NATIONAL DIAGNOSTIC REFERENCE LEVELS IN INTERVENTIONAL RADIOLOGY SUITES IN LEBANON: A MULTICENTER SURVEY

2019 ◽  
Vol 187 (1) ◽  
pp. 50-60 ◽  
Author(s):  
C Rizk ◽  
J Farah ◽  
F Vanhavere ◽  
G Fares
Keyword(s):  
Radiation Protection ◽  
Pacemaker Implantation ◽  
High Dose ◽  
National Council ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Transcatheter Aortic Valve ◽  
Multicenter Survey ◽  
Area Product

ABSTRACT Air kerma-area product (PKA), cumulative air kerma at patient entrance reference point, fluoroscopy time and number of images were retrospectively collected from 15 hospitals in Lebanon for 11282 fluoroscopically-guided interventional (FGI) procedures between March 2016 and November 2018. National diagnostic reference levels (NDRLs) were established based on the third quartile of the distribution of median values of exposure parameters per department for 27 types of FGI procedures. NDRLs were in line with international DRLs except for coronary angiography (CA), percutaneous coronary interventions (PCI) and transcatheter aortic valve implantation (TAVI) which require optimisation. Additionally, following the National Council on Radiation Protection and Measurements report 168, PCI, TAVI, triple chamber pacemaker implantation, endovascular aortic repair, nephrostomy, kyphoplasty and percutaneous transhepatic biliary drainage were classified as potentially high-dose procedures with >5% of the patients with PKA exceeding 300 Gycm2. The established NDRLs will promote dose optimisation and patient radiation protection.

scholarly journals Pediatric Diagnostic Reference Levels for Diagnostic and Therapeutic Cardiac Catheterization in Japan

2021 ◽  
Author(s):  
Toru Ishibashi ◽  
Yasutaka Takei ◽  
Mamoru Kato ◽  
Yukari Yamashita ◽  
Atsuko Tsukamoto ◽  
...  
Keyword(s):  
Cardiac Catheterization ◽  
Pediatric Patients ◽  
Age Groups ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Air Kerma ◽  
Cardiac Angiography ◽  
Pediatric Cardiac Catheterization ◽  
One Year ◽  
Area Product

Abstract To propose Japanese national DRLs for air-kerma at the reference point (Ka,r), air-kerma area product (PKA), fluoroscopy time (FT), and number of cine images (CI) for four age groups. We posted a nationwide questionnaire to 132 facilities. Questions focused on identifying the procedure, age, weight, height, Ka,r, PKA, FT, and CI during diagnostic and therapeutic pediatric cardiac catheterization. For diagnostic cardiac angiography, the 75th percentile values were as follows; Ka,r: 103, 127, 194, and 351 mGy; PKA: 7.0, 12.3, 14.3, and 47.2 Gy.cm2; FT: 36.8, 30.7, 33.4, and 35.7 min; and CI: 2018, 2313, 2408, and 2016 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. For therapeutic cardiac angiography, the 75th percentile values were as follows: Ka,r: 146, 209, 130, and 501 mGy; PKA: 7.54, 16.0, 8.35, and 46.0 Gy.cm2; FT: 56.5, 52.0, 49.4, and 52.0 min; and CI: 4075, 4514, 3576, and 5984 images for less than one year, 1–5 years, 6–10 years, and 11–15 years respectively. Our survey of diagnostic and therapeutic cardiac catheterization in Japanese pediatric patients showed that all age-based Japanese 75th percentiles for the Ka,r, PKA, FT, and CI were higher than in other surveys. Based on the result of our study, it is necessary to establish DRLs for pediatric cardiac catheterization examinations in Japan, in order to optimize the safety of pediatric protocols for diagnostic and therapeutic cardiac catheterization.

RADIATION EXPOSURE OF PAEDIATRIC GENERAL RADIOGRAPHY, FLUOROSCOPY AND CT PROCEDURES IN THE CZECH REPUBLIC—PILOT STUDY

2019 ◽  
Vol 186 (2-3) ◽  
pp. 391-396 ◽  
Author(s):  
Kateřina Chytrá ◽  
Leoš Novák ◽  
Pavel Rejtar ◽  
Martin Homola ◽  
Kateřina Daníčková ◽  
...  
Keyword(s):  
Pilot Study ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
University Hospitals ◽  
Tube Voltage ◽  
The Czech Republic ◽  
Air Kerma ◽  
Volumetric Ct ◽  
Dose Management ◽  
Area Product

Abstract The pilot dose survey on paediatric general radiography, fluoroscopy and CT procedures was performed in four university hospitals. The analysis of data was focused on the radiography and CT imaging of head, chest, abdomen, pelvis and spine and fluoroscopic procedures of gastrointestinal and urinary tracts. The survey was conducted by the National Radiation Protection Institute. Two hospitals exported data from the patient dose management system, while the others collected the data manually. The methodology of diagnostic reference levels assessment was proposed and tested. Local diagnostic reference levels were calculated in terms of air kerma-area product $P_{KA}$, CT air kerma-length product $P_{KL,CT}$ and volumetric CT air kerma index $C_{VOL}$. The lack of procedure standardisation, e.g. in tube voltage setting irrespective of patient’s weight, was revealed at one hospital. Dose and exposure parameters distributions with respect to patient’s anatomical constitution are presented in this article. In future, this pilot study will be a base for national survey of paediatric diagnostic reference levels.

A MULTICENTRE SURVEY OF LOCAL DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSE FOR CORONARY ANGIOGRAPHY AND PERCUTANEOUS TRANSLUMINAL CORONARY INTERVENTION PROCEDURES IN KOREA

2019 ◽  
Vol 187 (3) ◽  
pp. 378-382
Author(s):  
Jung Su Kim ◽  
Bong-Ki Lee ◽  
Dong Ryeol Ryu ◽  
Kwang Jin Chun ◽  
Hyun-Hee Choi ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
High Radiation ◽  
Exposure Data ◽  
Area Product ◽  
Percutaneous Transluminal

Abstract Interventional cardiology procedures can involve relatively high radiation doses compared to general radiography. During coronary angiography (CAG) and percutaneous transluminal coronary intervention (PCI), the same area is exposed to radiation for a long period. In this study, radiation exposure data of 1071 examinations in Korean hospitals were collected, and the achievable dose (AD) and diagnostic reference levels (DRLs) in actual medical practice for two types of interventional cardiology procedures in Korea were established. In CAG, 75th percentile DRLs and AD of the total kerma-area product were 47.0 and 33.1 Gy·cm 2, respectively. In PCI, those values were 171.3 and 102.6 Gy·cm2, respectively. This is the first study to introduce the DRLs for cardiovascular interventional procedures in Korea. These results will help optimise the interventional cardiology procedures for Korean cardiac centres.

scholarly journals Establishing local diagnostic reference levels for common orthopaedic procedures using the mini C-arm fluoroscope

2021 ◽  
Vol 94 (1117) ◽  
pp. 20190878
Author(s):  
Anna Kropelnicki ◽  
Rosemary Eaton ◽  
Alexandra Adamczyk ◽  
Jacqueline Waterman ◽  
Pegah Mohaghegh
Keyword(s):  
Radiation Exposure ◽  
Best Practice ◽  
District General Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Data Set ◽  
Dose Area Product ◽  
The Third ◽  
Retrospective Audit ◽  
Area Product

Objective: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years. Methods: This retrospective audit evaluates the end dose–area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital. We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope. Results: For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures. Advances in knowledge: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.

AVERAGE GLANDULAR DOSES AND NATIONAL DIAGNOSTIC REFERENCE LEVELS IN MAMMOGRAPHY EXAMINATIONS IN TURKEY

2020 ◽  
Vol 190 (1) ◽  
pp. 100-107
Author(s):  
Aydın Parmaksız ◽  
Gökçe K Ataç ◽  
Emine Bulur ◽  
Tolga İnal ◽  
Aslıhan Alhan
Keyword(s):  
Age Groups ◽  
Skin Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
The Third ◽  
Air Kerma ◽  
Entrance Skin Dose ◽  
Breast Thickness

Abstract In order to establish national diagnostic reference levels for mammography examinations, entrance skin air kerma, entrance skin dose and average glandular doses (AGDs) were calculated for a total of 25 624 cranio-caudal (CC) and mediolateral oblique (MLO) projections of 6309 patients for 40–49 and 50–64 age groups. The average entrance skin air kerma and entrance skin dose values for both age groups were found to be higher in MLO projections compared with CC projections. The minimum and maximum values of AGDs were determined as 0.4 and 7.9 mGy for both projections. The maximum numbers of AGDs for CC and MLO projections were calculated in the range of 1.1–1.5 and 1.6–2.0 mGy, respectively. The third quartile values of AGDs were calculated for each compressed breast thickness between 20 and 99 mm. The first national diagnostic reference levels of the country were established for each 10-mm compressed breast thickness in mammography examinations.

PROPOSAL FOR LOCAL DIAGNOSTIC REFERENCE LEVELS IN GENERAL RADIOGRAPHY IN JAPAN

2019 ◽  
Author(s):  
Yasuki Asada ◽  
Koji Ono ◽  
Yuya Kondo ◽  
Kazuma Sugita ◽  
Takuma Ichikawa ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Distributions ◽  
X Ray ◽  
Non Invasive ◽  
Air Kerma ◽  
Aichi Prefecture

Abstract The present study aimed to propose local diagnostic reference levels (DRLs) formulated by calculating entrance surface doses for general radiography at 20 facilities of Aichi prefecture in Japan, by comparing these values with DRLs established in Japan in 2015 (DRLs 2015) and assessing radiation dose differences among facilities. X-ray outputs (half-value layer and air kerma) of each facility were measured with a non-invasive type of detector. The results were employed to formulate local DRLs based on the 75th percentiles of dose distributions. These local DRLs were lower than the DRLs 2015 for all examinations. If proposed local DRLs from other 46 prefectures can be collected, this paper can be used to benefit the next effort to draft better DRL for Japan.

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