Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters.

Autor: Bundy JJ; Wake Forest Baptist Health, One Medical Center Boulevard, Winston-Salem, NC, 27157, USA., McCracken IW; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Shin DS; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Monroe EJ; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Johnson GE; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Ingraham CR; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Kanal KM; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Bundy RA; Wake Forest Baptist Health, One Medical Center Boulevard, Winston-Salem, NC, 27157, USA., Jones ST; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Valji K; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA., Chick JFB; University of Washington, 1959 Northeast Pacific Street, Seattle, WA, 98195, USA. jeffreychick@gmail.com.
Jazyk: angličtina
Zdroj: CVIR endovascular [CVIR Endovasc] 2020 Sep 22; Vol. 3 (1), pp. 69. Date of Electronic Publication: 2020 Sep 22.
DOI: 10.1186/s42155-020-00159-6
Abstrakt: Purpose: To quantify and categorize fluoroscopically-guided procedures with radiation doses exceeding 5000 mGy reference point air kerma (K a,r ). K a,r  > 5000 mGy has been defined as a "significant radiation dose" by the Society of Interventional Radiology. Identification and analysis of interventions with high radiation doses has the potential to reduce radiation-induced injuries.
Materials and Methods: Radiation dose data from a dose monitoring system for 19 interventional suites and 89,549 consecutive patient encounters from January 1, 2013 to August 1, 2019 at a single academic institution were reviewed. All patient encounters with K a,r  > 5000 mGy were included. All other encounters were excluded (n = 89,289). Patient demographics, medical specialty, intervention type, fluoroscopy time (minutes), dose area product (mGy·cm 2 ), and K a,r (mGy) were evaluated.
Results: There were 260 (0.3%) fluoroscopically-guided procedures with K a,r  > 5000 mGy. Of the 260 procedures which exceeded 5000 mGy, neurosurgery performed 81 (30.5%) procedures, followed by interventional radiology (n = 75; 28.2%), neurointerventional radiology (n = 55; 20.7%), and vascular surgery (n = 49; 18.4%). The procedures associated with the highest K a,r were venous stent reconstruction performed by interventional radiology, arteriovenous malformation embolization performed by neurointerventional radiology, spinal hardware fixation by neurosurgery, and arterial interventions performed by vascular surgery. Neurointerventional radiology had the highest mean K a,r (7,799 mGy), followed by neurosurgery (7452 mGy), vascular surgery (6849 mGy), and interventional radiology (6109 mGy). The mean K a,r for interventional radiology performed procedures exceeding 5000 mGy was significantly lower than that for neurointerventional radiology, neurosurgery, and vascular surgery.
Conclusions: Fluoroscopically-guided procedures with radiation dose exceeding 5000 mGy reference point air kerma are uncommon. The results of this study demonstrate that a large proportion of cases exceeding 5000 mGy were performed by non-radiologists, who likely do not receive the same training in radiation physics, radiation biology, and dose reduction techniques as radiologists.
Databáze: MEDLINE
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