EuroSafe Imaging 2020
Performed at one institution, Observational, Prospective, Dosimetric comparison, Embolisation, Dosimetry, Angioplasty, Percutaneous, Catheter arteriography, Interventional vascular, Interventional non-vascular, Action 4 - Dose management systems
A. Klepanec, D. Salat, L. Janosikova, J. Harsany, M. Hoferica, P. Janega
Description of activity and work performed
We retrospectively analysed data which we have collected prospectively from October 2017 till January 2019 from 484 different interventional radiological procedures (35 aortoiliac interventions, 137 femoropopliteal and below-the knee interventions, 117 arteriovenous fistula (AVF) interventions, 12 biliary interventions, 13 transjugular intrahepatic portosystemic shunts (TIPS), 41 visceral embolisations, 15 uterine fibroid embolisations (UFE), 20 renal artery stentings, 94 carotid artery stentings). All procedures were performed using single plane flat detector angiography system Innova IGS 540 (GE HealthCare, Buc, France) installed with DQC (Dose Quality Control) system (URO, Slovakia) a system invented for auto-collection of patient´s radiation dose data from different X-ray modalities. Default settings were set for fluoroscopy in different interventional radiology procedures for 2fps or 7.5 fps and multisegment digital subtraction angiography (DSA) with variable framerate (4, 2, or 1 fps for the different segments). The collected data for vascular and non-vascular interventional radiological procedures included total DAP (Gycm2), cumulative air kerma (mGy), fluoroscopy DAP (Gy cm2), fluoroscopy dose (mGy), fluoroscopy time (min), acquisition DAP (Gy cm2), acquisition dose (mGy), acquisition time (seconds) and number of images during acquisition radiography for each patient undergoing thrombectomy using the reference dose quantities provided by machines with the system calculating effective dose using conversion. Data were obtained from two interventional radiologist with real-time dosimetry system attached outside their protective lead apron to the left breast pocket by Raysafe i3 system (Unfors RaySafe AB, Sweden).
Mean operator dose from real time dosimetry ranged from 4,69±0,37 µSv in carotid artery stenting procedures till 98,23±19,18 µSv in TIPS procedures. For patients, mean total DAP ranged from 217,74±50,29 Gy cm2 in AVF interventions till 11892,1±1788,3 Gy cm2 in embolisations. Cumulative air kerma ranged from 13,19±4,15 mGy in AVF interventions till 668,93±88,32 mGy in embolisations. Fluoroscopy time ranged from 5,74±0,36 minutes in AVF interventions till 22,28±2,27 minutes in TIPS procedures.