Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

Lubis, Lukmanda Evan; Badawy, Mohamed Khaldoun

doi:10.1088/1742-6596/694/1/012049

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Dose-area product was at least cut by half for fluoroscopy and DSA in comparison to similar software setups in investigations performed on the same first-generation system 9,10 ; however, there is still only little evidence on the evaluated second-generation system. 11,26 Although several studies emphasized the importance of radiation dose reduction, [27][28][29] our results suggest that substantial decreased radiation exposure for patients and operating staff can be achieved using the investigated angiography platform and the optimized protocol in group 2. We assume that enhanced IQ for C-TACE interventions in group 2 may have been facilitated through higher image resolution, better differentiation of arteries and (micro)catheters, as well as improved assessment of ethiodized oil distribution (Fig.…”

Section: Discussionmentioning

confidence: 70%

Advanced Robotic Angiography Systems for Image Guidance During Conventional Transarterial Chemoembolization

et al. 2019

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Objectives: The aim of this study was to compare 2 advanced robotic angiography systems for real-time image guidance in terms of radiation dose and image quality (IQ) during conventional transarterial chemoembolization (C-TACE) of hepatic malignant tumors. Materials and Methods: One hundred six patients (57 women/49 men; mean age, 60 ± 11 years) who had undergone C-TACE using 2 generations of robotic angiography platforms for image guidance were included in this retrospective study. Patients were divided into 2 groups (n = 53, respectively): group 1 (first generation) and group 2 (second generation). Radiation dose for fluoroscopy and digital subtraction angiography (DSA) was compared between first-generation and second-generation angiography equipment, respectively. Among several features of the second-generation compared with the first-generation system, improvements included a refined crystalline detector system for enhanced noise reduction and advanced CARE filter software for lowering radiation dose. Radiation dose was measured using an ionization chamber. Image quality was assessed by 3 radiologists using 5-point Likert scales. Results: Both groups were comparable in terms of number and location of lesions, as well as body weight, body mass index, and anatomical variants of feeding hepatic arteries (all P > 0.05). Dose-area product (DAP) for fluoroscopy was significantly lower in group 2 (1.4 ± 1.1 Gy•cm 2 ) compared with group 1 (2.8 ± 3.4 Gy•cm 2 ; P = 0.001). For DSA, DAP was significantly lower (P = 0.003) in group 2 (2.2 ± 1.2 Gy•cm 2 ) versus group 1 (4.7 ± 2.3 Gy•cm 2 ). Scores for DSA IQ indicated significant improvements for group 2 by 30% compared with group 1 (P = 0.004). Regarding fluoroscopy, scores for IQ were 76% higher in group 2 compared with group 1 (P = 0.001). Good to excellent interrater agreement with Fleiss kappa coefficients of κ = 0.75 for group 1 and κ = 0.74 for group 2 were achieved. Conclusions: Most recent generation robotic angiography equipment allows for considerable radiation dose reductions while improving IQ in fluoroscopy and DSA image guidance during C-TACE treatment.

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Section: Discussionmentioning

confidence: 70%

Advanced Robotic Angiography Systems for Image Guidance During Conventional Transarterial Chemoembolization

et al. 2019

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“…All fluoroscopic equipment sold in the US since 2006 has been required to display procedural dose. Fluoroscopy time, not impacted by frame rate or high dose requirements of steep angulation, is not an accurate measure of dose . True dose measures include: Total air Kerma at the interventional reference point (IRP) ( K a,r , Gy), and air Kerma area product ( P KA , Gy cm 2 ).…”

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confidence: 99%

Real time patient dosimetry in the cath lab: Can you see what they get?

Chambers

Koduri

2018

Cathet Cardio Intervent

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Real time radiation dose monitoring in the cath lab may provide immediate feedback for potential dose reduction during PCI. Radiation dose monitoring to predict potential tissue injury utilizes equipment measured air Kerma at the interventional reference point (IRP) with then calculated specific tissue peak skin dose. The role of the cath lab Quality Committee is not only to assess individual high dose radiation cases but also to create processes and assess new technologies to assure radiation dose is best utilized in all cases.

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Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

Cited by 2 publications

References 29 publications

Advanced Robotic Angiography Systems for Image Guidance During Conventional Transarterial Chemoembolization

Advanced Robotic Angiography Systems for Image Guidance During Conventional Transarterial Chemoembolization

Real time patient dosimetry in the cath lab: Can you see what they get?

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