DIAGNOSTIC REFERENCE LEVELS AND COMPLEXITY INDICES IN INTERVENTIONAL RADIOLOGY

Area of Science:

• Interventional Radiology
• Medical Physics
• Radiation Protection

Background:

• Diagnostic Reference Levels (DRLs) are crucial for optimizing radiation doses in medical imaging.
• Interventional radiology (IR) procedures involve complex techniques with varying radiation exposure.
• Complexity Indices (CIs) can help standardize radiation dose assessment in IR.

Purpose of the Study:

• To establish typical Diagnostic Reference Levels (DRLs) for hepatic chemoembolisation (HC), iliac stent placement (ISP), and femoropopliteal revascularisation (FR).
• To investigate the utility of Complexity Indices (CIs) in determining DRLs for IR procedures.
• To estimate effective dose and patient stochastic effects using Dose Area Product (DAP) and conversion factors.

Main Methods:

• Collected Dose Area Product (DAP), Reference Air Kerma (Ka,r), and fluoroscopy time (FT) data for 218 patients undergoing HC, ISP, and FR.
• Assigned Complexity Indices (CIs) to each procedure to facilitate DRL extraction.
• Calculated effective dose using DAP values and literature-derived E/DAP conversion factors.

Main Results:

• Established DRL values for DAP: 141 Gy*cm² (HC), 130 Gy*cm² (ISP), and 28 Gy*cm² (FR).
• Established DRL values for Ka,r: 634.6 mGy (HC), 300.1 mGy (ISP), and 112.0 mGy (FR).
• Established DRL values for FT: 15.3 min (HC), 12.4 min (ISP), and 17.9 min (FR).

Conclusions:

• Complexity Indices (CIs) are valuable tools for optimizing DRLs in interventional radiology.
• The established DRLs provide benchmarks for radiation dose management in these specific IR procedures.
• This study contributes to patient safety by offering data for dose optimization in common IR interventions.