Purpose: To determine whether grid removal during routine biliary interventional procedures performed in a flat-panel interventional suite results in adequate image quality and a significant decrease of patient radiation exposure. Materials and Methods: Routine biliary interventional procedures were defined as those in which absence of fine image detail during fluoroscopy carries no procedural impact, including substitution of internal-external biliary drains (n = 25) or bilioplasty of benign biliary anastomotic strictures (n = 5). All patients had undergone a previous procedure in which the grid was used. Constant object-to-detector and source-to-image distance were maintained in each patient during the grid/no-grid procedures. The same fluoroscopy protocol was used for all examinations. The dose area product (DAP [cGy.cm 2]) and procedure fluoroscopy time (seconds) were recorded for each procedure. DAP was normalized per unit of fluoroscopy time (nDAP [cGy.cm 2/s]). Results: In all procedures, image quality was considered adequate by two different interventional radiologists, and all procedures were successfully completed without significant changes in fluoroscopy time between the two groups (p = 0.13). In every procedure without the grid, nDAP was inferior compared with nDAP in procedures performed using the grid. The mean decrease in dose was 39.2 ± 23.5 % (p = 0.000001). Conclusion: Our preliminary data show that removal of the grid during routine biliary procedures is feasible and results in a significant decrease of patient radiation exposure. This seems of particular relevance because most of these patients require frequent reintervention. Larger studies with more procedures are warranted to confirm these data.
- ALARA principle
- Antiscatter grid
- Biliary procedures
- Radiation protection
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine