Influence of radiographic technique and equipment on absorbed ovarian doseassociated with uterine artery embolization

PURPOSE: To evaluate the influence of pulsed fluoroscopy (PF), nonpulsed fl uoroscopy (NPF), and various fluoroscopic techniques on the absorbed ovaria n dose (AOD) associated with uterine artery embolization (UAE) of leiomyoma ta, MATERIAL AND METHODS: Ovarian location was estimated from preprocedural pel vic magnetic resonance images of 23 patients previously treated by means of UAE, The AOD was measured with thermoluminescent dosimeters (TLD) placed i nto an anthropomorphic phantom at the determined ovarian location. The foll owing measurements from PF and NPF were obtained: 21.89 minutes of nonmagni fied posterior-anterior fluoroscopy, 10 minutes of nonmagnified oblique flu oroscopy, 10 minutes of posterior-anterior magnified fluoroscopy, 10 minute s of combined oblique magnified fluoroscopy, and 47 simulated angiographic exposures. Numbers for nonmagnified posterior-anterior fluoroscopy time and exposure numbers were chosen from the average values from previous UAE pro cedures. AOD from pulsed and nonpulsed nonmagnified posterior-anterior fluo roscopy was compared to measurements from oblique magnified, posterior-ante rior magnified, and oblique fluoroscopy, RESULTS: AOD from NPF was, on average, 1.7 times higher than from PF, When compared with nonmagnified posterior-anterior fluoroscopy, the AOD from obl ique magnified fluoroscopy was 1.9 times greater; the AOD from nonmagnified oblique fluoroscopy was 1.1 times greater. The AOD from oblique magnified fluoroscopy was 1.5 times higher on the side closer to the x-ray tube than on the contralateral side. AOD from serial angiographic exposures contribut ed only less than 7% to the total AOD for the average UAE procedure. CONCLUSIONS: The AOD associated with UAE can best be reduced by limiting fl uoroscopy time and the use of oblique or magnified fluoroscopy, Contributio n of angiographic exposures to AOD is much less significant.