TY - JOUR
T1 - Patient Radiation Doses in IR Procedures
T2 - The American College of Radiology Dose Index Registry-Fluoroscopy Pilot
AU - Jones, A. Kyle
AU - Wunderle, Kevin A.
AU - Fruscello, Tom
AU - Simanowith, Michael
AU - Cline, Brendan
AU - Dharmadhikari, Shalmali
AU - Duan, Xinhui
AU - Durack, Jeremy C.
AU - Hirschl, David A.
AU - Kim, Don Soo
AU - Mahmood, Usman
AU - Mann, Steve D.
AU - Martin, Charles
AU - Metwalli, Zeyad
AU - Moirano, Jeffrey M.
AU - Neill, Rebecca A.
AU - Newsome, Janice
AU - Padua, Horacio
AU - Schoenfeld, Alan H.
AU - Miller, Donald L.
N1 - Funding Information:
M.S. and T.F. are employees of the American College of Radiology. J.D. is a board member and past president of the Society of Interventional Radiology Foundation. He is an employee of Ajax Health, which invests in a variety of health care–related companies not discussed in this manuscript; receives consulting fees from Serpex Medical and Adient Medical and travel honorarium from Asia Pacific Society of Cardiovascular and Interventional Radiology; reports a patent on “Spectroscopy based biopsy tissue analysis” and leadership role in the American College of Radiology Interventional Radiology Research Committee; and holds stock or stock options in Cordis, Serpex Medical, Adient Medical, and Inventure. D.L.M. reports support from U.S. Food and Drug Administration and leadership role in the National Council on Radiation Protection and Measurements. X.D. reports grants from the Cancer Prevention and Research Institute of Texas . B.C. receives a fellow grant from the Radiological Society of North America (RSNA) and consulting fees from Philips. S.M. is the Vice Chair of the ACR DIR Fluoroscopy Committee. C.M. receives consulting fees from Boston Scientific, Terumo, and Medtronic and honorarium from the Interventional Radiology Section at University of Colorado; serves as a consultant for Boston Scientific and as the President of the Ohio Radiologic Society. None of the other authors have identified a conflict of interest.
Funding Information:
M.S. and T.F. are employees of the American College of Radiology. J.D. is a board member and past president of the Society of Interventional Radiology Foundation. He is an employee of Ajax Health, which invests in a variety of health care–related companies not discussed in this manuscript; receives consulting fees from Serpex Medical and Adient Medical and travel honorarium from Asia Pacific Society of Cardiovascular and Interventional Radiology; reports a patent on “Spectroscopy based biopsy tissue analysis” and leadership role in the American College of Radiology Interventional Radiology Research Committee; and holds stock or stock options in Cordis, Serpex Medical, Adient Medical, and Inventure. D.L.M. reports support from U.S. Food and Drug Administration and leadership role in the National Council on Radiation Protection and Measurements. X.D. reports grants from the Cancer Prevention and Research Institute of Texas. B.C. receives a fellow grant from the Radiological Society of North America (RSNA) and consulting fees from Philips. S.M. is the Vice Chair of the ACR DIR Fluoroscopy Committee. C.M. receives consulting fees from Boston Scientific, Terumo, and Medtronic and honorarium from the Interventional Radiology Section at University of Colorado; serves as a consultant for Boston Scientific and as the President of the Ohio Radiologic Society. None of the other authors have identified a conflict of interest.
Funding Information:
The authors thank Dustin A. Gress and Judy Burleson, Irene Stephens, and Kay Zacharias-Andrews from the American College of Radiology (ACR) for their support to the DIR-Fluoro pilot study. This pilot study was supported by the National Radiology Data Registry (NRDR) of the ACR. The views expressed in this manuscript represent those of the authors and do not necessarily represent the official views of NRDR or ACR. The authors thank ACR staff for assistance and acknowledge guidance and input by the Dose Index Registry steering committee for supporting the pilot efforts .
Publisher Copyright:
© 2022 SIR
PY - 2023/4
Y1 - 2023/4
N2 - Purpose: To update normative data on fluoroscopy dose indices in the United States for the first time since the Radiation Doses in Interventional Radiology study in the late 1990s. Materials and Methods: The Dose Index Registry-Fluoroscopy pilot study collected data from March 2018 through December 2019, with 50 fluoroscopes from 10 sites submitting data. Primary radiation dose indices including fluoroscopy time (FT), cumulative air kerma (Ka,r), and kerma area product (PKA) were collected for interventional radiology fluoroscopically guided interventional (FGI) procedures. Clinical facility procedure names were mapped to the American College of Radiology (ACR) common procedure lexicon. Distribution parameters including the 10th, 25th, 50th, 75th, 95th, and 99th percentiles were computed. Results: Dose indices were collected for 70,377 FGI procedures, with 50,501 ultimately eligible for analysis. Distribution parameters are reported for 100 ACR Common IDs. FT in minutes, Ka,r in mGy, and PKA in Gy-cm2 are reported in this study as (n; median) for select ACR Common IDs: inferior vena cava filter insertion (1,726; FT: 2.9; Ka,r: 55.8; PKA: 14.19); inferior vena cava filter removal (464; FT: 5.7; Ka,r: 178.6; PKA: 34.73); nephrostomy placement (2,037; FT: 4.1; Ka,r: 39.2; PKA: 6.61); percutaneous biliary drainage (952; FT: 12.4; Ka,r: 160.5; PKA: 21.32); gastrostomy placement (1,643; FT: 3.2; Ka,r: 29.1; PKA: 7.29); and transjugular intrahepatic portosystemic shunt placement (327; FT: 34.8; Ka,r: 813.0; PKA: 181.47). Conclusions: The ACR DIR-Fluoro pilot has provided state-of-the-practice statistics for radiation dose indices from IR FGI procedures. These data can be used to prioritize procedures for radiation optimization, as demonstrated in this work.
AB - Purpose: To update normative data on fluoroscopy dose indices in the United States for the first time since the Radiation Doses in Interventional Radiology study in the late 1990s. Materials and Methods: The Dose Index Registry-Fluoroscopy pilot study collected data from March 2018 through December 2019, with 50 fluoroscopes from 10 sites submitting data. Primary radiation dose indices including fluoroscopy time (FT), cumulative air kerma (Ka,r), and kerma area product (PKA) were collected for interventional radiology fluoroscopically guided interventional (FGI) procedures. Clinical facility procedure names were mapped to the American College of Radiology (ACR) common procedure lexicon. Distribution parameters including the 10th, 25th, 50th, 75th, 95th, and 99th percentiles were computed. Results: Dose indices were collected for 70,377 FGI procedures, with 50,501 ultimately eligible for analysis. Distribution parameters are reported for 100 ACR Common IDs. FT in minutes, Ka,r in mGy, and PKA in Gy-cm2 are reported in this study as (n; median) for select ACR Common IDs: inferior vena cava filter insertion (1,726; FT: 2.9; Ka,r: 55.8; PKA: 14.19); inferior vena cava filter removal (464; FT: 5.7; Ka,r: 178.6; PKA: 34.73); nephrostomy placement (2,037; FT: 4.1; Ka,r: 39.2; PKA: 6.61); percutaneous biliary drainage (952; FT: 12.4; Ka,r: 160.5; PKA: 21.32); gastrostomy placement (1,643; FT: 3.2; Ka,r: 29.1; PKA: 7.29); and transjugular intrahepatic portosystemic shunt placement (327; FT: 34.8; Ka,r: 813.0; PKA: 181.47). Conclusions: The ACR DIR-Fluoro pilot has provided state-of-the-practice statistics for radiation dose indices from IR FGI procedures. These data can be used to prioritize procedures for radiation optimization, as demonstrated in this work.
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U2 - 10.1016/j.jvir.2022.11.003
DO - 10.1016/j.jvir.2022.11.003
M3 - Article
C2 - 36379286
AN - SCOPUS:85144250502
SN - 1051-0443
VL - 34
SP - 544-555.e11
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 4
ER -