Patient Radiation Doses in Interventional Radiology Procedures: Comparison of Fluoroscopy Dose Indices between the American College of Radiology Dose Index Registry-Fluoroscopy Pilot and the Radiation Doses in Interventional Radiology Study,Journal of Vascular and Interventional Radiology

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Patient Radiation Doses in Interventional Radiology Procedures: Comparison of Fluoroscopy Dose Indices between the American College of Radiology Dose Index Registry-Fluoroscopy Pilot and the Radiation Doses in Interventional Radiology Study
Journal of Vascular and Interventional Radiology ( IF 2.6 ) Pub Date : 2022-08-27 , DOI: 10.1016/j.jvir.2022.08.023
A Kyle Jones ₁ , Kevin A Wunderle ₂ , Tom Fruscello ₃ , Michael Simanowith ₃ , Brendan Cline ₄ , Shalmali Dharmadhikari ₅ , Xinhui Duan ₆ , Jeremy C Durack ₇ , David Hirschl ₈ , Don-Soo Kim ₉ , Usman Mahmood ₁₀ , Steve D Mann ₄ , Charles Martin ₂ , Zeyad Metwalli ₁ , Jeffrey M Moirano ₁₁ , Rebecca A Neill ₅ , Janice Newsome ₅ , Horacio Padua ₉ , Alan H Schoenfeld ₈ , Donald L Miller ₁₂

Affiliation

Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, Ohio.
American College of Radiology, Reston, Virginia.
Department of Radiology, Duke University Medical Center, Durham, North Carolina.
Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, Texas.
Ajax Health, New York, New York.
Department of Radiology, Montefiore Medical Center, Bronx, New York.
Department of Radiology, Boston Children's Hospital, Boston, Massachusetts.
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Radiology, University of Washington, Seattle, Washington.
United States Food and Drug Administration, Silver Spring, Maryland.

Purpose

To compare radiation dose index distributions for fluoroscopically guided interventions in interventional radiology from the American College of Radiology (ACR) Fluoroscopy Dose Index Registry (DIR-Fluoro) pilot to those from the Radiation Doses in Interventional Radiology (RAD-IR) study.

Materials and Methods

Individual and grouped ACR Common identification numbers (procedure types) from the DIR-Fluoro pilot were matched to procedure types in the RAD-IR study. Fifteen comparisons were made. Distribution parameters, including the 10th, 25th, 50th, 75th, and 95th percentiles, were compared for fluoroscopy time (FT), cumulative air kerma (K_a,r), and kerma area product (P_KA). Two derived indices were computed using median dose indices. The procedure-averaged reference air kerma rate ( $\bar{K_{a, r}}$ ) was computed as K_a,r / FT. The procedure-averaged x-ray field size at the reference point (A_r) was computed as P_KA / (K_a,r × 1,000).

Results

The median FT was equally likely to be higher or lower in the DIR-Fluoro pilot as it was in the RAD-IR study, whereas the maximum FT was almost twice as likely to be higher in the DIR-Fluoro pilot than it was in the RAD-IR study. The median K_a,r was lower in the DIR-Fluoro pilot for all procedures, as was median P_KA. The maximum K_a,r and P_KA were more often higher in the DIR-Fluoro pilot than in the RAD-IR study. $\bar{K_{a, r}}$ followed the same pattern as K_a,r, whereas A_r was often greater in DIR-Fluoro.

Conclusions

The median dose indices have decreased since the RAD-IR study. The typical K_a,r rates are lower, a result of the use of lower default dose rates. However, opportunities for quality improvement exist, including renewed focus on tight collimation of the imaging field of view.

中文翻译：

介入放射学程序中的患者辐射剂量：美国放射学会剂量指数登记-荧光检查试点与介入放射学研究中的辐射剂量之间的荧光检查剂量指数比较

目的

比较美国放射学会 (ACR) 荧光镜剂量指数登记 (DIR-Fluoro) 试点的介入放射学中荧光镜引导干预的辐射剂量指数分布与介入放射学辐射剂量 (RAD-IR) 研究的辐射剂量指数分布。

材料和方法

来自 DIR-Fluoro 试点的单个和分组 ACR 通用识别号（程序类型）与 RAD-IR 研究中的程序类型相匹配。进行了十五次比较。_{比较荧光检查时间 (FT)、累积空气比释动能 (K a,r} ) 和比释动能面积积 ( P _KA ) 的分布参数，包括第 10、25、50、75 和 95 个百分位数。使用中值剂量指数计算了两个衍生指数。程序平均参考空气比释动能率 ( $\bar{钾_{A, r}}$ ) 计算为 K _a,r / FT。_{参考点 (A r} )处的程序平均 X 射线射野大小计算为P _KA / (K _a,r × 1,000)。

结果

中值 FT 在 DIR-Fluoro 试点中可能高于或低于 RAD-IR 研究，而最大 FT 在 DIR-Fluoro 试点中的可能性几乎是在 RAD-IR 研究中的两倍。 RAD-IR 研究。在所有程序的 DIR-Fluoro 试验中，中值 K _a,r都较低，中值P _KA也是如此。与 RAD-IR 研究相比，DIR-Fluoro 试验中的最大 K _a,r和P _KA通常更高。 $\bar{钾_{A, r}}$ _{遵循与 K a,r}相同的模式，而A _r在 DIR-Fluoro 中通常更大。