A national patient dose survey and setting of reference levels for interventional radiology in Bulgaria

Objectives A national study on patient dose values in interventional radiology and cardiology was performed in order to assess current practice in Bulgaria, to estimate the typical patient doses and to propose reference levels for the most common procedures. Methods Fifteen units and more than 1,000...

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Bibliographic Details
Published in:European radiology 2012-06, Vol.22 (6), p.1240-1249
Main Authors: Zotova, R., Vassileva, J., Hristova, J., Pirinen, M., Järvinen, H.
Format: Article
Language:English
Subjects:
Angiography - standards
Angiography - statistics & numerical data
Approximation
Body Burden
Bulgaria
Calibration
Cardiology
Cardiology - standards
Diagnostic Radiology
Dosimetry
Health Surveys
Humans
Imaging
Internal Medicine
Interventional
Interventional Radiology
Medical imaging
Medicine
Medicine & Public Health
Neuroradiology
Patients
Radiation
Radiation Dosage
Radiography, Interventional - standards
Radiography, Interventional - statistics & numerical data
Radiology
Radiology - standards
Reference Values
Ultrasound
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Summary:Objectives A national study on patient dose values in interventional radiology and cardiology was performed in order to assess current practice in Bulgaria, to estimate the typical patient doses and to propose reference levels for the most common procedures. Methods Fifteen units and more than 1,000 cases were included. Average values of the measured parameters for three procedures—coronary angiography (CA), combined procedure (CA + PCI) and lower limb arteriography (LLA)—were compared with data published in the literature. Results Substantial variations were observed in equipment and procedure protocols used. This resulted in variations in patient dose: air-kerma area product ranges were 4–339, 6–1,003 and 0.2–288 Gy cm 2 for CA, CA + PCI and LLA respectively. Reference levels for air kerma-area product were proposed: 40 Gy cm 2 for CA, 140 Gy cm 2 for CA + PCI and 45 Gy cm 2 for LLA. Auxiliary reference intervals were proposed for other dose-related parameters: fluoroscopy time, number of images and entrance surface air kerma rate in fluoroscopy and cine mode. Conclusions There is an apparent necessity for improvement in the classification of peripheral procedures and for standardisation of the protocols applied. It is important that patient doses are routinely recorded and compared with reference levels. Key Points • Patient doses in interventional radiology are high and vary greatly • Better standardisation of procedures and techniques is needed to improve practice • Dose reference levels for most common procedures are proposed
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-012-2386-5