Local diagnostic reference levels for angiographic and fluoroscopic procedures: Australian practice.

Although diagnostic and interventional fluoroscopic procedures are amongst the highest dose examinations performed in radiology, these procedures currently lack established national diagnostic reference levels (DRLs) in Australia. In this absence, local diagnostic reference levels (LDRLs) are proposed for a wide range of diagnostic and interventional angiographic and fluoroscopic procedures based upon data collected from 11,000 examinations, performed over a 2.5 year period at a major Australian public, teaching hospital. Each procedure type assessed included a minimum of 50 cases. LDRLs were defined for each procedure in terms of the 75th percentile of the dose area product and median fluoroscopic times have also been provided. The detailed categories of procedures used in this study may inform the Australian Radiation Protection and Nuclear Safety Agency when establishing national DRLs for angiographic and fluoroscopic procedures. Until national DRLs for these complex procedures are available, these LDRLs may provide guidance to other institutions on achievable dose levels.