title: Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France.
abstract: OBJECTIVE
  A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom.
  
  
  METHODS
  Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions.
  
  
  RESULTS
  Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm2and 11 mins for cerebral angiography, 35 Gy.cm2and 16 mins for biliary drainage, 75 Gy.cm2and 6 mins for lower limbs arteriography and 70 Gy.cm2and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published.
  
  
  CONCLUSIONS
  This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs.
  
  
  CONCLUSIONS
  • Delivered dose in interventional radiology depends on procedure, practice and patient. • National RLs are proposed for 15 interventional procedures. • Reference levels (RLs) are useful to benchmark practices and optimize protocols. • RLs are proposed for kerma area product, air kerma, fluoroscopy time and number of images. • RLs should be adapted to the procedure complexity and updated regularly.
authors.affiliation: Institut de Radioprotection et de Sûreté Nucléaire, 31 avenue de la Division Leclerc, 92260, Fontenay-aux-Roses, France.|French Society of Medical Physicists (SFPM), Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Etard
authors.affiliation: French Society of Medical Physicists (SFPM), Paris, France.|Department of Radiology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Bigand
authors.affiliation: French Society of Medical Physicists (SFPM), Paris, France.|Department of Medical Physics and Radiation Protection, Lariboisière Hospital, AP-HP, 2 rue Ambroise Paré, 75010, Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Salvat
authors.affiliation: Department of Radiology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex, France.|French Society of Radiology (SFR) - Interventional Radiology Federation (FRI), Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vidal
authors.affiliation: French Society of Radiology (SFR) - Interventional Radiology Federation (FRI), Paris, France.|Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Beregi
authors.affiliation: French Society of Medical Physicists (SFPM), Paris, France.|Department of Pediatric Radiology, Trousseau University Hospital, AP-HP, 26 rue du Dr Arnold Netter, 75012, Paris, France.
authors.forename: Amaury
authors.initials: A
authors.lastname: Hornbeck
authors.affiliation: French Society of Medical Physicists (SFPM), Paris, France. joel.greffier@chu-nimes.fr.|Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029, Nîmes Cedex 9, France. joel.greffier@chu-nimes.fr.
authors.forename: Joël
authors.identifier: http://orcid.org/0000-0002-1735-5129
authors.initials: J
authors.lastname: Greffier
mesh_terms: D005602:France; D006801:Humans; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods*; D015642:Radiology, Interventional / Q000379:methods*; D012189:Retrospective Studies
keywords: Interventional radiology; Patient dose; Patient dosimetry; Radiation protection; Reference levels