European Radiology

, Volume 27, Issue 5, pp 1783–1786 | Cite as

Radiation doses to operators performing transjugular intrahepatic portosystemic shunt using a flat-panel detector-based system and ultrasound guidance for portal vein targeting

  • Roberto Miraglia
  • Roberta Gerasia
  • Luigi Maruzzelli
  • Mario D’Amico
  • Angelo Luca



The aim of this study was to prospectively evaluate effective dose (E) of operators performing transjugular intrahepatic portosystemic shunts (TIPS) in a single centre. Patients’ radiation exposure was also collected.


Between 8/2015 and 6/2016, 45 consecutive TIPS were performed in adult patients using a flat-panel detector-based system (FPDS) and real-time ultrasound guidance (USG) for portal vein targeting. Electronic personal dosimeters were used to measure radiation doses to the primary and assistant operators, anaesthesia nurse and radiographer. Patients’ radiation exposure was measured with dose area product (DAP); fluoroscopy time (FT) was also collected.


Mean E for the primary operator was 1.40 μSv (SD 2.68, median 0.42, range 0.12 – 12.18), for the assistant operator was 1.29 μSv (SD 1.79, median 0.40, range 0.10 – 4.89), for the anaesthesia nurse was 0.21 μSv (SD 0.67, median 0.10, range 0.03 – 3.99), for the radiographer was 0.42 μSv (SD 0.71, median 0.25, range 0.03 – 2.67). Mean patient DAP was 59.31 GyCm2 (SD 56.91, median 31.58, range 7.66 – 281.40); mean FT was 10.20 min (SD 7.40, median 10.40, range 3.8 – 31.8).


The use of FPDS and USG for portal vein targeting allows a reasonably low E to operators performing TIPS.

Key points

The operators’ E vary according to the complexity of the procedure.

FPDS and USG allow a reasonably low E to TIPS operators.

FPDS and USG have an important role in reducing the occupational exposure.


TIPS Radiation protection Occupational exposure Ultrasound Liver 



Transjugular intrahepatic portosystemic shunt


Dose area product


Fluoroscopy time


Effective dose


Flat-panel detector based system


Real-time ultrasound guidance



The scientific guarantor of this publication is Dr. Angelo Luca. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: prospective, observational, performed at one institution.


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Copyright information

© European Society of Radiology 2016

Authors and Affiliations

  • Roberto Miraglia
    • 1
  • Roberta Gerasia
    • 1
  • Luigi Maruzzelli
    • 1
  • Mario D’Amico
    • 1
  • Angelo Luca
    • 1
  1. 1.Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT)PalermoItaly

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