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Establishing Local Diagnostic Reference Levels in IR Procedures with Dose Management Software.

Christina Heilmaier1, Niklaus Zuber1, Christian Berthold1

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Local diagnostic reference levels (DRLs) were established for interventional radiology (IR) procedures using dose management software. This helps improve patient radiation protection by accounting for procedure complexity.

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Area of Science:

  • Medical Imaging
  • Radiology
  • Radiation Protection

Background:

  • Diagnostic reference levels (DRLs) are crucial for optimizing radiation dose in medical imaging.
  • Interventional radiology (IR) procedures involve complex radiation exposure scenarios.
  • Standardized DRLs are needed to ensure consistent radiation protection across different institutions.

Purpose of the Study:

  • To establish local diagnostic reference levels (DRLs) for diagnostic and therapeutic interventional radiology (IR) procedures.
  • To utilize dose management software for accurate dose assessment and DRL derivation.
  • To enhance patient radiation protection through improved dose monitoring.

Main Methods:

  • Collected and analyzed dose data from 1,403 vascular and nonvascular IR procedures over 18 months.
  • Utilized dose management software for data analysis and DRL calculation (Kerma-Area Product [KAP]).
  • Categorized procedures into simple, standard, and difficult based on complexity, and calculated Spearman correlation coefficients between dose metrics.

Main Results:

  • Local DRLs were proposed for IR procedures, with Kerma-Area Product (KAP) generally increasing with complexity.
  • A very strong correlation was observed between KAP and cumulative air kerma (KA,R).
  • Moderate to strong correlations were found between KAP/KA,R and procedure time, varying by procedure type and complexity.

Conclusions:

  • Dose management software effectively derives local DRLs for IR procedures, considering complexity.
  • The proposed local DRLs can inform the development of more detailed national DRLs.
  • Implementation of these DRLs contributes to enhanced patient radiation protection in IR.