Erschienen in:
02.05.2020 | Computed Tomography
National dose reference levels in computed tomography–guided interventional procedures—a proposal
verfasst von:
Joël Greffier, Gilbert Ferretti, Julia Rousseau, Olivier Andreani, Emilie Alonso, Aymeric Rauch, Romain Gillet, Julien Le Roy, Laurie Cabrol-Faivre, Frederic Douane, Arthur David, Simon Henry, Thibaut Jacques, Xavier Stefanovic, Eric Decoux, Frederic Lafay, Franck Pilleul, Franck Couzon, Claire Boutet, Bernard Woerly, Patrick Baur, Nicolas Sans, Marie Faruch, Aurélie Moussier-Lherm, Lambros Tselikas, Alexis Jacquier, Emeline Bigand, Eric Pessis, Christophe Teriitehau, Florian Magnier, Lucie Cassagnes, Marc Haberlay, David Boutteau, Eric De Kerviler, Cynthia Majorel-Gouthain, Didier Defez, Aurélie Vuillod, Olivier Rouviere, Laurent Hennequin, Audrey Fohlen, Rabih Alwan, Alexandre Malakhia, Sébastien Aubry, Anthony Dohan, Marie Eresue-Bony, Romain Gautier, Romaric Dal, Djamel Dabli, Thomas Hebert, Robert Kovacs, Lama Hadid-Beurrier, Valérie Bousson, Mélody Potel, Yves Barbotteau, Célian Michel, Bouchra Habib-Geryes, Marc André, Thierry Arnaud, Nathalie Bestion, Olivier Ernst, Sylvie Monfraix, Pierre Yves Brillet, Boris Guiu, Loic Boussel, Mathilde Demonchy, Jean Paul Beregi, Julien Frandon
Erschienen in:
European Radiology
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Ausgabe 10/2020
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Abstract
Objectives
To establish national reference levels (RLs) in interventional procedures under CT guidance as required by the 2013/59/Euratom European Directive.
Methods
Seventeen categories of interventional procedures in thoracic, abdominopelvic, and osteoarticular specialties (percutaneous infiltration, vertebroplasty, biopsy, drainage, tumor destruction) were analyzed. Total dose length product (DLP), number of helical acquisitions (NH), and total DLP for helical, sequential, or fluoroscopic acquisitions were recorded for 10 to 20 patients per procedure at each center. RLs were calculated as the 3rd quartiles of the distributions and target values for optimization process (TVOs) as the median. RLs and TVOs were compared with previously published studies.
Results
Results on 5001 procedures from 49 centers confirmed the great variability in patient dose for the same category of procedures. RLs were proposed for the DLPs and NHs in the seventeen categories. RLs in terms of DLP and NH were 375 mGy.cm and 2 NH for spinal or peri-spinal infiltration, 1630 mGy.cm and 3 NH for vertebroplasty, 845 mGy.cm and 4 NH for biopsy, 1950 mGy.cm and 8 NH for destruction of tumors, and 1090 mGy.cm and 5 NH for drainage. DLP and NH increased with the complexity of procedures.
Conclusions
This study was the first nationwide multicentric survey to propose RLs for interventional procedures under CT guidance. Heterogeneity of practice in centers were found with different levels of patient doses for the same procedure. The proposed RLs will allow imaging departments to benchmark their practice with others and optimize their protocols.
Key Points
• National reference levels are proposed for 17 categories of interventional procedures under CT guidance.
• Reference levels are useful for benchmarking practices and optimizing protocols.
• Reference levels are proposed for dose length product and the number of helical acquisitions.