Analysis of Factors Affecting Air Kerma Area Product Obtained during Uterine Artery Embolization Procedures Using Logistic Regression

Abstract Purpose Uterine artery embolization (UAE) is a common interventional radiology procedure used in medicine; the procedure is safe but there is always a concern regarding radiation dose received by the patient. The aim of this study was to use multivariable logistic regression analysis (MLRA) to study a certain number of independent prognostic variables believed to provide an estimate of the likelihood of obtaining a high kerma area product (P KA) at the end of the procedure. Method Radiation dose indices registered by the angiographic system structured dose report, the total fluoroscopy time (FT), the patient’ body mass index (BMI), the number of images taken during the procedures (IMGS), and the performing physician experience (EXPER) were used to drive a logistic regression model (LRM). Results The LRM found was: Logit (P KA) = −6.1525 + 0.0416 (FT) + 0.1028 (IMGS) + 0.1675 (BMI) – 0.1012 (EXPER). The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve; by calculating the area under the curve (AUC), we found AUC = 0.7896, with optimal ROC point of 0.3261, 0.8036. Conclusion The suggested LRM seems to indicate that patients with higher BMI, have taken longer FT, acquired higher IMGS and the procedure done by a less experienced performing physician is more susceptible to receive a higher P KA at the end. The proposed LRM is useful in predicting the occurrence of higher radiation exposure interventions and can be used in patients’ radiation dose optimization strategies during UAE procedures.

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Optimizing the Angiography Protocol to Reduce Radiation Dose in Uterine Artery Embolization: The Impact of Digital Subtraction Angiographies on Radiation Exposure

CardioVascular and Interventional Radiology ◽

10.1007/s00270-021-03032-8 ◽

2022 ◽

Author(s):

Alessandro Cina ◽

Lorenzo Steri ◽

Pierluigi Barbieri ◽

Andrea Contegiacomo ◽

Enrico Maria Amodeo ◽

...

Keyword(s):

Radiation Dose ◽

Radiation Exposure ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Digital Subtraction ◽

Artery Embolization ◽

Reduce Radiation Dose ◽

The Impact

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Factors Affecting Early Surgical Intervention After Uterine Artery Embolization

Obstetrical & Gynecological Survey ◽

10.1097/00006254-200212000-00005 ◽

2002 ◽

Vol 57 (12) ◽

pp. 810-815 ◽

Cited By ~ 32

Author(s):

Haya Al-Fozan ◽

Togas Tulandi

Keyword(s):

Uterine Artery Embolization ◽

Uterine Artery ◽

Surgical Intervention ◽

Artery Embolization ◽

Factors Affecting ◽

Early Surgical Intervention

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Evaluation of scattered radiation dose received by medical staff during uterine artery embolization in the operating room

Technology and Health Care ◽

10.3233/thc-209002 ◽

2020 ◽

Vol 28 ◽

pp. 3-11

Author(s):

Hsien-Wen Chiang ◽

Hsien-Jen Chiang ◽

Jung-Hui Li ◽

Leo Leung-Chit Tsang

Keyword(s):

Radiation Dose ◽

Operating Room ◽

Scattered Radiation ◽

Medical Staff ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Artery Embolization

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Assessment of organ radiation dose associated with uterine artery embolization

Acta Radiologica ◽

10.1080/02841850500447211 ◽

2006 ◽

Vol 47 (2) ◽

pp. 179-185 ◽

Cited By ~ 17

Author(s):

O. Glomset ◽

J. Hellesnes ◽

N. Heimland ◽

G. Hafsahl ◽

H. J. Smith

Keyword(s):

Statistical Analysis ◽

Radiation Dose ◽

Uterine Artery Embolization ◽

Uterine Artery ◽

Skin Dose ◽

Artery Embolization ◽

System A ◽

Significant Difference ◽

The Mean ◽

Peak Skin Dose

Purpose: To evaluate the radiation dose to the skin, uterus, and ovaries during uterine artery embolization. Material and Methods: Guided uterine artery embolization for leiomyomata and two types of X-ray equipment with different dose levels were utilized during fluoroscopy in 20 women (ages ranging from 32 to 52 years, body weights from 55 to 68 kg). The first 13 women were treated using a non-pulsed system A, with 3.3 mm Al filtering and, for simplicity, a fixed peak voltage 80 kV. During treatment of the other 7 women, a pulsed system B with 5.4 mm Al filtering and an identical fixed voltage was used. The dose area product (DAP) was recorded. The vaginal dose of the first 13 patients and the peak skin dose of all patients were measured with thermoluminescent dosimeters (TLDs). TLDs were placed in the posterior vaginal fornix and on the skin at the beam entrance site. The uterine and ovarian doses were estimated based on the measured skin doses, normalized depth dose, and organ depth values. The effective dose (Deff) was estimated based on the observed DAP values. The measured vaginal doses and the corresponding estimated uterine doses were compared statistically, as were the DAP values from systems A and B. Results: For system A, the mean fluoroscopic time was 20.9 min (range 12.7–31.1), and for system B 35.9 min (range 16.4–55.4). The mean numbers of angiographic exposures for systems A and B were 82 (range 30–164) and 37 (range 20–72), respectively. The mean peak skin dose for system A was 601.5 mGy (range 279–1030) and for system B 453 mGy (range 257–875). The mean DAP for system A was 88.6 Gy·cm2 (range 41.4–161.0) and for system B 52.5 Gy·cm2 (range 20.1–107.9). Statistical analysis showed a significant difference between the DAP values, the DAP for system B being the lower one. The mean estimated effective doses from systems A and B were 32 mSv (range 15.1–58.4) and 22 mSv (range 9–46), respectively. The mean estimated maximum uterine and ovarian doses using system A were 81 mGy (range 30–247) and 85 mGy (range 24–207), respectively; when using system B, the respective doses were 101 mGy (range 45–182) and 105 mGy (range 31–246). The measured vaginal doses had a mean value of 52.5 mGy (range 12–124). Statistical analysis revealed a significant difference between the estimated uterine doses and the measured vaginal doses. Conclusion: A significant difference was found between the estimated uterine doses and the corresponding measured vaginal doses. This has to be kept in mind when using vaginal doses as a substitute for the uterine dose. There was also a significant difference between the DAP values from systems A and B. System B, with pulsed fluoroscopy and greater filtration, gave the lower exposure. The maximum skin dose indicates that skin injuries are unlikely to occur. The ovarian doses are also below the threshold for temporary or permanent sterility. The stochastic risk for radiation-induced cancer and genetic injury to the patient's future children is not considered as substantial.

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