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01-10-2020 | Computed Tomography | Computed Tomography

National dose reference levels in computed tomography–guided interventional procedures—a proposal

Authors: Joël Greffier, Gilbert Ferretti, Julia Rousseau, Olivier Andreani, Emilie Alonso, Aymeric Rauch, Romain Gillet, Julien Le Roy, Laurie Cabrol-Faivre, Frederic Douane, Arthur David, Simon Henry, Thibaut Jacques, Xavier Stefanovic, Eric Decoux, Frederic Lafay, Franck Pilleul, Franck Couzon, Claire Boutet, Bernard Woerly, Patrick Baur, Nicolas Sans, Marie Faruch, Aurélie Moussier-Lherm, Lambros Tselikas, Alexis Jacquier, Emeline Bigand, Eric Pessis, Christophe Teriitehau, Florian Magnier, Lucie Cassagnes, Marc Haberlay, David Boutteau, Eric De Kerviler, Cynthia Majorel-Gouthain, Didier Defez, Aurélie Vuillod, Olivier Rouviere, Laurent Hennequin, Audrey Fohlen, Rabih Alwan, Alexandre Malakhia, Sébastien Aubry, Anthony Dohan, Marie Eresue-Bony, Romain Gautier, Romaric Dal, Djamel Dabli, Thomas Hebert, Robert Kovacs, Lama Hadid-Beurrier, Valérie Bousson, Mélody Potel, Yves Barbotteau, Célian Michel, Bouchra Habib-Geryes, Marc André, Thierry Arnaud, Nathalie Bestion, Olivier Ernst, Sylvie Monfraix, Pierre Yves Brillet, Boris Guiu, Loic Boussel, Mathilde Demonchy, Jean Paul Beregi, Julien Frandon

Published in: European Radiology | Issue 10/2020

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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Title: National dose reference levels in computed tomography–guided interventional procedures—a proposal
Authors: Joël Greffier
Gilbert Ferretti
Julia Rousseau
Olivier Andreani
Emilie Alonso
Aymeric Rauch
Romain Gillet
Julien Le Roy
Laurie Cabrol-Faivre
Frederic Douane
Arthur David
Simon Henry
Thibaut Jacques
Xavier Stefanovic
Eric Decoux
Frederic Lafay
Franck Pilleul
Franck Couzon
Claire Boutet
Bernard Woerly
Patrick Baur
Nicolas Sans
Marie Faruch
Aurélie Moussier-Lherm
Lambros Tselikas
Alexis Jacquier
Emeline Bigand
Eric Pessis
Christophe Teriitehau
Florian Magnier
Lucie Cassagnes
Marc Haberlay
David Boutteau
Eric De Kerviler
Cynthia Majorel-Gouthain
Didier Defez
Aurélie Vuillod
Olivier Rouviere
Laurent Hennequin
Audrey Fohlen
Rabih Alwan
Alexandre Malakhia
Sébastien Aubry
Anthony Dohan
Marie Eresue-Bony
Romain Gautier
Romaric Dal
Djamel Dabli
Thomas Hebert
Robert Kovacs
Lama Hadid-Beurrier
Valérie Bousson
Mélody Potel
Yves Barbotteau
Célian Michel
Bouchra Habib-Geryes
Marc André
Thierry Arnaud
Nathalie Bestion
Olivier Ernst
Sylvie Monfraix
Pierre Yves Brillet
Boris Guiu
Loic Boussel
Mathilde Demonchy
Jean Paul Beregi
Julien Frandon
Publication date: 01-10-2020
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: European Radiology / Issue 10/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-06903-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

National dose reference levels in computed tomography–guided interventional procedures—a proposal

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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