Optimization of the Maximum Skin Dose Measurement Technique Using Digital Imaging and Communication in Medicine—Radiation Dose Structured Report Data for Patients Undergoing Cerebral Angiography

Abstract

Understanding the maximum skin dose is important for avoiding tissue reactions in cerebral angiography. In this study, we devised a method for using digital imaging and communication in medicine—radiation dose structured report (DICOM-RDSR) data to accurately estimate the maximum skin dose from the total air kerma at the patient entrance reference point (Total Ka,r). Using a test data set (n = 50), we defined the mean ratio of the maximum skin dose obtained from measurements with radio-photoluminescence glass dosimeters (RPLGDs) to the Total Ka,r as the conversion factor, CFKa,constant, and compared the accuracy of the estimated maximum skin dose obtained from multiplying Total Ka,r by CFKa,constant (Estimation Model 1) with that of the estimated maximum skin dose obtained from multiplying Total Ka,r by the functional conversion factor CFKa,function (Estimation Model 2). Estimation Model 2, which uses the quadratic function for the ratio of the fluoroscopy Ka,r to the Total Ka,r (Ka,r ratio), provided an estimated maximum skin dose closer to that obtained from direct measurements with RPLGDs than compared with that determined using Estimation Model 1. The same results were obtained for the validation data set (n = 50). It was suggested the quadratic function for the Ka,r ratio provides a more accurate estimate of the maximum skin dose in real time.

Effect of Exposure Angulation on the Occupational Radiation Exposure during Cardiac Angiography: Simulation Study

“…In addition, an experimental measurement using a phantom was conducted to obtain the patient dose under equivalent conditions to the simulation. The patient dose was extracted using dose report data issued in angiography [10].…”

Assessment of Radiation Dose in Medical Imaging and Interventional Radiology Procedures for Patient and Staff Safety

“…Radiation doses associated with endovascular treatments such as thoracic endovascular aortic repair and endovascular aortic repair using a hybrid operating room system, which is increasingly being used to perform endovascular procedures, were determined, and the results showed that some patients were exposed to >2 Gy as the air kerma at the patient entrance reference point (K a,r ) [ 13 ]. During cerebral angiography including neurointerventional radiology procedures, it was suggested that the quadratic function for the K a,r ratio provided a more accurate estimate of the maximum skin dose in real time [ 14 ].…”