title: Preliminary diagnostic reference levels for endoscopic retrograde cholangio-pancreatography in Greece.
abstract: The main objective of this study was to determine the preliminary Diagnostic Reference Levels (DRLs) in terms of Kerma Area Product (KAP) and fluoroscopy time (Tf) during Endoscopic Retrograde Cholangio-Pancreatography (ERCP) procedures. Additionally, an investigation was conducted to explore the statistical relation between KAP and Tf. Data from a set of 200 randomly selected patients treated in 4 large hospitals in Greece (50 patients per hospital) were analyzed in order to obtain preliminary DRLs for KAP and Tf during therapeutic ERCP procedures. Non-parametric statistic tests were performed in order to determine a statistically significant relation between KAP and Tf. The resulting third quartiles for KAP and Tf for hospitals (A, B, C and D) were found as followed: KAPA=10.7Gycm(2), TfA=4.9min; KAPB=7.5Gycm(2), TfB=5.0min; KAPC=19.0Gycm(2), TfC=7.3min; KAPD=52.4Gycm(2), TfD=15.8min. The third quartiles, calculated for the total 200 cases sample, are: KAP=18.8Gycm(2) and Tf=8.2min. For 3 out of 4 hospitals and for the total sample, p-values of statistical indices (correlation of KAP and Tf) are less than 0.001, while for the Hospital A p-values are ranging from 0.07 to 0.08. Using curve fitting, we finally determine that the relation of Tf and KAP is deriving from a power equation (KAP=Tf(1.282)) with R(2)=0.85. The suggested Preliminary DRLs (deriving from the third quartiles of the total sample) for Greece are: KAP=19Gycm(2) and Tf=8min, while the relation between KAP and Tf is efficiently described by a power equation.
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Tsapaki
authors.affiliation: Space Radiobiology Research, Physics Department, University of Strathclyde, Glasgow, Scotland, United Kingdom; "Attikon" General University Hospital, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, Greece. Electronic address: panagiotis.delinikolas@strath.ac.uk.
authors.forename: P
authors.initials: P
authors.lastname: Delinikolas
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: K D
authors.initials: KD
authors.lastname: Paraskeva
authors.affiliation: "Venizelio" General Hospital, Heraklion, Crete, Greece.
authors.forename: I A G
authors.initials: IA
authors.lastname: Paspatis
authors.affiliation: "Hygeia" Hospital, Athens, Greece.
authors.forename: H
authors.initials: H
authors.lastname: Scotiniotis
authors.affiliation: "Nicea" General Hospital, Piraeus, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Georgopoulos
authors.affiliation: "Nicea" General Hospital, Piraeus, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Voudoukis
authors.affiliation: "Nicea" General Hospital, Piraeus, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Finou
authors.affiliation: "Venizelio" General Hospital, Heraklion, Crete, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Athanasopoulos
authors.affiliation: "Venizelio" General Hospital, Heraklion, Crete, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Lydakis
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Giannakopoulos
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Mathou
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Angelogiannakopoulou
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Triantopoulou
authors.affiliation: "Konstantopoulio" General Hospital, Nea Ionia, Athens, Greece.
authors.forename: J A
authors.initials: JA
authors.lastname: Karagiannis
mesh_terms: D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods* / Q000592:standards*; D005471:Fluoroscopy / Q000379:methods; D006115:Greece; D006801:Humans; D012015:Reference Standards
keywords: Diagnostic reference levels; ERCP; Fluoroscopy time; Patient dose