Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of european alert thresholds

This study aims to investigate and set up noncentre-specific European alert thresholds to help physicians acknowledge patient doses while performing fluoroscopically-guided procedures. Chemoembolisation (CE), neuroembolisation (NE) and percutaneous coronary interventions (PCI) procedures which are typically associated with high exposure levels were studied. NE procedures were found to deliver the largest use of X-rays and to implicate thereby the highest skin doses to the patient. For the same procedure, doses measured at different facilities showed large differences owing to the multiple parameters affecting exposure (X-ray equipment and detector, operator’s training and skills, patient’s BMI and morphology). As a result of the inter-centre dose variability, the set-up of universal alert thresholds was challenging whereas the collected data can be used to establish local alert thresholds. To conclude on the feasibility of non-centre-specific alert thresholds, more studies and clarifications of the reasons of intercentre dose variability should be carried out.