title: Radiation exposure to patients and personnel during interventional ERCP at a teaching institution.
abstract: BACKGROUND
  This study was designed to determine the radiation dose to patients and personnel during ERCP procedures.
  
  
  METHODS
  Phantom studies were performed to compare dosimetry for two image capture systems and to determine the effectiveness of shielding in reducing stray radiation. Radiation techniques and dosimetry were recorded in 72 patients undergoing ERCP.
  
  
  RESULTS
  Phantom studies indicated that increasing fluoroscopy voltage from 75 to 96 kV decreased entrance dose by 50%. Image capture by digital radiography decreased radiation exposure by 66%. Shielding decreased stray radiation exposure by 93%. All patients underwent cholangiography (n = 71) and/or pancreatography (n = 53). The mean number of interventional ERCP procedures performed per patient was 1.8 (range, 0 to 6). The mean measured patient entrance dose was 80 mGy (8 R; range, 0.2 to 73 R); however, the calculated mean entrance dose (based on measured intensifying screen doses) may have been as high as 3000 mGy (30 R; range, 0.8 to 300 R). Measured patient exposure increased with fluoroscopy time (r = 0.9) and with the number of interventions performed (r = 0.3). The mean dose to personnel was estimated at 0.04 mR.
  
  
  CONCLUSIONS
  The patient radiation dose depended most on fluoroscopy time. The dose may be lowered by minimizing fluoroscopy time, using higher voltage and lower current for fluoroscopy, and using digital radiography for documentation. Personnel were adequately protected.
authors.affiliation: Department of Radiology, Indiana University School of Medicine, Indiana University Medical Center, Indianapolis 46202-5253, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Heyd
authors.forename: K K
authors.initials: KK
authors.lastname: Kopecky
authors.forename: S
authors.initials: S
authors.lastname: Sherman
authors.forename: G A
authors.initials: GA
authors.lastname: Lehman
authors.forename: S M
authors.initials: SM
authors.lastname: Stockberger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D009729:Nursing; D010179:Pancreas / Q000000981:diagnostic imaging; D010361:Patients; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods; D011839:Radiation, Ionizing; D015641:Radiography, Interventional / Q000379:methods; D011871:Radiology; D011874:Radiometry; D013679:Technology, Radiologic