Patient radiation exposure during diagnostic and therapeutic interventional neuroradiology procedures

• Published in: Journal of neurointerventional surgery Vol. 2; no. 1; pp. 6 - 10
• Main Authors: Alexander, M D, Oliff, M C, Olorunsola, O G, Brus-Ramer, M, Nickoloff, E L, Meyers, P M
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.03.2010; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Cerebral Angiography - adverse effects; Cerebral Angiography - methods; Data collection; Diagnostic tests; Female; Follow-Up Studies; Humans; Interventions and basic science; Ischemia; Male; Medical imaging; Middle Aged; Mortality; Neuroradiography - adverse effects; Neuroradiography - methods; Patient safety; Radiation Dosage; Radiography, Interventional - adverse effects; Radiography, Interventional - methods; Radiology, Interventional - methods; Retrospective Studies; Stroke; Studies
• ISSN: 1759-8478; 1759-8486
• DOI: 10.1136/jnis.2009.000802

PurposeIncreasing in number and complexity, interventional neuroradiology (INR) procedures are becoming an important source of radiation exposure for patients. In accordance with the ALARA principle, radiation exposure during INR procedures should be curtailed as much as possible while reaching successful treatment outcomes. Moreover, the extent of radiation exposure should be one outcome measure used to assess new technologies and procedural efficacy, and training programs should include techniques for exposure limitation. This study provides a methodology and preliminary data to assess radiation exposure during different INR procedure types.Materials and methodsAll patients undergoing endovascular procedures in two biplanar dedicated neuroangiography suites at a major academic medical center were monitored according to procedure type, pathological indication, fluoroscopy time and machine-generated patient dose estimates between April 2006 and July 2008.Results1678 patients underwent cerebral arteriography during the study period. Women (62.1%) accounted for the majority of patients, but men (38.9%) were more likely to undergo an interventional procedure than women (32.8%). Diagnostic studies accounted for 64.9% of procedures. Variable exposures were found between diagnostic and interventional procedures. Exposure differed depending on indications for the procedure and procedure type.ConclusionRadiation exposure is an increasingly important consideration in the development of minimally invasive neurological procedures including cerebral angiography and INR. The type of procedure and lesion type allow the practitioner to estimate radiation exposure. Such information informs the clinical decision making process. Normative data should be collected and used for comparison purposes as one measure of technical and procedural success.