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Updated Radiation Dose Distributions for Fifteen Fluoroscopically-Guided Interventional Procedures

X Li*, Z Li , K Yang , B Liu , Massachusetts General Hospital, Belmont, MA


(Tuesday, 7/16/2019) 4:30 PM - 5:30 PM

Room: Exhibit Hall | Forum 1

Purpose: To present updated procedure-specific distributions of air kerma at the reference point (Kâ‚?,áµ£) for fluoroscopically-guided interventional (FGI) procedures.

Methods: Based on two studies in 1998-2004, NCRP reports No. 168 and 172 presented K�,ᵣ distributions for 24 procedures. Among which, 15 procedures were performed at our institute from May 2016 to October 2018, based on a review of FGI data recorded in our in-house semiautomated dose monitoring system and dictation reports. This IRB approved retrospective study included 4016 adult cases (2089 cases on men; 1927 cases on women). The fluoroscopic systems included Axiom Artis, Axiom Artis Biplane, Artis zeego, Artis zee Biplane, and Artis zee Multipurpose (Siemens Healthcare, Forchheim, Germany). Patient age at the procedure time was 59.7±15.8 years for the men (median age, 62 years; age range, 18–98 years) and 58.2±16.4 years for the women (median age, 61 years; age range, 18–97 years). Data analysis was conducted with statistical software (R, version 3.5.1) to determine five percentiles (10th, 25th, 50th, 75th, 95th).

Results: Among 3619 cases in torso, ultrasound guidance was used in 3147 (87%) cases. Among 15 procedures, the median and 75th percentile Kâ‚?,áµ£ values from this study were generally consistent with the median Kâ‚?,áµ£ of NCRP Report No. 168 and the 75th percentile Kâ‚?,áµ£ of NCRP Report No. 172 for inferior vena cava filter placement, hepatic chemoembolization, and pelvic artery embolization. For twelve other procedures, such as cerebral aneurysm and uterine fibroid embolization, our Kâ‚?,áµ£ data are lower than the NCRP data.

Conclusion: This study illustrates a trend of using ultrasound guidance when feasible in contemporary FGI procedures. The updated K�,ᵣ distributions can serve purposes for IRB applications, for FGI procedure planning, and for dose management, in compliance with the Joint Commission’s standards for organizations providing fluoroscopy services.


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