Radiation exposure in 101 non-coronary fluoroscopically guided interventional procedures: reference levels of air kerma at the reference point and air kerma area product.

OBJECTIVES: To present the median value and 75th percentile of air kerma at the reference point (Ka,r), air kerma-area product (KAP), and fluoroscopic time for a large number of fluoroscopically guided interventional (FGI) procedures.
METHODS: This retrospective study included the consecutive non-coronary FGI procedures from a Radiology department between May 2016 and October 2018 at a large tertiary-care hospital in the U.S. An in-house developed, semi-automated software, integrated with a dictation system, was used to record patient examination information, including Ka,r, KAP and fluoroscopic time. The included patient procedures were categorized into procedure types. A software package R (v. 3.5.1, R Foundation) was used to calculate procedure-specific quartiles of radiation exposure.
RESULTS: Based on analysis of 24,911 FGI cases, median value and 75th percentile are presented for each of Ka,r, KAP and fluoroscopic time for 101 procedures that can act as benchmark for comparison for dose optimization studies.
CONCLUSION: This study provides reference levels ( 50th and 75th percentiles) for a comprehensive list of FGI procedures, reflecting an overall picture of the latest FGI studies for diagnosis, targeted minimally invasive intervention, and therapeutic treatment. ADVANCES IN KNOWLEDGE: This study provides reference levels (50th and 75th percentiles) for the largest number of fluoroscopically guided interventional procedures reported to date (101 procedures), in terms of air kerma at the reference point, air kerma-area product, and fluoroscopic time, among which these quartiles for ≥50 procedures are presented for the first time.