1. National dose reference levels in computed tomography–guided interventional procedures—a proposal
- Author
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Patrick Baur, Olivier Rouvière, Arthur David, Robert Kovacs, Marie Eresue-Bony, Alexandre Malakhia, Romaric Dal, Olivier Andreani, Audrey Fohlen, Eric de Kerviler, Marie Faruch, Mathilde Demonchy, Eric Decoux, Laurie Cabrol-Faivre, Julien Le Roy, Lambros Tselikas, Célian Michel, Lucie Cassagnes, Frederic Lafay, Anthony Dohan, Claire Boutet, Emeline Bigand, Aurélie Vuillod, Christophe Teriitehau, Lama Hadid-Beurrier, Romain Gillet, Thierry Arnaud, Djamel Dabli, Yves Barbotteau, Rabih Alwan, J. Frandon, Bernard Woerly, Nathalie Bestion, Emilie Alonso, Xavier Stefanovic, Valérie Bousson, Simon Henry, Pierre Yves Brillet, Boris Guiu, Cynthia Majorel-Gouthain, Franck Couzon, Alexis Jacquier, Joël Greffier, Mélody Potel, F. Pilleul, Thibaut Jacques, Loic Boussel, Didier Defez, Aymeric Rauch, Nicolas Sans, Eric Pessis, Aurélie Moussier-Lherm, Marc Andre, Jean Paul Beregi, Olivier Ernst, Frederic Douane, Laurent Hennequin, Thomas Hebert, Romain Gautier, Gilbert Ferretti, Sylvie Monfraix, Bouchra Habib-Geryes, Julia Rousseau, Sébastien Aubry, David Boutteau, Marc Haberlay, Florian Magnier, RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Adolescent ,Biopsy ,Computed tomography ,Radiation Dosage ,Radiography, Interventional ,030218 nuclear medicine & medical imaging ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Reference Values ,Surveys and Questionnaires ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Neuroradiology ,Aged, 80 and over ,Vertebroplasty ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Interventional radiology ,General Medicine ,Middle Aged ,Spine ,3. Good health ,Quartile ,Fluoroscopy ,030220 oncology & carcinogenesis ,Total dose ,Female ,France ,Radiology ,Tomography, X-Ray Computed ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
To establish national reference levels (RLs) in interventional procedures under CT guidance as required by the 2013/59/Euratom European Directive. 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 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. 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. • 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.
- Published
- 2020