Effective Dose Assessment for Patients Undergoing Contemporary Fluoroscopically Guided Interventional Procedures

Area of Science:

• Medical Physics
• Radiology
• Radiation Safety

Background:

• Fluoroscopically guided interventional (FGI) procedures are increasingly common, necessitating accurate radiation dose assessment.
• Establishing procedure-specific radiation dose metrics is crucial for patient safety and quality improvement.
• Existing national benchmarks for air kerma-area product (KAP) and effective dose are limited for many FGI procedures.

Purpose of the Study:

• To determine procedure-specific air kerma-area product (KAP) and effective dose for a wide range of FGI procedures.
• To provide data that can be used for clinical research protocol design and dose management programs.
• To assist healthcare organizations in assessing compliance with radiation safety standards.

Main Methods:

• Retrospective analysis of dose data from 24,911 adult FGI cases across 12 examination rooms.
• Calculation of effective dose using KAP and conversion coefficients, primarily from NCRP Report 160.
• Statistical analysis to determine mean values and percentiles (10th, 25th, 50th, 75th, 95th) for KAP and effective dose.

Main Results:

• Procedure-specific KAP and effective dose values were established for 101 FGI procedures.
• National benchmarks were unavailable for 89 KAP values and all 101 effective dose values.
• Twelve common procedures showed median KAP < 3.26 Gy·cm² and median effective dose < 0.70 mSv, while some infrequent procedures had higher doses (e.g., portography 95th percentile KAP ≥ 985 Gy·cm², effective dose ≥ 256 mSv).

Conclusions:

• The study provides essential procedure-specific radiation dose data (KAP and effective dose) for numerous FGI procedures.
• These data are valuable for designing clinical research, implementing dose management, and meeting regulatory compliance in the absence of national benchmarks.
• The findings highlight the variability in radiation doses among FGI procedures, underscoring the need for tailored dose monitoring and optimization strategies.