Local diagnostic reference levels for lower limb angiography procedure in Morocco

The escalating utilization and complexity of fluoroscopically guided procedures contribute to prolonged examination durations and heightened risks of adverse radiation risk. Diagnostic Reference Levels (DRLs) are essential for optimizing radiation dose. The aim of this study is to establish local DRLs for Lower Limb Angiography (LLA) procedure. The investigation was conducted at at the Mohammed VI University Hospital Center in Marrakech, Morocco. The dosimetric data collected were the cumulative Dose Area Product (DAP), Fluoroscopic Time (FT), and Number of Frames (NF). The quantities' distributions were analyzed statistically, and local DRLs were determined as the 75th percentile, with the medians as typical values. The proposed LDRLs were compared to international studies. A total of 100 patients were included and performed examinations using a single C-arm machine. The Typical doses in terms of Kair were 0.21Gy, 59.34 Gy.cm2 for DAP, 1.1 min for FT and 538 frames. The derived local DRLs and Typical doses in terms of DAP, Kair, and NF were largely higher than those published by the other international studies. In terms of FT, the local DRL and typical value were significantly lower than values defined in other studies. These comparisons revealed a significant potential for optimization. This research establishes a standard for radiation dose in LLA examination at the studied hospital. These findings can inform future investigations in the country, facilitating comparative analyses.