Background and Purpose
The implementation of Euratom Council Directive 2013/59 into Italian legislation (D. Lgs 101/2020) requires the Ministry of Health, in collaboration with the Istituto Superiore di Sanità (ISS) and relevant scientific organizations, to facilitate the evaluation and regular updating of Diagnostic Reference Levels (DRLs) for procedures in diagnostic and interventional radiology.
Materials and methods
This study presents the update of the Italian Diagnostic Reference Levels derived from a survey conducted between 2019 and 2022 by a Working Group (WG) organized by ISS. A total of 53 hospitals across Italy were involved, of which 38 contributed to data collection related to body procedures. The survey concerned the collection of data related to different interventional radiology procedures: Trans-Arterial Chemo Embolization (TACE), EndoVascular Aneurysms Repair (EVAR), Transjugular Intrahepatic Porto-systemic Shunt (TIPS), Angioplasty and stenting for peripheral arterial disease of the lower limbs (LL), Percutaneous Biliary Interventions (PBI), Endoscopic Retrograde Cholangio-Pancreatography (ERCP), PTA (Percutaneous Transluminal Angioplasty) and/or Carotid stenting and Vertebroplasty. For each procedure, Air Kerma AT REFERENCE POINT(Ka,r), Kerma Area Product (PKA) and Fluoroscopy Time (FT) were collected. Clinical parameters were obtained for TACE, EVAR, PBI, LL and Vertebroplasty, too. A PKA multivariable analysis was performed to identify which parameters significantly influence the dosimetric data and to derive DRL related to procedure complexity.
Results
New DRL values were derived for each of these procedures, except for TIPS, for which the typical value was used: 45 Gy.cm2 for PBI, 24 Gy.cm2 for LL, 62 Gy.cm2 for PTA and/or Carotid stenting, 252 Gy.cm2 for TIPS, 18 Gy.cm2 for ERCP, 134 Gy.cm2 for EVAR, 91 Gy.cm2 for Vertebroplasty and 255 Gy.cm2 for TACE. DRL were also established according to the complexity of the procedure for TACE and EVAR.
Conclusion
This national survey successfully established diagnostic reference levels (DRLs) for seven interventional body procedures (TACE, EVAR, TIPS, LL, PBI, ERCP, PTA, Vertebroplasty) across Italian hospitals, providing facilities with systematic tools to optimize patient radiation exposure through comparison with national values and complexity-stratified reference levels.
扫码关注我们
求助内容:
应助结果提醒方式:
