TY - JOUR
T1 - Patient Radiation Doses in Interventional Radiology Procedures
T2 - Comparison of Fluoroscopy Dose Indices between the American College of Radiology Dose Index Registry-Fluoroscopy Pilot and the Radiation Doses in Interventional Radiology Study
AU - Jones, A. Kyle
AU - Wunderle, Kevin A.
AU - Fruscello, Tom
AU - Simanowith, Michael
AU - Cline, Brendan
AU - Dharmadhikari, Shalmali
AU - Duan, Xinhui
AU - Durack, Jeremy C.
AU - Hirschl, David
AU - Kim, Don Soo
AU - Mahmood, Usman
AU - Mann, Steve D.
AU - Martin, Charles
AU - Metwalli, Zeyad
AU - Moirano, Jeffrey M.
AU - Neill, Rebecca A.
AU - Newsome, Janice
AU - Padua, Horacio
AU - Schoenfeld, Alan H.
AU - Miller, Donald L.
N1 - Funding Information:
D.L.M. reports support from the U.S. Food and Drug Administration and a leadership or fiduciary role in the National Council on Radiation Protection and Measurements. X.D. reports grants from the Cancer Prevention and Research Institute of Texas. J.D. receives consulting fees from Serpex Medical and Adient Medical and travel honorarium from the Asia Pacific Society of Cardiovascular and Interventional Radiology; reports a patent planned on spectroscopy-based biopsy tissue analysis and a leadership or fiduciary role in the Society of Interventional Radiology and American College of Interventional Radiology Research Committee; holds stock or stock options in Cordis, Serpex Medical, and Adient Medical; and is the Chief Clinical Officer for Ajax Health, Cordis Accelerator, and Adient Medical. J.M.M. is the chair of American Association of Physicists in Medicine Spring Clinical Meeting planning committee and receives registration fees from the American Association of Physicists in Medicine. B.C. has received the Radiological Society of North America Fellow grant and reports consulting fees from Philips for testing inferior vena cava filter removal sheath. K.A.W. reports support from the American College of Radiology. S.M. is the Vice Chair of the American College of Radiology Dose Index Registry-Fluoroscopy Committee. C.M. receives consulting fees from Boston Scientific, Terumo, and Medtronic Inc; received an honorarium for a Grand Rounds lecture in the Interventional Radiology Section University of Colorado; serves as a consultant for Boston Scientific—Interventional Radiology Scientific Advisory Board; and serves as the President of the Ohio Radiologic Society, without any remuneration. None of the other authors have identified a conflict of interest.
Funding Information:
D.L.M. reports support from the U.S. Food and Drug Administration and a leadership or fiduciary role in the National Council on Radiation Protection and Measurements. X.D. reports grants from the Cancer Prevention and Research Institute of Texas . J.D. receives consulting fees from Serpex Medical and Adient Medical and travel honorarium from the Asia Pacific Society of Cardiovascular and Interventional Radiology; reports a patent planned on spectroscopy-based biopsy tissue analysis and a leadership or fiduciary role in the Society of Interventional Radiology and American College of Interventional Radiology Research Committee; holds stock or stock options in Cordis, Serpex Medical, and Adient Medical; and is the Chief Clinical Officer for Ajax Health, Cordis Accelerator, and Adient Medical. J.M.M. is the chair of American Association of Physicists in Medicine Spring Clinical Meeting planning committee and receives registration fees from the American Association of Physicists in Medicine. B.C. has received the Radiological Society of North America Fellow grant and reports consulting fees from Philips for testing inferior vena cava filter removal sheath. K.A.W. reports support from the American College of Radiology . S.M. is the Vice Chair of the American College of Radiology Dose Index Registry-Fluoroscopy Committee. C.M. receives consulting fees from Boston Scientific, Terumo, and Medtronic Inc; received an honorarium for a Grand Rounds lecture in the Interventional Radiology Section University of Colorado; serves as a consultant for Boston Scientific—Interventional Radiology Scientific Advisory Board; and serves as the President of the Ohio Radiologic Society, without any remuneration. None of the other authors have identified a conflict of interest.
Publisher Copyright:
© 2022 SIR
PY - 2022
Y1 - 2022
N2 - 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 (Ka,r), and kerma area product (PKA). Two derived indices were computed using median dose indices. The procedure-averaged reference air kerma rate (Ka,r) was computed as Ka,r / FT. The procedure-averaged x-ray field size at the reference point (Ar) was computed as PKA / (Ka,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 Ka,r was lower in the DIR-Fluoro pilot for all procedures, as was median PKA. The maximum Ka,r and PKA were more often higher in the DIR-Fluoro pilot than in the RAD-IR study. Ka,r followed the same pattern as Ka,r, whereas Ar was often greater in DIR-Fluoro. Conclusions: The median dose indices have decreased since the RAD-IR study. The typical Ka,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.
AB - 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 (Ka,r), and kerma area product (PKA). Two derived indices were computed using median dose indices. The procedure-averaged reference air kerma rate (Ka,r) was computed as Ka,r / FT. The procedure-averaged x-ray field size at the reference point (Ar) was computed as PKA / (Ka,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 Ka,r was lower in the DIR-Fluoro pilot for all procedures, as was median PKA. The maximum Ka,r and PKA were more often higher in the DIR-Fluoro pilot than in the RAD-IR study. Ka,r followed the same pattern as Ka,r, whereas Ar was often greater in DIR-Fluoro. Conclusions: The median dose indices have decreased since the RAD-IR study. The typical Ka,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.
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U2 - 10.1016/j.jvir.2022.08.023
DO - 10.1016/j.jvir.2022.08.023
M3 - Article
C2 - 36031041
AN - SCOPUS:85139291391
SN - 1051-0443
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
ER -