Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Oct;30(10):5690-5701.
doi: 10.1007/s00330-020-06903-9. Epub 2020 May 2.

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

Joël Greffier  1 , Gilbert Ferretti  2 , Julia Rousseau  2 , Olivier Andreani  3 , Emilie Alonso  3 , Aymeric Rauch  4 , Romain Gillet  4 , Julien Le Roy  5 , Laurie Cabrol-Faivre  5 , Frederic Douane  6 , Arthur David  6 , Simon Henry  7 , Thibaut Jacques  7 , Xavier Stefanovic  8 , Eric Decoux  8 , Frederic Lafay  9 , Franck Pilleul  10 , Franck Couzon  11 , Claire Boutet  11 , Bernard Woerly  12 , Patrick Baur  12 , Nicolas Sans  13 , Marie Faruch  13 , Aurélie Moussier-Lherm  14 , Lambros Tselikas  15 , Alexis Jacquier  16 , Emeline Bigand  16 , Eric Pessis  17 , Christophe Teriitehau  17 , Florian Magnier  18 , Lucie Cassagnes  18 , Marc Haberlay  19 , David Boutteau  19 , Eric De Kerviler  20 , Cynthia Majorel-Gouthain  21   22 , Didier Defez  21 , Aurélie Vuillod  21   23 , Olivier Rouviere  22 , Laurent Hennequin  24 , Audrey Fohlen  25 , Rabih Alwan  26 , Alexandre Malakhia  26 , Sébastien Aubry  26 , Anthony Dohan  27 , Marie Eresue-Bony  28 , Romain Gautier  28 , Romaric Dal  29 , Djamel Dabli  30 , Thomas Hebert  31 , Robert Kovacs  32 , Lama Hadid-Beurrier  33 , Valérie Bousson  33 , Mélody Potel  34 , Yves Barbotteau  35 , Célian Michel  36 , Bouchra Habib-Geryes  37 , Marc André  38 , Thierry Arnaud  39 , Nathalie Bestion  39   40 , Olivier Ernst  41 , Sylvie Monfraix  42 , Pierre Yves Brillet  43 , Boris Guiu  44 , Loic Boussel  23 , Mathilde Demonchy  45 , Jean Paul Beregi  46 , Julien Frandon  46
Affiliations
Multicenter Study

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

Joël Greffier et al. Eur Radiol. 2020 Oct.

Erratum in

  • Correction to: National dose reference levels in computed tomography-guided interventional procedures-a proposal.
    Greffier J, Ferretti G, Rousseau J, Andreani O, Alonso E, Rauch A, Gillet R, Le Roy J, Cabrol-Faivre L, Douane F, David A, Henry S, Jacques T, Stefanovic X, Decoux E, Lafay F, Pilleul F, Couzon F, Boutet C, Woerly B, Baur P, Sans N, Faruch M, Moussier-Lherm A, Tselikas L, Jacquier A, Bigand E, Pessis E, Teriitehau C, Magnier F, Cassagnes L, Haberlay M, Boutteau D, De Kerviler E, Majorel-Gouthain C, Defez D, Vuillod A, Rouviere O, Hennequin L, Fohlen A, Alwan R, Malakhia A, Aubry S, Dohan A, Eresue-Bony M, Gautier R, Dal R, Dabli D, Hebert T, Kovacs R, Hadid-Beurrier L, Bousson V, Potel M, Barbotteau Y, Michel C, Habib-Geryes B, André M, Arnaud T, Bestion N, Ernst O, Monfraix S, Brillet PY, Guiu B, Boussel L, Demonchy M, Beregi JP, Frandon J. Greffier J, et al. Eur Radiol. 2020 Nov;30(11):6384-6386. doi: 10.1007/s00330-020-06948-w. Eur Radiol. 2020. PMID: 32500191

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.

Keywords: Multidetector computed tomography; Physics; Radiation exposure; Radiology, interventional.

PubMed Disclaimer

Publication types

MeSH terms