Radiation exposure to patients during endoscopic retrograde cholangiopancreatography: A multicentre study in Finland

Abstract

PurposeEndoscopic retrograde cholangiopancreatography (ERCP) has the potential for high patient dose, which is why attention is required regarding radiation protection. The available data about patient radiation doses in ERCP show a large variation that needs to be further investigated. The aim of this study was to determine the radiation doses to patients during ERCP, evaluate the risk of radiation-induced injury and to calculate the effective dose (ED) in patients who underwent an ERCP procedure. MethodsA multicentre study which included ten hospitals was carried out in Finland. A total of 227 patient radiation doses in ERCP were recorded during a 4-month period in 2012. Entrance surface dose (ESD) was estimated by using thermoluminescent dosimeters (TLD) implemented in one of the hospitals. ED was calculated from dose area product (DAP) measurements. The data were analysed with the IBM SPSS Statistics version 21 (2012) software. ResultsThe patient radiation doses in ERCP varied significantly in this study. The mean DAP was 5.15 (0.08–57.00) Gy cm², fluoroscopy time 2.4 (0.03–22.2) min and the number of X-ray images was 2.5 (0–14). A strong linear correlation was observed between the DAP and fluoroscopy time. The average ESD and ED in ERCP was 10 mGy and 1 mSv, respectively. ConclusionPatients received a greater radiation dose in therapeutic ERCP compared to diagnostic ERCP. The increase in frequency and complexity of ERCP procedures indicates the possibility of an increase in radiation exposure to patient. The results suggest that efforts at optimization and dose reduction in ERCP should be made.