Heilmaier Christina, Zuber Niklaus, Berthold Christian, Kara Levent, Weishaupt Dominik
Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland.
Department of Radiology and Nuclear Medicine, Stadtspital Triemli Zurich, Birmensdorferstrasse 497, CH-8063 Zurich, Switzerland.
J Vasc Interv Radiol. 2017 Mar;28(3):429-441. doi: 10.1016/j.jvir.2016.10.006. Epub 2016 Dec 26.
To obtain local diagnostic reference levels (DRLs) in diagnostic and therapeutic IR procedures with dose management software to improve radiation protection.
Dose data of various vascular and nonvascular IR procedures performed within 18 months were collected and analyzed with dose management software. To account for different levels of complexity, procedures were subdivided into simple, standard, and difficult procedures as graded by interventional radiologists. Based on these analyses, local DRLs (given as kerma-area product [KAP]) were proposed. Comparison with dose data of others was conducted, and Spearman correlation coefficients were calculated to evaluate relationships between dose metrics.
Analysis included 1,403 IR procedures (simple/standard/difficult, n = 346/702/355). Within the same procedure, KAP tended to increase with level of complexity. Overall, very strong correlation between KAP (Gy ∙ cm) and cumulative air kerma (K; Gy) was observed, and moderate to strong correlation between KAP and time and K and time was observed. For simple procedures, strong correlation was seen between KAP and time and K and time; for standard and difficult procedures, only moderate correlation was seen. Correlation between KAP and time and K and time was strong in nonvascular procedures but only moderate in vascular procedures.
Dose management software can be used to derive local DRLs for various IR procedures, taking into consideration different levels of complexity. Proposed local DRLs can contribute to obtaining detailed national DRLs as part of efforts to improve patients' radiation protection further.
利用剂量管理软件获取诊断和治疗性介入放射学程序中的局部诊断参考水平（DRLs），以改善辐射防护。
收集18个月内进行的各种血管和非血管介入放射学程序的剂量数据，并用剂量管理软件进行分析。为了考虑不同的复杂程度，介入放射科医生将程序分为简单、标准和困难程序。基于这些分析，提出了局部DRLs（以比释动能面积乘积[KAP]表示）。与其他机构的剂量数据进行比较，并计算Spearman相关系数以评估剂量指标之间的关系。
分析包括1403例介入放射学程序（简单/标准/困难，n = 346/702/355）。在同一程序中，KAP往往随着复杂程度的增加而升高。总体而言，观察到KAP（Gy∙cm）与累积空气比释动能（K；Gy）之间存在非常强的相关性，并且观察到KAP与时间以及K与时间之间存在中度至强相关性。对于简单程序，KAP与时间以及K与时间之间存在强相关性；对于标准和困难程序，仅观察到中度相关性。KAP与时间以及K与时间之间的相关性在非血管程序中很强，但在血管程序中仅为中度。
剂量管理软件可用于推导各种介入放射学程序的局部DRLs，同时考虑不同的复杂程度。提议的局部DRLs有助于获得详细的国家DRLs，作为进一步改善患者辐射防护工作的一部分。
