title: Radiation exposure in nonvascular fluoroscopy-guided interventional procedures.
abstract: OBJECTIVE
  To investigate the radiation exposure in non-vascular fluoroscopy guided interventions and to search strategies for dose reduction.
  
  
  METHODS
  Dose area product (DAP) of 638 consecutive non-vascular interventional procedures of one year were analyzed with respect to different types of interventions; gastrointestinal tract, biliary interventions, embolizations of tumors and hemorrhage. Data was analyzed with special focus on the fluoroscopy doses and frame doses. The third quartiles (Q3) of fluoroscopy dose values were defined in order to set a reference value for our in-hospital practice.
  
  
  RESULTS
  Mean fluoroscopy times of gastrostomy, jejunostomy, right and left sided percutaneous biliary drainage, chemoembolization of the liver and embolization due to various hemorrhages were 5.9, 8.6, 13.5, 16.6, 17.4 and 25.2 min, respectively. The respective Q3 total DAP were 52.9, 73.3, 155.1, 308.4, 428.6 and 529.3 Gy*cm2. Overall, around 66% of the total DAP originated from the radiographic frames with only 34% of the total DAP applied by fluoroscopy (P<0.001). The investigators experience had no significant impact on the total DAP applied, most likely since there was no stratification to intervention-complexity.
  
  
  CONCLUSIONS
  To establish Diagnostic Reference Levels (DRLs), there is a need to establish a registry of radiation dose data for the most commonly performed procedures. Documentation of interventional procedures by fluoroscopy "grabbing" has the potential to considerably reduce radiation dose applied and should be used instead of radiographic frames whenever possible.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, 55131, Mainz, Germany. kloeckner@radiologie.klinik.uni-mainz.de
authors.forename: Roman
authors.initials: R
authors.lastname: Kloeckner
authors.forename: Anton
authors.initials: A
authors.lastname: Bersch
authors.forename: Daniel Pinto
authors.initials: DP
authors.lastname: dos Santos
authors.forename: Jens
authors.initials: J
authors.lastname: Schneider
authors.forename: Christoph
authors.initials: C
authors.lastname: Düber
authors.forename: Michael Bernhard
authors.initials: MB
authors.lastname: Pitton
mesh_terms: D005471:Fluoroscopy; D006801:Humans; D011829:Radiation Dosage; D015641:Radiography, Interventional; D011874:Radiometry; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors