[OA099] Patient dose evaluation and optimization during hysterosalpingography using digital X_ray equipment. (August 2018)

• Record Type: Journal Article
• Authors: Cretti, Fabiola; Perugini, Giovanna; Lando, Bruno
• Is Part Of: Physica medica. Volume 52(2018)Supplement 1
• Page Start: 38
• Page End: 39
• Publication Date: 2018-08
• Subjects: Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2018.06.171
• Languages: English
• ISSNs: 1120-1797

Abstract

Abstract : Introduction: Hysterosalpingography (HSG) is the radiological examination of the uterus and fallopian tubes and is most primarily used to evaluate tubal patency in healthy patients of child bearing age with infertility. In light of ICRP (International Commission on Radiological Protection) recommendations and Italian Legislation concerning the protection of individuals against ionizing radiation risk related to medical exposure, the present work aimed at monitoring and optimizing the radiation dose imparted to patients undergoing this procedure. Materials and Methods: A first survey was carried out in our radiology department, collecting data from 31 subjects during HSG, carried out using digital equipment (model Opera, Housing GMM, Italy, with over-couch tube, CsI flat panel detector Thales, model Pixium RAD 4343 with pixel size 148 μ m, Automatic Exposure Control). Data showed a wide variability, with the mean DAP (Dose Area Product) being higher than those reported by other authors[1] from other departments, suggesting need for optimization. After intervention (consisting in reducing the field size, the fluoroscopy time and the number of radiographs) a new group of 53 subjects was monitored, showing significant DAP reduction. ESAKs (Entrance Surface Air Kerma – free in air) – calculated by using normalized radiation output (previously assessed during quality controls), current*time product (recorded during HSG) and source-skin distance – were converted to dose to ovaries by using appropriate coefficients. Also ED (effective dose) was evaluated. Results: Mean DAP decreased from 3348 to 634 mGy*cm 2 . The 75th percentile of the DAP distribution, 800 mGy*cm 2, was adopted as Institutional Diagnostic Reference Level. Mean estimated dose to ovaries was about 0.8 mGy and mean effective dose was about 0.3 mSv. Conclusions: Periodic review of the procedures, in light of both technological advances and clinical requests, is necessary in order to improve clinical practice with guaranteed patient safety.