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

Area of Science:

• Interventional Radiology
• Medical Imaging
• Radiation Oncology

Background:

• Uterine artery embolization (UAE) is a key treatment for pre-menopausal women.
• Understanding radiation dose distribution across UAE procedural stages is crucial for dose reduction strategies.
• This study retrospectively analyzed radiation dose per procedural stage, comparing digital subtraction angiography (DSA) and conventional roadmap (CRM).

Purpose of the Study:

• To compare the radiation dose contribution of DSA versus CRM during uterine artery embolization.
• To identify procedural stages with the highest radiation dose.
• To provide recommendations for reducing radiation exposure in UAE procedures.

Main Methods:

• Retrospective analysis of 100 pre-menopausal women undergoing UAE.
• Group A (50 patients): DSA used for all road-mapping stages (Aortogram, bilateral internal iliac artery (IIA), bilateral uterine artery (UA)).
• Group B (50 patients): CRM used for bilateral IIA road-mapping, DSA for other stages.

Main Results:

• Mean total dose-area product (DAP) was 39.7 Gy·cm² for DSA (Group A) and 33.6 Gy·cm² for CRM (Group B).
• Bilateral IIA road-mapping contributed the highest radiation dose in both groups (DSA: 5.9 Gy·cm² left, 5.5 Gy·cm² right; CRM: 1.5 Gy·cm² left, 1.5 Gy·cm² right).
• Fluoroscopy time was similar: 10 min (Group A) vs. 9.4 min (Group B).

Conclusions:

• Bilateral internal iliac artery digital subtraction angiography (IIA DSA) represents the largest radiation dose contributor during uterine artery embolization.
• Utilizing conventional roadmap (CRM) for IIA road-mapping significantly reduces procedural radiation dose.
• Recommendations for dose reduction include using CRM, intermittent fluoroscopy, and potentially eliminating the aortogram.