Patient Radiation Doses in Interventional Radiology Procedures: Comparison of Fluoroscopy Dose Indices between the American College of Radiology Dose Index Registry-Fluoroscopy Pilot and the Radiation Doses in Interventional Radiology Study

Authors

A Kyle Jones
Kevin A Wunderle
Tom Fruscello
Michael Simanowith
Brendan Cline
Shalmali Dharmadhikari
Xinhui Duan
Jeremy C Durack
David Hirschl
Don-Soo Kim
Usman Mahmood
Steve D Mann
Charles Martin
Zeyad Metwalli
Jeffrey M Moirano
Rebecca A Neill
Janice Newsome
Horacio Padua
Alan H Schoenfeld
Donald L Miller

Language

English

Publication Date

4-1-2023

Journal

Journal of Vascular and Interventional Radiology

DOI

10.1016/j.jvir.2022.08.023

PMID

36031041

Abstract

Purpose: To compare radiation dose index distributions for fluoroscopically guided interventions in interventional radiology from the American College of Radiology (ACR) Fluoroscopy Dose Index Registry (DIR-Fluoro) pilot to those from the Radiation Doses in Interventional Radiology (RAD-IR) study.

Materials and methods: Individual and grouped ACR Common identification numbers (procedure types) from the DIR-Fluoro pilot were matched to procedure types in the RAD-IR study. Fifteen comparisons were made. Distribution parameters, including the 10th, 25th, 50th, 75th, and 95th percentiles, were compared for fluoroscopy time (FT), cumulative air kerma (Ka,r), and kerma area product (PKA). Two derived indices were computed using median dose indices. The procedure-averaged reference air kerma rate (Ka,r¯) was computed as Ka,r / FT. The procedure-averaged x-ray field size at the reference point (Ar) was computed as PKA / (Ka,r × 1,000).

Results: The median FT was equally likely to be higher or lower in the DIR-Fluoro pilot as it was in the RAD-IR study, whereas the maximum FT was almost twice as likely to be higher in the DIR-Fluoro pilot than it was in the RAD-IR study. The median Ka,r was lower in the DIR-Fluoro pilot for all procedures, as was median PKA. The maximum Ka,r and PKA were more often higher in the DIR-Fluoro pilot than in the RAD-IR study. Ka,r¯ followed the same pattern as Ka,r, whereas Ar was often greater in DIR-Fluoro.

Conclusions: The median dose indices have decreased since the RAD-IR study. The typical Ka,r rates are lower, a result of the use of lower default dose rates. However, opportunities for quality improvement exist, including renewed focus on tight collimation of the imaging field of view.

Keywords

Humans, Radiology, Interventional, Radiation Dosage, Fluoroscopy, Radiography, Interventional, Registries

Published Open-Access

yes

Recommended Citation

Jones, A Kyle; Wunderle, Kevin A; Fruscello, Tom; et al., "Patient Radiation Doses in Interventional Radiology Procedures: Comparison of Fluoroscopy Dose Indices between the American College of Radiology Dose Index Registry-Fluoroscopy Pilot and the Radiation Doses in Interventional Radiology Study" (2023). Faculty, Staff and Student Publications. 5931.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5931