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Radiation Doses in Interventional Radiology Procedures: The RAD-IR Study Part I: Overall Measures of Dose
Journal article   Peer reviewed

Radiation Doses in Interventional Radiology Procedures: The RAD-IR Study Part I: Overall Measures of Dose

Donald L. Miller, Stephen Balter, Patricia E. Cole, Hollington T. Lu, Beth A. Schueler, Michael Geisinger, Alejandro Berenstein, Robin Albert, Jeffrey D. Georgia, Patrick T. Noonan, …
Journal of vascular and interventional radiology, v 14(6), pp 711-727
2003
DOI: https://doi.org/10.1097/01.RVI.0000079980.80153.4B
PMID: 12817038
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

PSD CD RAD-IR FDA CI IEC IRP SPF DAP Several terms have specialized meanings within the context of medical physics. These terms are defined in the Appendix and are indicated in the text with an asterisk when first used IVC ICRP DPF SPECF TIPS
To determine patient radiation doses for interventional radiology and neuroradiology procedures, to identify procedures associated with higher radiation doses, and to determine the effects of various parameters on patient doses. A prospective observational study was performed at seven academic medical centers. Each site contributed demographic and radiation dose data for subjects undergoing specific procedures in fluoroscopic suites equipped with built-in cumulative dose (CD) and dose–area–product (DAP) measurement capability compliant with International Electrotechnical Commission standard 60601–2–43. The accuracy of the dosimetry was confirmed by comprehensive measurements and by frequent consistency checks performed over the course of the study. Data were collected on 2,142 instances of interventional radiology procedures, 48 comprehensive physics evaluations, and 581 periodic consistency checks from the 12 fluoroscopic units in the study. There were wide variations in dose and statistically significant differences in fluoroscopy time, number of images, DAP, and CD for different instances of the same procedure, depending on the nature of the lesion, its anatomic location, and the complexity of the procedure. For the 2,142 instances, observed CD and DAP correlate well overall ( r = 0.83, P < .000001), but correlation in individual instances is poor. The same is true for the correlation between fluoroscopy time and CD ( r = 0.79, P < .000001). The correlation between fluoroscopy time and DAP ( r = 0.60, P < .000001) is not as good. In 6% of instances (128 of 2,142), which were principally embolization procedures, transjugular intrahepatic portosystemic shunt (TIPS) procedures, and renal/visceral artery stent placements, CD was greater than 5 Gy. Most procedures studied can result in clinically significant radiation dose to the patient, even when performed by trained operators with use of dose-reducing technology and modern fluoroscopic equipment. Embolization procedures, TIPS creation, and renal/visceral artery stent placement are associated with a substantial likelihood of clinically significant patient dose. At minimum, patient dose data should be recorded in the medical record for these three types of procedures. These data should include indicators of the risk of deterministic effects as well as the risk of stochastic effects.

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315 citations in Web of Science
337 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Peripheral Vascular Disease
Radiology, Nuclear Medicine & Medical Imaging
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