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IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
Establishing updated diagnostic reference levels for interventional radiology: a national Italian survey incorporating procedure complexity Indices 为介入放射学建立更新的诊断参考水平:一项纳入程序复杂性指数的意大利全国调查
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01 DOI: 10.1016/j.ejrad.2025.112648
Monica Cavallari , Sveva Grande , Alessandra Palma , Catherine Klersy , Renato Padovani , Antonio Orlacchio , Gaetano Compagnone , Antonella Rosi , Loredana D’Ercole

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.
背景和目的为在意大利立法中落实欧洲原子能共同体理事会第2013/59号指令(D. Lgs 101/2020),要求卫生部与高等卫生研究所(ISS)和相关科学组织合作,促进诊断和介入放射学程序的诊断参考水平(drl)的评估和定期更新。材料和方法本研究介绍了由ISS组织的工作组(WG)在2019年至2022年期间进行的一项调查得出的意大利诊断参考水平的更新。意大利共有53家医院参与其中,其中38家医院协助收集与人体手术有关的数据。这项调查收集了与不同介入放射治疗程序有关的数据:经动脉化疗栓塞(TACE)、血管内动脉瘤修复(EVAR)、经颈静脉肝内门静脉-全身分流术(TIPS)、下肢外周动脉疾病血管成形术和支架植入术(LL)、经皮胆道介入术(PBI)、内镜逆行胆道-胰腺造影(ERCP)、PTA(经皮腔内血管成形术)和/或颈动脉支架植入术和椎体成形术。每个手术收集Air Kerma AT参考点(Ka,r)、Kerma面积积(PKA)和透视时间(FT)。获得TACE、EVAR、PBI、LL和椎体成形术的临床参数。进行PKA多变量分析,以确定哪些参数显著影响剂量学数据,并得出与程序复杂性相关的DRL。结果除TIPS外,每种方法均获得了新的DRL值,其典型值为45 Gy。PBI为cm2, 24gy。l的平方厘米是62gy。PTA和/或颈动脉支架植入术,252gy。TIPS为cm2, 18 Gy。ERCP为134gy。EVAR的平方厘米是91 Gy。cm2椎体成形术,255 Gy。cm2为TACE。根据TACE和EVAR程序的复杂性,建立了DRL。结论:这项全国性调查成功建立了意大利各医院7种介入性身体手术(TACE、EVAR、TIPS、LL、PBI、ERCP、PTA、椎体成形术)的诊断参考水平(drl),通过与国家标准和复杂性分层参考水平的比较,为优化患者辐射暴露提供了系统工具。
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
IF 3.3 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2026-01-01
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引用次数: 0
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European Journal of Radiology
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