Interventional Radiology at a Single Institution over 9 Years: A Comprehensive Evaluation of Procedures and an Estimation of Collective Effective Dose

Review of air kerma‐area product, effective dose and dose conversion coefficients for non‐cardiac interventional fluoroscopy procedures

“…There is no consistent method used in the literature for categorizing interventional fluoroscopy procedures. Some of the literature uses very specific categories, based on the specific type and anatomic location of procedures, and sometimes on the indication for the procedure . Other literature uses more general categories .…”

“…The “biliary” category includes biliary drainage, biliary stent placement and other unspecified biliary procedures. Relatively recent data are available for these procedures . Data from the last 10 yr are also available for nonvascular kidney interventions, and percutaneous intestinal access …”

“…Recently published data use the category of “abdomen” for a variety of procedures in this anatomic region, including renal angiography. There is an additional category of “pelvis”, as the organs irradiated differ between the pelvis and abdomen, and therefore DC E differs for these two regions. “Lower extremity” includes procedures where imaging is limited to infrainguinal structures, but because of the way these procedures are normally performed this category likely also includes some procedures where the iliac arteries (and possibly the abdominal aorta) are imaged.…”

“…On the other hand, thrombolysis of iliac veins and stenting of iliac arteries both involve irradiation of the same region; if P KA is the same for both cases, E will also be the same. Thus, for example, the “head and/or neck vascular interventions” category includes all types of interventions in this region, including embolization, thrombolysis, angioplasty and stenting . This approach has the advantage that these categories correspond more closely to the categorizations used in much of the published literature and avoids issues related to the relatively small amount of data available for many more specific procedures.…”

“…E may be calculated for interventional fluoroscopy examinations in different ways . In some publications, E is determined by using the irradiation geometry for the clinical protocol and radiation dose data for clinical procedures as inputs into a Monte Carlo radiation transport simulation that uses computational models of human anatomy . In other publications, the irradiation geometry for the clinical protocol and radiation dose data for clinical procedures are used as parameters for irradiation of physical anthropomorphic phantoms containing dosimeters .…”