Reference Levels for Patient Radiation Doses in Interventional Radiology: Proposed Initial Values for U.S. Practice

Sufficient data exist to permit an initial proposal of values for reference levels for interventional radiologic procedures in the United States.


To propose initial values for patient reference levels for fluoroscopically guided procedures in the United States.

Materials and Methods

This secondary analysis of data from the Radiation Doses in Interventional Radiology Procedures (RAD-IR) study was conducted under a protocol approved by the institutional review board and was HIPAA compliant. Dose distributions (percentiles) were calculated for each type of procedure in the RAD-IR study where there were data from at least 30 cases. Confidence intervals for the dose distributions were determined by using bootstrap resampling. Weight banding and size correction methods for normalizing dose to patient body habitus were tested.


The different methods for normalizing patient radiation dose according to patient weight gave results that were not significantly different (P > .05). The 75th percentile patient radiation doses normalized with weight banding were not significantly different from those that were uncorrected for body habitus. Proposed initial reference levels for various interventional procedures are provided for reference air kerma, kerma-area product, fluoroscopy time, and number of images.


Sufficient data exist to permit an initial proposal of values for reference levels for interventional radiologic procedures in the United States. For ease of use, reference levels without correction for body habitus are recommended. A national registry of radiation-dose data for interventional radiologic procedures is a necessary next step to refine these reference levels.

© RSNA, 2009

Supplemental material:


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Article History

Received March 17, 2009; revision requested May 11; final revision received May 18; accepted June 15; final version accepted June 22.
Published in print: Dec 2009