Radiation Exposure in Nonvascular Fluoroscopy-Guided Interventional Procedures

Kloeckner, Roman; Bersch, Anton; Santos, Daniel Pinto dos; Schneider, Jens; Düber, Christoph; Pitton, Michael Bernhard

doi:10.1007/s00270-011-0206-y

Cited by 24 publications

(23 citation statements)

References 30 publications

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“…Among others, Peruzzo Cornetto et al tabulated data for 23 procedures in an Italian hospital, Compagnone et al published data from a different Italian hospital for nine interventional procedures, Dauer et al published P KA data for 43 interventional fluoroscopy procedures at a single U.S. institution, Bundy et al did the same for 12 procedures at a different U.S. medical center, Erskine et al published P KA data for 32 interventional fluoroscopy procedures in Australia, Étard et al’s report contains data from France for 15 procedures, Pitton et al published data for 17 interventional vascular procedures at a German hospital, Schmitz et al reported data on biliary interventions at 23 different facilities, and Ruiz‐Cruces et al reported data for seven interventional procedures performed at eight hospitals in Spain. Many other published studies were also consulted to estimate one or more of P KA , E , and DC E …”

Section: Resultsmentioning

confidence: 99%

“…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 .…”

Section: Methodsmentioning

confidence: 99%

“…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 …”

Section: Methodsmentioning

confidence: 99%

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

Miller

2020

Medical Physics

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Purpose To provide current data on average air kerma‐area product (PKA) and effective dose (E) for noncardiac interventional fluoroscopy procedures and suggested values of dose coefficients (DCE) for conversion of PKA to estimates of effective dose. Methods A PubMed literature search covering the time period from 2006 to August 2019 was performed to obtain recent data on PKA, E and DCE for interventional fluoroscopy procedures. Results There is very wide variation in the reported values of PKA, E, and DCE in the literature. A number of factors are involved in this variability and the resultant uncertainty in average values of these dose quantities. Conclusions The values of PKA, average E and suggested DCE presented here can be of use for comparison of the radiation detriment from different procedures and may be useful for categorizing detriment within an order of magnitude or so. They do not represent actual or expected radiation dose or detriment from any specific procedure or for a specific patient and should be not be used as such.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Miller

2020

Medical Physics

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“…A registry analysis of 17 centers [8] with 106 data sets described a median DAP of 430 cGy*cm 2 . Kloeckner et al [9] report a median DAP of 3260 cGy*cm 2 . Baumann et al investigated the influence of real time dosimetry on the level of radiation exposure among other things during 9 gastrostomies.…”

Section: Discussionmentioning

confidence: 99%

“…Kloeckner et al [9] report a mean fluoroscopy time of 5.9 minutes. In their article Baumann et al describe how the use of real-time dosimetry [10] allowed an increase of fluoroscopy time from 5.6 to 7.6 minutes with a corresponding reduction of DAP.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Petersen¹,

Reinhardt²,

Fuchs³

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TPurpose Analysis of patient´s X-ray exposure during percutaneous radiologic gastrostomies (PRG) in a larger population. Materials and MethodsData of primary successful PRGprocedures, performed between 2004 and 2015 in 146 patients, were analyzed regarding the exposition to X-ray. Dose-area-product (DAP), dose-length-product (DLP) respectively, and fluoroscopy time (FT) were correlated with the used x-ray systems (Flatpanel Detector (FD) vs. Image Itensifier (BV)) and the necessity for periprocedural placement of a nasogastric tube. Additionally, the effective X-ray dose for PRG placement using fluoroscopy (DL), computed tomography (CT), and cone beam CT (CBCT) was estimated using a conversion factor. ResultsThe median DFP of PRG-placements under fluoroscopy was 163 cGy*cm 2 (flat panel detector systems: 155 cGy*cm 2 ; X-ray image intensifier: 175 cGy*cm 2 ). The median DLZ was 2.2 min. Intraprocedural placement of a naso-or orogastric probe (n = 68) resulted in a significant prolongation of the median DLZ to 2.5 min versus 2 min in patients with an already existing probe. In addition, dose values were analyzed in smaller samples of patients in which the PRG was placed under CBCT (n = 7, median DFP = 2635 cGy*cm 2 ), or using CT (n = 4, median DLP = 657 mGy*cm). Estimates of the median DFP and DLP showed effective doses of 0.3 mSv for DL-assisted placements (flat panel detector 0.3 mSv, X-ray image converter 0.4 mSv), 7.9 mSv using a CBCT -flat detector, and 9.9 mSv using CT. This corresponds to a factor 26 of DL versus CBCT, or a factor 33 of DL versus CT.Conclusion In order to minimize X-ray exposure during PRGprocedures for patients and staff, fluoroscopically-guided interventions should employ flat detector systems with short transmittance sequences in low dose mode and with slow image frequency. Series recordings can be dispensed with. The intraprocedural placement of a naso-or orogastric probe significantly extends FT, but has little effect on the overall dose of the intervention. Due to the significantly higher X-ray exposure, the use of a CBCT as well as PRG-placements using CT should be limited to clinically absolutely necessary exceptions with strict indication. Ergebnisse Das mediane DFP von PRG-Anlagen unter DL lag bei 163 cGy*cm 2 (FD: 155 cGy*cm 2 ; BV: 175 cGy*cm 2 ). Die mediane DLZ betrug 2,2 min. Dabei führte eine intraprozedurale Anlage einer naso-oder orogastralen Sonde (n = 68) zu einer signifikanten Verlängerung der medianen DLZ auf 2,5 min gegenüber 2 min bei Patienten mit bereits liegender Sonde. Zusätzlich wurden Dosiswerte von kleineren Patientengruppen analysiert, bei denen die PRG CBCT-gestützt (n = 7; medianes DFP = 2635 cGy*cm 2 ), oder CT-gestützt (n = 4, medianes DLP = 657 mGy*cm) angelegt wurde. Durch Abschätzungen aus den medianen DFP bzw. DLP ergaben sich effektive Dosen von 0,3 mSv für DL-gestützte Anlagen (FD 0,3 mSv; BV 0,4 mSv), mittels FD mit CBCT 7,9 mSv, und bei PRG-Anlagen im CT eine effektive Dosis von 9,9 mSv. Das entspricht einem Faktor 26 von DL gegenüber ...

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Radiation dose during transarterial chemoembolization and associated factors

Choi,

Chung

2024

Abdom Radiol

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Radiation Exposure in Nonvascular Fluoroscopy-Guided Interventional Procedures

Cited by 24 publications

References 30 publications

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

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

Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies

Radiation dose during transarterial chemoembolization and associated factors

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