Radioprotection No. 60-1 | Page 38

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

Table 2. Median, mean and third quartile values for K, KAP, T, and N. Procedure

Number of exams

K( mGy) KAP( mGym 2) T( minutes) Number of Exposures Mean Median Q Mean Median Q Mean Median Q Mean Median Q

K, Air Kerma( mGy); KAP, Kerma-Area Product( mGym 2); T, Procedure duration( minutes); N, Number of exposures.

The associated error(%) presented in Table 3 was calculated based on the percentage difference between the value from the Present Study and the NCRP 160 reference value using the following equation( 2):

Associated Error ð % Þ!

Present Study ðDCCEÞ�NCRP 160 ðDCCEÞ ¼

100 NCRP 160 ðDCCEÞ ð2Þ where:

– Present Study( DCCE) refers to the value of the Dose Cumulative Corresponding Exposure( DCCE) determined in the current study.

– NCRP 160( DCCE) refers to the value of the Dose Cumulative Corresponding Exposure( DCCE) as reported in the NCRP 160 report.

4 Discussion

The original OCR software met the development proposal, accurately extracting information from PNG images and being a valuable tool for controlling doses in equipment whose value is not available in DICOM headers. The use of Monte Carlo simulations to estimate the Effective Dose in interventional radiology procedures has already been discussed by Aroua et al.( 2007). The authors determined through a study with a polymethyl methacrylate( PMMA) simulator and Monte Carlo simulations that a simple conversion factor can be used for estimates of E through KAP values. The advantage of the method proposed in the present study is the semi-automatic collection of data, without the need for on-site presence, providing agility to the radiology safety officer staff.

The data presented in Table 1 provide insight into the typical radiation doses patients might receive during such procedures and serve as a potential benchmark for future studies and dose management.

As expected, our findings indicate that the median Kermaarea product( KAP) and median exposure time vary significantly depending on the complexity and duration of the procedures. For instance, procedures such as thoracic angiography and abdominal aortography demonstrate higher median KAP values, which is reflective of their intricate nature and the necessity for prolonged fluoroscopy time.

The mean KAP values reported here can be instrumental in setting dose thresholds within radiation management programs, especially when considering the 75th percentile as a reference point. This is aligned with the Joint Commission’ s requirements for radiation dose management and can contribute to establishing standards that ensure patient safety without compromising diagnostic efficacy.

Notably, the majority of procedures have median effective doses that exceed the annual background radiation, indicating the importance of judicious use of fluoroscopy to minimize patient radiation exposure. Despite this, the median values for many procedures remain below dose levels associated with increased risk for radiation injury, which underscores the effectiveness of current radiation safety practices in interventional radiology.

Regarding radiation injury, the ICRP suggests that doses to the skin above 2 Gy can lead to deterministic effects such as erythema and hair removal, with higher doses potentially causing more severe injuries such as necrosis. Our study shows that procedures such as thoracic angiography and abdominal aortography, which have higher KAP values and exposure times, are more likely to reach these dose levels if not carefully monitored. This demonstrates the importance of maintaining rigorous radiological safety protocols and continuous monitoring to ensure that doses are kept as low as reasonably achievable( ALARA) while achieving the desired clinical outcomes, reaffirming the effectiveness of our current radiological practices.