Radioprotection No. 60-1 | Page 37

M. Alvarez et al.: Radioprotection 2025, 60( 1), 28 – 36 31

Table 1. Protocol details for each examination with six modalities divided into areas of intervention: coronary, cerebral, and peripheral.

Coronary percutaneous transluminal angioplasty, stent placement, or radiofrequency ablation

Pulse width

Focus

Dose / frame( mGy / fr)

Projections( C-arm Positions)

kV, kilovoltage peak; mmCu, millimeters of copper filtration; RAO, Right Anterior Oblique; LAO, Left Anterior Oblique; AP, Anteroposterior.

3 Results

Table 2 presents an overview of interventional radiology procedures, highlighting number of exams, air kerma( K, measured in mGy), Kerma Area Product( KAP, measured in mGym 2), procedure duration( T, measured in minutes), and the number of exposures taken( N). The first column lists the procedures, as“ Coronary percutaneous transluminal angioplasty, stent placement, or radiofrequency ablation” had the most exams( 526), followed by“ Lower limb arteriography”( 386) and“ Head and / or neck angiography”( 168). The median values for K( air kerma) vary across procedures, with the highest observed in“ Head and / or neck angiography” at 645.5 mGy, while the lowest is seen in“ Coronary angiography( diagnostic)” at 28.0 mGy.

The KAP median values reveal a broader range, with the“ Transjugular intrahepatic portosystemic shunt placement” recording the highest median at 18,794 mGym 2, and the“ Coronary angiography( diagnostic)” showing the lowest median at 625 mGym 2. Similarly, the procedure duration( T) median spans from 2.6 minutes for“ Lower limb arteriography” to 20.2 minutes for“ Thoracic angiography of pulmonary artery or aorta”.

Figure 3 presents a series of boxplots summarizing the distribution of radiation metrics across various fluoroscopically guided interventional procedures. Panel A displays the range of doses( in mGy) absorbed by patients, illustrating substantial variability across procedures with some, like Thoracic Angiography and Abdominal Aortography, reaching up to 2000 mGy. Panel B shows the Kerma-Area Product( KAP) measured in mGy · m 2, where procedures involving higher complexity or longer duration, such as Abdominal

Aortography, again demonstrate elevated values, some exceeding 60,000 mGy · m 2. Panel C details the procedure duration in minutes, highlighting significant procedural duration for Hepatic Artery Embolization and Thoracic Angiography, with times occasionally extending beyond 50 minutes. Finally, Panel D illustrates the number of exposures per procedure, with certain procedures like Thoracic Angiography necessitating upwards of 30 exposures, indicating a higher complexity and possibly greater patient risk.

Table 3 provides a detailed comparison of radiation exposure metrics across various interventional radiology procedures, juxtaposing findings from the present study against reference values from the literature and established standards. The Kerma Area Product( KAP) values and Effective Dose( E) are presented in columns for both the current study and referenced studies, highlighting the variance between them.

For instance, the KAP for coronary percutaneous transluminal angioplasty, stent placement, or radiofrequency ablation from this study is reported at 29.8 Gy · cm 2, which is slightly higher than the reference value of 26.0 Gy · cm 2. Conversely, the KAP for head and / or neck angiography shows a significant increase in the present study, 163.9 Gy · cm 2, compared to the referenced 14.1 Gy · cm 2. This may be due the routine use of 3D Cone Beam acquisitions, which were not cited in the reference literature( Aroua et al., 2007).

Effective dose( E) measurements in the present study also show substantial agreement from referenced data, with the most notable disparity observed in abdominal angiography or aortography, where the present study’ s value is 30.5 mSv compared to 73.9 mSv from the literature, which may be due the lower number of CINE acquisitions used in our institution.