Diagnostic reference levels in interventional neuroradiology procedures – a systematic review

Abstract

Abstract Introduction The establishment of diagnostic reference levels (DRLs) is challenge for interventional neuroradiology (INR) due to the complexity and variability of its procedures. Objective The main objective of this systematic review is to analyse and compare DRLs in fluoroscopy-guided procedures in INR. Methods An observational study reporting DRLs in INR procedures, specifically cerebral arteriography, cerebral aneurysm embolisation, cerebral thrombectomy, embolisation of arteriovenous malformations (AVM), arteriovenous fistulas (AVF), retinoblastoma embolisation, and spinal cord arteriography. Comprehensive literature searches for relevant studies published between 2017 and 2023 were conducted using the Scopus, PubMed, and Web of Science databases. Results A total of 303 articles were identified through an extensive literature search, with 159 removed due to duplication. The title and abstract of 144 studies were assessed and excluded if they did not meet the inclusion criteria. Thirty-one out of the 144 articles were selected for a thorough full-text screening. Twenty-one articles were included in the review after the complete text screening. Conclusion The different conditions of patients undergoing INR procedures pose a barrier to the standardization of DRLs; nevertheless, they are extremely important for monitoring and optimising radiological practices.