NICE, FRANCE — German investigators significantly reduced radiation exposures without causing complications in 64 women undergoing uterine fibroid embolization.
Bilateral embolization was possible in 63 patients, Dr. Dierk Vorwerk reported at the annual meeting of the Cardiovascular and Interventional Radiological Society of Europe.
Embolization failed in a single uterine artery in just one woman.
No “specific complications” were found, according to Dr. Vorwerk of the Klinikum Ingolstadt (Germany).
“Strict adherence to simple radiation protection rules decreases dose area product significantly. Dose reduction per image significantly decreases dose but does not increase fluoroscopy time,” he said.
From January 2004 through June 2005, he and his colleagues treated 64 patients 32–48 years of age with a unilateral, subradical embolization approach.
In the first consecutive group (group A) of 26 patients, Dr. Vorwerk used pulsed radiation at 7.5 images per second and digital subtraction angiography (DSA). Radiation doses were reduced by 1.2 μGy per image for group A; the protocol included collimation. Besides DSA runs before and after embolization on each side, aortography was done as the final run.
For a second group of 29 patients, the protocol was revised to a dose of 1.2 μGy per image and maximum collimation with a 40-cm intensifier. DSA runs were only done before catheter placement for group B. There was no aortography.
For the final group of nine patients, the dose was further reduced by 0.48 μGy per image. The investigators also avoided oblique runs.
The physicians maintained average fluoroscopy time at 20.2 minutes, 21.3 minutes, and 19.8 minutes. Area dose product declined significantly from 52.7 Gy cm
Published studies cited by Dr. Vorwerk had reported mean fluoroscopy times of 11.8 and 22.5 minutes and average dose area product of 59.5 Gy cm