What is the radiation exposure to patients during a gynecoradiologic procedure?

Vishvanath C. Karande; Donna E. Pratt; Martin S. Balin; Seth G. Levrant; Randy S. Morris; Norbert Gleicher

doi:10.1016/S0015-0282(97)81931-0

Diagnostics Tubal and Uterine Imaging

What is the radiation exposure to patients during a gynecoradiologic procedure?

Karande VC, Pratt DE, Balin MS, Levrant SG, Morris RS, Gleicher N

Published February 1997 Fertility and Sterility, 67(2), 401-403

DOI 10.1016/S0015-0282(97)81931-0 PMID 9022623

RRM Academy Synopsis

Standard tubal X-ray techniques gave radiation within safety margins

In 332 infertility patients, radiation from X-ray guided tubal exams fell well within safe limits, the authors conclude. X-ray (fluoroscopy) time averaged 63 seconds for a normal HSG and 239 seconds for bilateral tubal catheterization.

Key Findings

Fluoroscopy time (rad time) averaged 63 seconds (SD 54) for a normal hysterosalpingogram (n = 94) and 100 seconds (SD 61) for an abnormal one (n = 53).
Selective salpingography averaged 111 seconds (SD 57) when done on one side (n = 36) and 142 seconds (SD 74) on both sides (n = 87).
Tubal catheterization averaged 176 seconds (SD 77) on one side (n = 27) and 239 seconds (SD 82) on both sides (n = 30).
Five patients had other procedures, lysis of intrauterine adhesions (n = 2) and resection of a uterine septum (n = 3), with rad times of 180 to 300 seconds.
The center limited each procedure to under 10 minutes of rad time, and no patient exceeded that limit.

Interpretation

The authors reviewed the records of 332 consecutive infertility patients. Each patient had an X-ray guided exam of the womb and tubes that began with hysterosalpingography (HSG). Some went on to selective salpingography or tubal catheterization. The study measured X-ray time, and the time grew as the procedure became more involved. The authors cited a 1990 national committee conclusion that genetic risk from pelvic fluoroscopy is very low when exposure time is limited and equipment is calibrated. They calculated a safe limit of about 10 minutes at the unit's top settings. The authors report that the physicians' times fell to a steady level within a few weeks of starting.

RRM Context

Restorative reproductive medicine looks for the cause of infertility in each partner. The fallopian tubes are part of that search. Selective salpingography examines the tubes one at a time and is among the procedures measured here. The paper gives exposure times for this exam and for the repair procedures that can follow.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To evaluate the risk of radiation exposure to infertility patients during a gynecoradiologic procedure.

Design

Retrospective clinical study.

Setting

Medical school-affiliated infertility center.

Patients

Three hundred thirty-two consecutive infertility patients undergoing a gynecoradiologic procedure.

Interventions

Patients underwent a gynecoradiologic procedure as part of their infertility workup and the fluoroscopic exposure time was analyzed.

Main Outcome Measures

The fluoroscopic exposure (rad time) during gynecoradiologic procedures, including hysterosalpingogram (HSG), selective salpingography, tubal catheterization, and others.

Results

The rad time (mean +/- SD) was 63 +/- 54 seconds for normal HSG (n = 94, range 17 to 404 seconds), 100 +/- 61 seconds for abnormal HSG (n = 53, range 28 to 272 seconds), 111 +/- 57 seconds for unilateral selective salpingography (n = 36, range 31 to 324 seconds), 142 +/- 74 seconds for bilateral selective salpingography (n = 87, range 40 to 430 seconds), 176 +/- 77 seconds for unilateral tubal catheterization (n = 27, range 70 to 342 seconds), and 239 +/- 82 seconds for bilateral tubal catheterization (n = 30, range 110 to 381 seconds). Five patients had other procedures, such as lysis of intrauterine adhesions (n = 2) and resection of an uterine septum (n = 3), for which the rad time was in a range of 180 to 300 seconds.

Conclusions

The radiation exposure of patients during a gynecoradiologic procedure, using previously described standard techniques, is well within established margins of safety.

Topics

Diagnostics

Tubal and Uterine Imaging Hysterosalpingography

Diagnostics › Tubal and Uterine Imaging › Hysterosalpingography

Vishvanath C. Karande, Donna E. Pratt, Martin S. Balin, Seth G. Levrant, Randy S. Morris, Norbert Gleicher

V Karande, D Pratt, M Balin, S Levrant, R Morris, N Gleicher

PMID 9022623 9022623 DOI 10.1016/S0015-0282(97)81931-0 10.1016/S0015-0282(97)81931-0 Karande et al. 1997, Karande 1997

Keywords

Environmental Exposure, Female, Fluoroscopy, Humans, Infertility, Female/diagnostic Imaging, Pelvis/diagnostic Imaging, Radiation, Retrospective Studies, Safety, Time Factors

What is the radiation exposure to patients during a gynecoradiologic procedure?

Standard tubal X-ray techniques gave radiation within safety margins

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Related research

Keywords