title: Optimisation strategies and justification: an example in uterine artery embolisation for fibroids.
abstract: Radiation risk has to be justified and optimised. This study discusses the radiation risk of uterine artery embolisation (UAE) for the treatment of fibroids. A total of 70 consecutive UAE dosimetry parameters were assessed. Using Monte Carlo simulation, organ and effective doses and dose conversion coefficients (DCCs) (mSv Gy cm(-2)) were calculated. During UAE optimisation, avoidance of oblique views and use of last-image-hold (LIH) documentation instead of digital subtraction angiography (DSA) were investigated. Mean dose-area product (DAP) was 37.1 Gy cm2 (median 23.7 Gy cm2) and mean fluoroscopy time was 18.4 min (median 16.6 min). Dose values decreased as the study progressed: mean DAP for patients 1-21, 68.5 Gy cm2; patients 22-43, 35.7 Gy cm2; and patients 44-69, 13.0 Gy cm2. Average DCC for DSA image procedures was 0.572, yielding a mean effective dose of 29.6 mSv (median 17.1 mSv). For LIH-only procedures, an average DCC of 0.813 was estimated [using mean effective dose: 10.6 mSv (median 8.1 mSv)].
authors.affiliation: Department of Radiology, Diakonissenkrankenhaus, Diakonissenstrasse 28, D-76199 Karlsruhe, Germany. radiologie@diak-ka.de
authors.forename: S
authors.initials: S
authors.lastname: Vetter
authors.forename: F W
authors.initials: FW
authors.lastname: Schultz
authors.forename: E-P
authors.initials: EP
authors.lastname: Strecker
authors.forename: J
authors.initials: J
authors.lastname: Zoetelief
mesh_terms: D000328:Adult; D001158:Arteries / Q000473:pathology*; D015992:Body Mass Index; D004307:Dose-Response Relationship, Radiation; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007889:Leiomyoma / Q000532:radiotherapy*; D008875:Middle Aged; D011874:Radiometry / Q000379:methods*; D013997:Time Factors; D014591:Uterine Diseases / Q000532:radiotherapy*