RADIATION EXPOSURE IN DIAGNOSTIC AND THER APEUTIC ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATICOGRAPHY [ERCP]

The increasing expansion of diagnostic and, in particular, of therapeu tic ERCP calls for greater consideration of the radiation dose to whic h the investigator and assistant personal are exposed and emphasizes t he question of additional radiation protection measures such as leadsh ielded glasses and thyroid protection. Materials and methods: Local ra diation doses were measured in 19 ERCP sessions at head level of the e ndoscopist, assistant staff and the radiologist, respectively. The flu oroscopic time, the area dose product (ADP) and the measuring height w ere recorded. A quotient based on the measured local dose and the ADP was formed which includes all variables having an effect on the scatte red radiation. Using this quotient and the known ADP-values radiation exposure levels were mapped over a period of three months and then ext rapolated to obtain the annual dose. Results: Not only the FT but also the ADP, the measuring height, and the source-image-distance (SID) ar e found to influence the magnitude of the radiation dose to which the investigator and his assistants are exposed at head level. For an assu med rate of 1200 ERCPs per year a median radiation at head level of 16 .5 mSv/a is calculated for the investigator, and a corresponding head- level dose of 5.5 mSv/a for the assistants. This shows that the eye do se to which the investigator (and his assistants) are exposed amounts to 10% (5%) and the thyroid dose to 5% (1.5%) of the legally prescribe d limit dose. If fewer ERCPs are performed, or if the investigations a re divided up among several doctors and assistants, radiation exposure is reduced accordingly. Conclusions: Under the prevailing investigati on conditions additional radiation protection measures such as leadshi elded safety glasses or thyroid protection do not appear necessary.