Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography

Table 1 Dose metrics and units for radiation exposure during endoscopic retrograde cholangiopancreatography or other image-guided procedures from each society and the associated diagnostic reference levels

Society	Year	Procedure	Numerical number	Metric	Unit
ESGE[2]	2012	ERCP	55-347	ESD	mGy
			3-333	KAP	Gy.cm2
ASGE[1]	2015	ERCP	Not listed	Radiation dose	mGy
				FT
ASGE-DDW supplement[39]	2018	ERCP	Not listed	Dose RP	mGy
				DAP	μGy.m2
				Dose rate	mGy/min
Japan DRLs[32]	2015	IVR	20	Dose rate	mGy/min
EC DRLs[30]	2014	ERCP	30-45	DAP	Gy.cm2
UK NDRL[35]	2016	Biliary intervention	43	DAP	Gy.cm2
			14	FT	min
German DRL[31]	2013	ERCP	2500	DFP	μGy.m2
ARPANSA DRL survey[62]	ongoing	ERCP/IVR	Not listed	Reference dose	Gy
				DAP	Gy.cm2
				Frame rate	fr/sec
				Total frames	number
ACC/HRS/NASCI/SCAI/SCCT expert consensus[63]	2018	Cardiovascular intervention	Not listed	Air kerma	Gy
				KAP, DAP	Gy.cm2

ESD: Entrance skin dose; KAP: Kerma-area product; FT: Fluoroscopy time; Dose RP: Dose reference point; DAP: Dose-area product; DFP: Dosis-flächen-produkt (Dose-area product); ERCP: Endoscopic retrograde cholangiopancreatography; DRLs: Diagnostic reference levels; ESGE: European society of gastrointestinal endoscopy; ASGE: American society for gastrointestinal endoscopy.