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National dose reference levels in computed tomography-guided interventional procedures-a proposal.

Joël Greffier1, Gilbert Ferretti2, Julia Rousseau2

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Summary
This summary is machine-generated.

This study establishes national reference levels (RLs) for CT-guided interventional procedures, revealing significant dose variability. The proposed RLs aid in benchmarking and optimizing patient radiation doses.

Keywords:
Multidetector computed tomographyPhysicsRadiation exposureRadiology, interventional

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Area of Science:

  • Medical Imaging
  • Radiology
  • Radiation Safety

Background:

  • European Directive 2013/59/Euratom mandates the establishment of national reference levels (RLs) for radiological procedures.
  • Interventional procedures under CT guidance are increasingly common, necessitating standardized dose metrics.

Purpose of the Study:

  • To establish national reference levels (RLs) for 17 categories of interventional procedures performed under CT guidance.
  • To provide benchmarks for optimizing radiation doses in these procedures.

Main Methods:

  • Analysis of 5001 procedures across 49 centers, covering thoracic, abdominopelvic, and osteoarticular interventions.
  • Data collection included dose length product (DLP) and number of helical acquisitions (NH).
  • RLs were determined as the 3rd quartiles, and target values for optimization (TVOs) as medians.

Main Results:

  • Significant variability in patient doses was observed for similar procedures across different centers.
  • National RLs were proposed for DLP and NH across 17 interventional categories.
  • Dose metrics (DLP and NH) generally increased with procedural complexity.

Conclusions:

  • This nationwide multicentric survey is the first to propose RLs for CT-guided interventional procedures.
  • The proposed RLs will enable imaging departments to compare and optimize their radiation dose protocols.
  • Identified heterogeneity in practice highlights the need for standardized protocols and dose optimization.