Complexity-based local diagnostic reference levels (DRLs) for standard endovascular aneurysm repair (EVAR) procedures
Eleftherios Tzanis1, Christos V Ioannou2, Dimitrios Tsetis3
1Department of Medical Physics, Medical School, University of Crete, P.O. Box 2208, Heraklion 71003, Crete, Greece.
Summary
This study established complexity-based diagnostic reference levels (DRLs) for endovascular aneurysm repair (EVAR), finding procedure complexity correlates with radiation dose. These complexity-based DRLs aid patient and staff radiation protection in interventional radiology.
Area of Science:
- Interventional Radiology
- Medical Physics
- Radiation Protection
Background:
- Endovascular aneurysm repair (EVAR) involves significant radiation exposure.
- Establishing standardized radiation dose metrics is crucial for patient safety.
- Local diagnostic reference levels (DRLs) help optimize radiation use.
Purpose of the Study:
- To establish complexity-based local diagnostic reference levels (DRLs) for standard EVAR procedures.
- To correlate procedure complexity with radiation dose metrics.
- To inform radiation protection strategies in EVAR.
Main Methods:
- Prospective collection of dosimetric data (fluoroscopy time, dose area product, air kerma) from 73 EVAR patients.
- Evaluation of procedure complexity for each patient.
- Statistical analysis using Spearman rank correlation to assess variable associations.
Main Results:
- Second quartiles for dose area product (DAP) in low, medium, and high complexity EVAR were 144.2, 160.1, and 189.5 Gycm² respectively.
- Strong correlations were observed between Body Mass Index (BMI) and DAP (r=0.68), and between air kerma and fluoroscopy time (r=0.76).
- Moderate correlations were found between BMI and air kerma (r=0.52), and between DAP and fluoroscopy time (r=0.57).
Conclusions:
- Procedure complexity is a significant factor influencing the total radiation dose in EVAR.
- Complexity-based DRLs are valuable tools for radiation protection in interventional radiology.
- Implementing these DRLs can enhance safety for both patients and healthcare professionals.
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