Radiation exposure in CT-guided interventions.
OBJECTIVE
To investigate radiation exposure in computed tomography (CT)-guided interventions, to establish reference levels for exposure, and to discuss strategies for dose reduction.


METHODS
We analyzed 1576 consecutive CT-guided procedures in 1284 patients performed over 4.5 years, including drainage placements; biopsies of different organs; radiofrequency and microwave ablations (RFA/MWA) of liver, bone, and lung tumors; pain blockages, and vertebroplasties. Data were analyzed with respect to scanner settings, overall radiation doses, and individual doses of planning CT series, CT intervention, and control CT series.


RESULTS
Eighty-five percent of the total radiation dose was applied during the pre- and post-interventional CT series, leaving only 15% applied by the CT-guided intervention itself. Single slice acquisition was associated with lower doses than continuous CT-fluoroscopy (37 mGy cm vs. 153 mGy cm, p<0.001). The third quartile of radiation doses varied considerably for different interventions. The highest doses were observed in complex interventions like RFA/MWA of the liver, followed by vertebroplasty and RFA/MWA of the lung.


CONCLUSIONS
This paper suggests preliminary reference levels for various intervention types and discusses strategies for dose reduction. A multicenter registry of radiation exposure including a broader spectrum of scanners and intervention types is needed to develop definitive reference levels.
Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University, Langenbeckstraße 1, 55131 Mainz, Germany. Electronic address: Roman.Kloeckner@unimedizin-mainz.de.
Roman
R
Kloeckner
Daniel Pinto
DP
dos Santos
Jens
J
Schneider
Levent
L
Kara
Christoph
C
Dueber
Michael B
MB
Pitton
D001822:Body Burden; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006801:Humans; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000706:statistics & numerical data*; D011874:Radiometry / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
Image-guided biopsy; Radiation dosage; Radiation protection; Radiology, Interventional; Tomography, Spiral computed