Radiation dose reduction in fluoroscopic procedures: left varicocele embolization as a model

Area of Science:

• Interventional Radiology
• Medical Physics
• Radiation Safety

Background:

• Left varicocele embolization (LVE) involves radiation exposure.
• Optimizing radiation dose is crucial in interventional procedures.

Purpose of the Study:

• To evaluate a radiation reduction program for LVE.
• To assess the impact on total radiation dose and dose per second.

Main Methods:

• Implemented a program with minimized fluoroscopy, low-dose presets, and virtual tools.
• Recorded patient data and radiation metrics (KAP, Ka,r).
• Standardized dose metrics using phantom-derived correction factors and derived a collimation index.

Main Results:

• Significant reductions in collimation index and standardized KAP/second were observed (p < 0.001).
• Median fluoroscopy time was 3 minutes, with a median KAP of 0.54 Gy/cm².
• The findings suggest a learning curve associated with collimation techniques.

Conclusions:

• A dedicated radiation reduction program can achieve very low dose rates for LVE.
• Collimation is the most effective real-time radiation reduction measure.
• Optimal collimation demonstrates a learning curve.