Optimisation strategies and justification: an example in uterine artery embolisation for fibroids

Authors: Vetter, S.; Schultz, F. W.; Strecker, E.-P.; Zoetelief, J.

Source: Radiation Protection Dosimetry, Volume 117, Numbers 1-3, 14 March 2006 , pp. 50-53(4)

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Abstract:

Radiation risk has to be justified and optimised. This study discusses the radiation risk of uterine artery embolisation (UAE) for the treatment of fibroids. A total of 70 consecutive UAE dosimetry parameters were assessed. Using Monte Carlo simulation, organ and effective doses and dose conversion coefficients (DCCs) (mSv Gy cm⁻²) were calculated. During UAE optimisation, avoidance of oblique views and use of last-image-hold (LIH) documentation instead of digital subtraction angiography (DSA) were investigated. Mean dose–area product (DAP) was 37.1 Gy cm² (median 23.7 Gy cm²) and mean fluoroscopy time was 18.4 min (median 16.6 min). Dose values decreased as the study progressed: mean DAP for patients 1–21, 68.5 Gy cm²; patients 22–43, 35.7 Gy cm²; and patients 44–69, 13.0 Gy cm². Average DCC for DSA image procedures was 0.572, yielding a mean effective dose of 29.6 mSv (median 17.1 mSv). For LIH-only procedures, an average DCC of 0.813 was estimated [using mean effective dose: 10.6 mSv (median 8.1 mSv)].

Document Type: Research article

DOI: http://dx.doi.org/10.1093/rpd/nci717

Publication date: 2006-03-14

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RPD publishes peer-reviewed papers covering all aspects of personal and environmental dosimetry and monitoring for both ionising and non-ionising radiations. This includes biological aspects, physical concepts, biophysical dosimetry, external and internal personal dosimetry and monitoring, environmental and workplace monitoring and accident dosimetry and dosimetry related to the protection of patients.