are key determinants of patient dose.
  • Establishing standardized protocols is crucial for dose optimization in endourological interventions.