Management of Radiation Exposure Received from Pulse Fluoroscopy during Percataneous Transheptic Biliang Drainage in Cholangiocarcinoma Patients

Abstract

Background and objectives:  The treatment of cholangiocarcinoma by percutaneous transhepatic biliary drainage is usually performed under pulse fluoroscopy. The authors studied the optimal  radiation dose in pulse fluoroscopy techniques and image quality to reduce radiation dose exposed to patients and medical personals.

Methods: Radiation dose in phantom and in 120 patients who underwent percutaneous transhepatic biliary drainage during pulse fluoroscopy were analyzed. The image quality was  studied. The study was performed at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.

Results: The radiation doses in phantom were 3.354 6.577 and 10.884 mGy by using 3.5, 7.5 and 15 frame-per-second protocol, respectively. At the 3.5 frame-per-second protocol, the  image presented shadow, so it was inappropriate for use in patients. The average of enhance skin dose in minute of patients who underwent percutaneous transhepatic biliary drainage were 0.94 ± 0.38  and 1.82 ± 0.91 mGy by using 7.5 and 15 frame-per-second protocol, respectively. There was no significant difference in image quality between the phantom and patients percutaneous transhepatic biliary drainage between using 7.5 and 15 frame-per-second protocol.

Conclusion: Pulse fluoroscopy at 7.5 frame-per-second protocol provided optimum radiation dose and image quality for percutaneous transhepatic biliary drainage.