Slave Oneile, Mahomed Nasreen
Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
SA J Radiol. 2023 Jan 19;27(1):2559. doi: 10.4102/sajr.v27i1.2559. eCollection 2023.
Interventional radiology (IR) is becoming more relevant in patient care and is associated with increased patient radiation exposure and radiation-induced adverse effects. Diagnostic reference levels (DRLs) are crucial for radiation control. There is a paucity of published DRLs for IR in South Africa and sub-Saharan Africa.
This study aimed to determine local DRLs for fluoroscopically-guided IR procedures and compare the achieved DRLs with published local and international DRLs.
Retrospective, descriptive, single-centre study. Kerma air product (KAP), reference point air kerma (K) and fluoroscopy time (FT) were collected for patients (12 years and older) who underwent IR procedures at a university hospital from 01 January 2019 to 31 December 2019. The 75th percentile of the distribution of each dose parameter (KAP, K and FT) per procedure was calculated and taken as the local diagnostic reference levels (LDRL). The established LDRLs were compared to published DRLs.
A total of 564 cases were evaluated. The 13 most frequent procedures (with 15 or more cases) represented 86.1% (487/564). Percutaneous transhepatic biliary drainage was the most common procedure ( = 146, 25.9%). Diagnostic cerebral angiogram DRLs exceeded the published DRL data ranges for all parameters (DRL 209.3), and interventional cerebral angiogram exceeded published ranges (DRL 275). Uterine artery embolisation (UAE) exceeded these ranges for KAP and K. (KAP-954.9 Gy/cm, K-2640.8 mGy).
The LDRLs for diagnostic cerebral angiogram, interventional cerebral angiogram and UAE exceeded published international DRL ranges. These procedures require radiation optimisation as recommended by the International Commission on Radiological Protection (ICRP).
In addition to informing radiation protection practices at the level of the institution, the established LDRLs contribute towards Regional and National DRLs.
介入放射学在患者护理中的作用日益重要，且与患者辐射暴露增加及辐射诱发的不良反应相关。诊断参考水平（DRLs）对于辐射控制至关重要。在南非和撒哈拉以南非洲，关于介入放射学的已发表诊断参考水平较少。
本研究旨在确定荧光镜引导下介入放射学程序的本地诊断参考水平，并将所达到的诊断参考水平与已发表的本地和国际诊断参考水平进行比较。
回顾性、描述性单中心研究。收集了2019年1月1日至2019年12月31日在一家大学医院接受介入放射学程序的12岁及以上患者的空气比释动能积（KAP）、参考点空气比释动能（K）和透视时间（FT）。计算每个程序的每个剂量参数（KAP、K和FT）分布的第75百分位数，并将其作为本地诊断参考水平（LDRL）。将既定的本地诊断参考水平与已发表的诊断参考水平进行比较。
共评估了564例病例。13种最常见的程序（病例数为15例或更多）占86.1%（487/564）。经皮经肝胆道引流是最常见的程序（=146，25.9%）。诊断性脑血管造影的诊断参考水平在所有参数上均超过已发表的诊断参考水平数据范围（诊断参考水平209.3），介入性脑血管造影超过已发表范围（诊断参考水平275）。子宫动脉栓塞术（UAE）在KAP和K方面超过了这些范围。（KAP - 954.9 Gy/cm，K - 2640.8 mGy）。
诊断性脑血管造影、介入性脑血管造影和子宫动脉栓塞术的本地诊断参考水平超过了已发表的国际诊断参考水平范围。这些程序需要按照国际放射防护委员会（ICRP）的建议进行辐射优化。
既定的本地诊断参考水平除了为机构层面的辐射防护实践提供信息外，还对区域和国家诊断参考水平有所贡献。
