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Patient dose reference levels in surgery: a multicenter study
J Greffier1, C Etard2, O Mares3
1Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France. joel.greffier@chu-nimes.fr.
European Radiology
|August 3, 2018
Summary
This study establishes diagnostic reference levels (DRLs) for common surgical procedures, providing benchmarks for radiation dose optimization in interventional surgery. These DRLs help assess and improve radiation practices in surgical settings.
Area of Science:
- Medical Physics
- Radiology
- Surgical Oncology
Background:
- European Directive 2013/59/Euratom mandates the assessment of diagnostic reference levels (DRLs) in surgical procedures.
- Radiation dose optimization is crucial in interventional surgery to minimize patient and staff exposure.
- Multicenter surveys are essential for establishing representative DRLs.
Purpose of the Study:
- To determine diagnostic reference levels (DRLs) for frequently performed surgical procedures.
- To comply with European radiation protection directives.
- To provide benchmarks for Kerma area product (KAP) and fluoroscopy time (FT) in surgical interventions.
Main Methods:
- A multicenter survey was conducted across six institutions.
- Kerma area product (KAP) and fluoroscopy time (FT) data were collected for 1870 procedures.
- DRLs were calculated as the 3rd quartiles for eight specific orthopedic, urologic, and gastrointestinal surgical procedures.
Main Results:
- DRLs were established for eight surgical procedures, including proximal femoral intramedullary nailing, laparoscopic cholecystectomy, and double-J ureteral catheter insertion.
- Significant differences in KAP and FT were observed based on surgical complexity (shoulder surgery) and technology used (C-arm type for extremity surgery).
- Specific DRL values for KAP and FT were reported for key procedures.
Conclusions:
- Diagnostic reference levels (DRLs) were successfully determined for eight surgical procedures.
- DRLs serve as valuable tools for benchmarking current practices and optimizing radiation protocols in surgery.
- Radiation dose in surgery is influenced by procedure type, clinical practice, and patient-specific factors.
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