Category: Imaging & Image Guided Therapy: Radiation Safety

MP4-18 - Defining reference levels for intra-operative radiation exposure in urological procedures: initial results from FLASH, a retrospective multi-centre study

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective : There is currently limited data to define reference levels for the use of ionising radiation in urological procedures. In this multi-centre study, we utilise methodology employed by the Health Protection Agency in establishing reference levels for diagnostic investigations in order to define analagous levels for common and reproducible urological procedures.


Methods : One thousand two hundred eighty-five procedures were identified across seven UK hospitals over a 1 year period. Exposure was defined in terms of both screening time and dose area product (DAP). Third quartile mean values for either parameter were used to define reference levels. Variations between centres and grades of lead surgeon were analysed as secondary outcomes.


Results :

Reference levels: ureteric stent insertion or replacement (4.27 Gycm2/77 seconds); ureteroscopy (3.6 Gycm2/81 seconds); percutaneous nephrolithotomy (PCNL) (16.15 Gycm2/426 seconds).


Grade of surgeon did not influence exposure in any procedure. Less variation was observed with screening time than with DAP. There exists significant variation in dose area product and screening time between centres.


Conclusions : This multi-centre study is the largest of its kind. It provides the most comprehensive reference to guide fluoroscopy use in common urological procedures, and is of value both at the point of delivery and for audit of local practice.

Nick Simson

Urology CT2
The Lister Hospital, Stevenage
London, England, United Kingdom

Thomas Stonier

Urology CT2
Princess Alexandra Hospital
London, England, United Kingdom

Narin Suleyman

Urology Registrar
Luton and Dunstable Hospital
Luton, England, United Kingdom

Miss Narin M Suleyman, BSc, MBBS, MRCS,. Luton and Dunstable Hospital. Specialist Registrar.

Miriam Salib

Radiology Registrar
Charing Cross Hospital
London, England, United Kingdom

Julian Peacock

Urology CT2
Worthing Hospital
Worthing, England, United Kingdom

Charles Horn

Foundation Doctor
Derriford Hospital
Plymouth, England, United Kingdom

Martin Connor

Urology CT2
North Middlesex University Hospital NHS Trust
London, England, United Kingdom

Abdurahman Bareh

Medical Student
St George’s Medical School
London, England, United Kingdom

Dominic Jaikaransingh

Medical Student
St George’s Medical School
London, England, United Kingdom

Nusrat Mohamed

Medical Student
St George’s Medical School
London, England, United Kingdom

Catherine Lovegrove

Foundation Doctor
West Middlesex Hospital
London, England, United Kingdom

Nimlan Shanmugathas

Foundation Doctor
Guy’s and St Thomas’ Hospital NHS Trust
Stanmore , England, United Kingdom

Omar Aboumarzouk

Urology Consultant
Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, UK
Glasgow, Scotland, United Kingdom