Local diagnostic reference levels for angiographic and fluoroscopic procedures: Australian practice

Area of Science:

• Medical Imaging
• Radiology
• Radiation Protection

Background:

• Fluoroscopic and interventional procedures are high-radiation dose examinations.
• Australia currently lacks national diagnostic reference levels (DRLs) for these procedures.
• This gap necessitates the establishment of local guidelines.

Purpose of the Study:

• To propose local diagnostic reference levels (LDRLs) for various fluoroscopic and angiographic procedures.
• To provide guidance on achievable radiation dose levels in the absence of national DRLs.
• To inform the Australian Radiation Protection and Nuclear Safety Agency for future national DRL establishment.

Main Methods:

• Collected data from 11,000 fluoroscopic and angiographic examinations over 2.5 years.
• Ensured a minimum of 50 cases per procedure type.
• Defined LDRLs using the 75th percentile of dose area product and median fluoroscopic times.

Main Results:

• Established LDRLs for a wide range of diagnostic and interventional procedures.
• Provided median fluoroscopic times for each procedure category.
• The data covers a significant volume of examinations from a major teaching hospital.

Conclusions:

• The proposed LDRLs offer immediate guidance for radiation dose management in Australia.
• This study provides a foundation for the development of national DRLs for complex radiological procedures.
• Institutions can use these LDRLs to benchmark and optimize radiation doses.