RADIATION EXPOSURE TO PATIENTS AND PERSONNEL DURING INTERVENTIONAL ERCP AT A TEACHING INSTITUTION

Background: This study was designed to determine the radiation dose to patients and personnel during ERCP procedures. Methods: Phantom studi es were performed to compare dosimetry for two image capture systems a nd to determine the effectiveness of shielding in reducing stray radia tion. Radiation techniques and dosimetry were recorded in 72 patients undergoing ERCP. Results: Phantom studies indicated that increasing fl uoroscopy voltage from 75 to 96 kV decreased entrance dose by 50%. Ima ge capture by digital radiography decreased radiation exposure by 66%. Shielding decreased stray radiation exposure by 93%. All patients und erwent cholangiography (n = 71) and/or pancreatography (n = 53). The m ean number of interventional ERCP procedures performed per patient was 1.8(range, 0 to 6). The mean measured patient entrance dose was 80 mG y (8 R; range, 0.2 to 73 R); however, the calculated mean entrance dos e (based on measured intensifying screen doses) may have been as high as 3000 mGy (30 R; range, 0.8 to 300 R). Measured patient exposure inc reased with fluoroscopy time (r = 0.9) and with the number of interven tions performed (r = 0.3). The mean dose to personnel was estimated at 0.04 mR. Conclusions: The patient radiation dose depended most on flu oroscopy time. The dose may be lowered by minimizing fluoroscopy time, using higher voltage and lower current for fluoroscopy, and using dig ital radiography for documentation. Personnel were adequately protecte d.