Measures of XXXX radiation exposure during endoscopic retrograde cholangiography: beyond fluoroscopy time.

@entity1 @entity1054
AIM: To determine whether fluoroscope time is a good predictor of @entity1 radiation exposure during endoscopic retrograde cholangiopancreatography. METHODS: This is a prospective observational study of consecutive @entity1 undergoing endoscopic retrograde cholangiopancreatography in a tertiary care setting. Data related to radiation exposure were collected. The following measures were obtained: @entity1054 ( @entity1054 ), dose area product (DAP) and dose at reference point (DOSERP). Coefficients of determination were calculated to analyze the correlation between @entity1054 , DAP and DOSRP. Agreement between @entity1054 and DAP/DOSRP was assessed using Bland Altman plots. RESULTS: Four hundred sixty-three data sets were obtained. @entity1054 average was 7.3 min. Fluoroscopy related radiation accounted for 86% of the total DAP while acquisition films related radiation accounted for 14% of the DAP. For any given @entity1054 there are wide ranges of DAP and DOSERP and the variability in both increases as fluoroscopy time increases. The coefficient of determination (R(2)) on the non transformed data for DAP and DOSERP versus @entity1054 were respectively 0.416 and 0.554. While fluoroscopy use was the largest contributor to @entity1 radiation exposure during endoscopic retrograde cholangiography (ERCP), there is a wide variability in DAP and DOSERP that is not accounted for by @entity1054 . DAP and DOSERP increase in variability as @entity1054 increases. This translates into poor accuracy of @entity1054 in predicting DAP and DOSERP at higher radiation doses. CONCLUSION: DAP and DOSERP in addition to @entity1054 should be adopted as new ERCP quality measures to estimate @entity1 radiation exposure.
