Congress:
EuroSafe Imaging 2020
Keywords:
Fluoroscopy, Catheter arteriography, Radioprotection / Radiation dose, Neuroradiology brain, Action 5 - Performance indicators for radiation protection management, Arterial access, Recanalisation, Stents, Acute, Embolism / Thrombosis, Ischaemia / Infarction, Retrospective, Observational, Performed at one institution
Authors:
M. Cavallari, L. D'Ercole, C. Klersy, E. Lafe, G. Sanfilippo, A. Sgreccia, F. Zappoli Thyrion
DOI:
10.26044/esi2020/ESI-02525
Background/introduction
ICRP publication 135 [1] suggests to derive the typical values (Table 1) where it is apparent that further optimization is being achieved locally, or where no national DRL values exist.
Table1. Typical values, methods of derivation, and areas of application.
Term
|
Area and
facilities surveyed
|
Value in distribution
used to set DRL
|
Application
|
Typical values
|
Healthcare facility consisting of several x-ray rooms or a small number of facilities or single facility linked to a
new technique
|
Median value of the distribution, as there are insufficient data to use the third quartile
|
Local use to identify x-ray units requiring further optimization
|
Using the concept of reference levels to X ray guided interventions raises several problems. In addition to technical variables (patient size, equipment performance and operational technique), procedures are often non-standard for clinical reasons. The complexity of procedure is affected by factors related to the patient’s anatomy and to the severity of the treated pathology.
Since the complexity of the procedure strongly influences patient exposure, it may not be appropriate to develop reference level without taking complexity into account.
Define reference levels related to complexity provides an additional tool for optimization processes in a facility.
The Commission has suggested one possible approach, incorporating the complexity of the interventional procedure, thereby adjusting the DRL value for different patient anatomy, lesion characteristics, and disease severity [1].
The International Atomic Energy Agency (IAEA) provides an example to establish DRL values using procedure complexity in interventional cardiology [2].