PATIENT AND STAFF RADIATION-DOSE IN FLUOROSCOPY-GUIDED TIPS PROCEDURES AND DOSE REDUCTION, USING DEDICATED FLUOROSCOPY EXPOSURE SETTINGS

Fluoroscopy guided interventions, such as transjugular intrahepatic po rtosystemic shunt (TIPS) procedures. can result in relatively high rad iation doses to patients and staff. The purpose of this study was to e valuate the possible benefit of dedicated fluoroscopy exposure factors in the reduction of doses. Doses to patients and staff were measured during fluoroscopy-guided TIPS procedures in two Dutch university hosp itals. Patient doses were calculated from dose-area product (DAF) meas urements, entrance beam dimensions and DAP conversion factors. Staff d oses were measured outside lead aprons using electronic personal dosem eters. Average patient entrance skin dose (ESD) rate during fluoroscop y was 49 mGy min(-1) (13 cases, average fluoroscopy duration 32 min) i n one hospital, and 6 mGy min(-1) (10 cases, average fluoroscopy durat ion 50 min) in the other. Estimated staff effective dose per procedure was 28 mu Sv average in the first hospital compared with 4 mu Sv aver age in the other. The use of dedicated fluoroscopy exposure factors, w ith a relatively high tube voltage and lower tube current resulted in a significant dose reduction for patient and staff in this type of rad iological intervention.