Original ArticlesRadiation doses to patients during ERCP☆
Section snippets
Methods
The unit on which the ERCP examinations were carried out consisted of a screening tube (Siregraph; Siemens, Erlangen, Germany), image intensifier (Optilux 25/17 HN, Siemens, manufactured 1985), and x-ray generator (Polydorus 100; Siemens). Previous survey of the equipment measured fluoroscopy dose rate, x-ray tube output and total filtration, and collimated field sizes.
In this study DAP measurements were carried out by using a transmission ionization chamber (NE Technology 240 Dose Area Product
Results
Clinical details of the ERCPs are given in Tables 1 and 2.Indication Gender Age Findings Acute pancreatitis F 41 No abnormality seen Abnormal LFTs, weight loss M 41 Chronic calcific pancreatitis, pancreatic duct stricture, distal CBD stricture Cholangitis, jaundice M 84 No abnormality seen Jaundice M 82 No abnormality seen Acute pancreatitis M 51 Cholelithiasis Acute cholecystitis F 28 No abnormality seen Chronic pancreatitis, pancreatic mass M 52 Chronic pancreatitis Acute pancreatitis F 57 No
Discussion
The measured DAP values for ERCPs were significantly different depending on whether the study was purely diagnostic or also included therapeutic intervention. The differences in doses between these 2 categories of ERCP is largely due to the differences in fluoroscopy time used in undertaking each type of study. It was found that the DAP measurement correlated well with fluoroscopy time and analysis of the relative contribution of fluoroscopy to the total DAP indicated that, on average, for
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2021, Current Problems in Diagnostic RadiologyCitation Excerpt :Continuous fluoroscopy will have higher doses as compared to pulse fluoroscopy or single frame fluoroscopy. In one study, the average exposure dose was 3.1 milliSievert (mSv) for diagnostic and 12.4 mSv for therapeutic ERCP, with fluoroscopy times of 2.3 minutes and 10.5 minutes, respectively.3 Radiation dose also varies with operator expertise and procedure complexity, and has also been shown to be lower for endoscopists performing large volume of cases.4
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Reprint requests: Dr. Catherine J. Larkin, Wellcome Research Labs, Royal Victoria Hospital, Belfast, N. Ireland.