Abstract
Objectives
To establish national reference levels (RLs) in interventional procedures under CT guidance as required by the 2013/59/Euratom European Directive.
Methods
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
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.
Conclusions
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.
Key Points
• 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.
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Change history
04 June 2020
The original version of this article, published on 02 May 2020, unfortunately contained a mistake.
Abbreviations
- CT:
-
Computed tomography
- CTDIvol :
-
Volume CT dose index
- DLP:
-
Dose length product
- FRI-SFR:
-
Federation of Interventional Radiology of the French Society of Radiology
- ICRP:
-
International Commission on Radiological Protection
- NH:
-
Total number of helical acquisitions
- RL:
-
Reference level
- SFPM:
-
French Society of Medical Physicists
- TAP:
-
Thorax and abdominopelvic
- TVO:
-
Target value for optimization
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Acknowledgements
The authors are very grateful to the staff of the 49 imaging departments (medical physicists and/or radiologists) who took the time and trouble to collect and check the data. We also thank Sarah Kabani and Teresa Sawyers for their help in editing the manuscript.
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The scientific guarantor of this publication is Jean Paul Beregi.
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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
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• retrospective
• observational
• multicenter study
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The original version of this article was revised: The spelling of Eric De Kerviler’s name was incorrect.
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Greffier, J., Ferretti, G., Rousseau, J. et al. National dose reference levels in computed tomography–guided interventional procedures—a proposal. Eur Radiol 30, 5690–5701 (2020). https://doi.org/10.1007/s00330-020-06903-9
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DOI: https://doi.org/10.1007/s00330-020-06903-9