Retrospective case-control study on radiation dose for uterine artery embolization procedures

Uterine artery embolization is performed in pre-menopausal women. Understanding the contribution of radiation dose at each stage of the procedure is important for potential dose reduction. The aim was to retrospectively analyse radiation dose on a per-procedural-stage basis, comparing digital subtraction angiography (DSA) and conventional roadmap (CRM).

Group A consisted of 50 patients where DSA was used for road mapping at all stages: (I) Aortogram, (II) Left internal iliac artery (IIA) DSA, (III) Left uterine artery (UA) DSA, (IV) Right IIA DSA and (V) Right UA DSA. Group B included 50 patients, where CRM was used for road mapping at stages (II) and (IV).

For Group A, mean total dose-area product (DAP) was 39.7 Gy·cm²; mean DAP for each stage were (I) Aortogram = 3.4 Gy·cm², (II) Left IIA DSA = 5.9 Gy·cm², (III) Left UA DSA = 3.2 Gy·cm², (IV) Right IIA DSA = 5.5 Gy·cm² and (V) Right UA DSA = 3.0 Gy·cm². For Group B, mean total DAP was 33.6 Gy·cm², mean DAP for each stage were (I) Aortogram = 3.3 Gy·cm², (II) Left IIA CRM = 1.5 Gy·cm², (III) Left UA DSA = 3.3 Gy·cm², (IV) Right IIA CRM = 1.5 Gy·cm² and (V) Right UA DSA = 3.3 Gy·cm². Fluoroscopy time was 10 and 9.4 min for Groups A and B, respectively.

The highest road-mapping radiation dose contribution was from bilateral IIA DSA. The use of CRM, intermittent fluoroscopy and elimination of the aortogram is recommended to further reduce procedural radiation dose.