Patient radiation dose in percutaneous biliary interventions: recommendations for DRLs on the basis of a multicentre study
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Patient radiation dose in percutaneous biliary interventions: recommendations for DRLs on the basis of a multicentre study. / Schmitz, Daniel; Vogl, Thomas; Nour-Eldin, Nour-Eldin Abdelrehim; Radeleff, Boris; Kröger, Jens-Christian; Mahnken, Andreas H; Ittrich, Harald; Gehl, Hans-Björn; Plessow, Bernd; Böttcher, Joachim; Tacke, Josef; Wispler, Markus; Rosien, Ulrich; Schorr, Wolfgang; Joerdens, Markus; Glaser, Nicolas; Fuchs, Erik-Sebastian; Tal, Andrea; Friesenhahn-Ochs, Bettina; Leimbach, Thomas; Höpner, Lars; Weber, Marko; Gölder, Stefan; Böhmig, Michael; Hetjens, Svetlana; Rudi, Jochen; Schegerer, Alexander.
in: EUR RADIOL, Jahrgang 29, Nr. 7, 07.2019, S. 3390-3400.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Patient radiation dose in percutaneous biliary interventions: recommendations for DRLs on the basis of a multicentre study
AU - Schmitz, Daniel
AU - Vogl, Thomas
AU - Nour-Eldin, Nour-Eldin Abdelrehim
AU - Radeleff, Boris
AU - Kröger, Jens-Christian
AU - Mahnken, Andreas H
AU - Ittrich, Harald
AU - Gehl, Hans-Björn
AU - Plessow, Bernd
AU - Böttcher, Joachim
AU - Tacke, Josef
AU - Wispler, Markus
AU - Rosien, Ulrich
AU - Schorr, Wolfgang
AU - Joerdens, Markus
AU - Glaser, Nicolas
AU - Fuchs, Erik-Sebastian
AU - Tal, Andrea
AU - Friesenhahn-Ochs, Bettina
AU - Leimbach, Thomas
AU - Höpner, Lars
AU - Weber, Marko
AU - Gölder, Stefan
AU - Böhmig, Michael
AU - Hetjens, Svetlana
AU - Rudi, Jochen
AU - Schegerer, Alexander
PY - 2019/7
Y1 - 2019/7
N2 - OBJECTIVE: Percutaneous biliary interventions (PBIs) can be associated with a high patient radiation dose, which can be reduced when national diagnostic reference levels (DRLs) are kept in mind. The aim of this multicentre study was to investigate patient radiation exposure in different percutaneous biliary interventions, in order to recommend national DRLs.METHODS: A questionnaire asking for the dose area product (DAP) and the fluoroscopy time (FT) in different PBIs with ultrasound- or fluoroscopy-guided bile duct punctures was sent to 200 advanced care hospitals. Recommended national DRLs are set at the 75th percentile of all DAPs.RESULTS: Twenty-three facilities (9 interventional radiology depts. and 14 gastroenterology depts.) returned the questionnaire (12%). Five hundred sixty-five PBIs with 19 different interventions were included in the analysis. DAPs (range 4-21,510 cGy·cm2) and FTs (range 0.07-180.33 min) varied substantially depending on the centre and type of PBI. The DAPs of initial PBIs were significantly (p < 0.0001) higher (median 2162 cGy·cm2) than those of follow-up PBIs (median 464 cGy·cm2). There was no significant difference between initial PBIs with ultrasound-guided bile duct puncture (2162 cGy·cm2) and initial PBIs with fluoroscopy-guided bile duct puncture (2132 cGy·cm2) (p = 0.85). FT varied substantially (0.07-180.33 min).CONCLUSIONS: DAPs and FTs in percutaneous biliary interventions showed substantial variations depending on the centre and the type of PBI. PBI with US-guided bile duct puncture did not reduce DAP, when compared to PBI with fluoroscopy-guided bile duct puncture. National DRLs of 4300 cGy·cm2 for initial PBIs and 1400 cGy·cm2 for follow-up PBIs are recommended.KEY POINTS: • DAPs and FTs in percutaneous biliary interventions showed substantial variations depending on the centre and the type of PBI. • PBI with US-guided bile duct puncture did not reduce DAP when compared to PBI with fluoroscopy-guided bile duct puncture. • DRLs of 4300 cGy·cm2for initial PBIs (establishing a transhepatic tract) and 1400 cGy·cm2for follow-up PBIs (transhepatic tract already established) are recommended.
AB - OBJECTIVE: Percutaneous biliary interventions (PBIs) can be associated with a high patient radiation dose, which can be reduced when national diagnostic reference levels (DRLs) are kept in mind. The aim of this multicentre study was to investigate patient radiation exposure in different percutaneous biliary interventions, in order to recommend national DRLs.METHODS: A questionnaire asking for the dose area product (DAP) and the fluoroscopy time (FT) in different PBIs with ultrasound- or fluoroscopy-guided bile duct punctures was sent to 200 advanced care hospitals. Recommended national DRLs are set at the 75th percentile of all DAPs.RESULTS: Twenty-three facilities (9 interventional radiology depts. and 14 gastroenterology depts.) returned the questionnaire (12%). Five hundred sixty-five PBIs with 19 different interventions were included in the analysis. DAPs (range 4-21,510 cGy·cm2) and FTs (range 0.07-180.33 min) varied substantially depending on the centre and type of PBI. The DAPs of initial PBIs were significantly (p < 0.0001) higher (median 2162 cGy·cm2) than those of follow-up PBIs (median 464 cGy·cm2). There was no significant difference between initial PBIs with ultrasound-guided bile duct puncture (2162 cGy·cm2) and initial PBIs with fluoroscopy-guided bile duct puncture (2132 cGy·cm2) (p = 0.85). FT varied substantially (0.07-180.33 min).CONCLUSIONS: DAPs and FTs in percutaneous biliary interventions showed substantial variations depending on the centre and the type of PBI. PBI with US-guided bile duct puncture did not reduce DAP, when compared to PBI with fluoroscopy-guided bile duct puncture. National DRLs of 4300 cGy·cm2 for initial PBIs and 1400 cGy·cm2 for follow-up PBIs are recommended.KEY POINTS: • DAPs and FTs in percutaneous biliary interventions showed substantial variations depending on the centre and the type of PBI. • PBI with US-guided bile duct puncture did not reduce DAP when compared to PBI with fluoroscopy-guided bile duct puncture. • DRLs of 4300 cGy·cm2for initial PBIs (establishing a transhepatic tract) and 1400 cGy·cm2for follow-up PBIs (transhepatic tract already established) are recommended.
KW - Adult
KW - Biliary Tract/diagnostic imaging
KW - Biliary Tract Surgical Procedures/methods
KW - Female
KW - Fluoroscopy/statistics & numerical data
KW - Germany
KW - Humans
KW - Male
KW - Radiation Dosage
KW - Radiation Exposure/statistics & numerical data
KW - Radiography, Interventional/statistics & numerical data
KW - Radiology, Interventional/standards
KW - Reference Values
KW - Retrospective Studies
KW - Stents
U2 - 10.1007/s00330-019-06208-6
DO - 10.1007/s00330-019-06208-6
M3 - SCORING: Review article
C2 - 31016441
VL - 29
SP - 3390
EP - 3400
JO - EUR RADIOL
JF - EUR RADIOL
SN - 0938-7994
IS - 7
ER -