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Diagnostic reference levels in interventional radiology: a systematic review
Iana Quintanilha de Borba1, Rochelle Lykawka2, Nayron Medeiros Soares2,3
1Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
This systematic review analyzed evidence for diagnostic reference levels (DRLs) in interventional radiology. Findings show DRLs are often local, with limited international standardization and a need for broader global efforts.
Area of Science:
- Radiology
- Medical Physics
Background:
- Diagnostic reference levels (DRLs) are crucial for optimizing radiation dose in medical imaging.
- Establishing DRLs in interventional radiology (IR) presents unique challenges due to procedural variability.
Purpose of the Study:
- To systematically review and analyze existing scientific evidence for establishing DRLs in interventional radiology.
- To identify current practices, challenges, and influencing factors in DRL determination for IR procedures.
Main Methods:
- Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Searched PubMed/Medline and Embase for studies on IR and DRLs, excluding CT-guided procedures and systematic reviews.
- Two independent reviewers assessed 30 eligible articles from an initial 475, extracting data on procedures, DRL values, and equipment.
Main Results:
- 30 articles yielded 113 procedures, with endovascular aneurysm repair and nephrostomy most frequent.
- Most DRL values (73%) were reported at the local level; national/regional DRLs were predominantly European.
- Influencing factors included technology, operator experience, and protocols; a lack of longitudinal studies was noted.
Conclusions:
- Standardized procedural terminology is needed for accurate DRL comparisons.
- A predominance of European studies highlights the need for wider international collaboration in DRL implementation for IR.
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