Patient dosimetry in diagnostic and interventional radiology: a practical approach using trigger levels

Faulkner, K.; Ortiz-López, P.; Vañó, Eliseo

doi:10.1093/rpd/nci737

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…For interventional units on which an assessment of CAK is not fitted, the DAP reading could provide an alternative option (van de Putte et al 2000, Karambatsakidou et al 2005, Faulkner et al 2006, Chida et al 2006, Domienik et al 2008, Bogaert et al 2009. Results for patient data collection show a clear link between CESD and DAP for particular types of procedure (figures 5 and 6), as has been found in other cardiology studies Rogers 2006b, Žontar et al 2010).…”

Section: Cesd and Dapmentioning

confidence: 63%

A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

Neil¹,

Padgham²,

Martin³

2010

J. Radiol. Prot.

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A study of peak skin doses (PSDs) during neuroradiology and cardiology interventional procedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made from squares held in cling film has allowed doses to the head to be mapped successfully. The displayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrance surface dose (CESD) and results indicate that this can provide a reliable indicator of the PSD in neuroradiology. Results linking PSD to CESD for interventional cardiology were variable, but CAK is still considered to provide the best option for use as an indicator of potential radiation-induced effects. A CESD exceeding 3 Gy is considered a suitable action level for triggering follow-up of patients in neuroradiology and cardiology for possible skin effects. Application of dose action levels defined in this way would affect 8% of neurological embolisation procedures and 5% of cardiology ablation and multiple stent procedures at the hospitals where the investigations were carried out. A close relationship was observed between CESD and dose-area product (DAP) for particular types of procedure, and DAPs of 200-300 Gy cm(2) could be used as trigger levels where CAK readings were not available. The DAP value would depend on the mean field size and would need to be determined for each application.

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Section: Cesd and Dapmentioning

confidence: 63%

A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

Neil¹,

Padgham²,

Martin³

2010

J. Radiol. Prot.

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“…But is has also been suggested for use in interventional cardiology [15]. Others [16][17][18] have also suggested using P KA as an indicator for high skin doses.…”

Section: Introductionmentioning

confidence: 99%

Local skin and eye lens equivalent doses in interventional neuroradiology

2009

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Abstract:The aim of this work was to assess patient skin and eye lens doses in interventional neuroradiology and to assess both stochastic and deterministic radiation risks. Kerma-area product, P KA was recorded and skin doses measured using thermoluminescence dosimeters. Estimated dose at interventional reference point, IRP, was compared with measured absorbed doses. The average and maximum fluoroscopy times were 32 and 189 min for coiling and 40 and 144min for embolisation. The average and maximum P KA for coiling were 121 and 436 Gycm 2 respectively and 189 and 677 Gycm 2 for embolisation. The average and maximum values of the measured maximum absorbed skin doses were 0.72 and 3.0Sv respectively for coiling and 0.79 and 2.1Sv for embolisation. Two out of the 52 patients received skin doses in excess of 2Sv. The average and maximum doses to the eye lens (left eye) were 51 and 51mSv (coiling) and 71 and 289mSv (embolisation). The ratio between the measured dose and the dose at the IRP was 0.44±0.18mSv/mGy indicating that the dose displayed by the x-ray unit overestimates the maximum skin dose but is still a valuable indication of the dose. The risk in our hospital skin erythema and lens cataract is therefore small.

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“…This program uses a significant dose (reference point dose of 5 Gy for coronary procedures) as an action trigger for additional documentation and followup, which is designed to set low enough dose value to minimize the probability of missing a clinical deterministic injury. Similarly, Faulkner et al proposed trigger levels for different interventional cardiology procedures based on different field sizes (DAP trigger level ranges from 20 to 400 Gy × cm 2 corresponding to field size from 10 to 200 cm 2 ), which may be used to identify patients at the risk of deterministic injuries [93]. …”

Section: Radiation-induced Risks To Patientsmentioning

confidence: 99%

Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

Sun

AbAziz

Yusof

2013

BioMed Research International

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Concerns about ionizing radiation during interventional cardiology have been increased in recent years as a result of rapid growth in interventional procedure volumes and the high radiation doses associated with some procedures. Noncancer radiation risks to cardiologists and medical staff in terms of radiation-induced cataracts and skin injuries for patients appear clear potential consequences of interventional cardiology procedures, while radiation-induced potential risk of developing cardiovascular effects remains less clear. This paper provides an overview of the evidence-based reviews of concerns about noncancer risks of radiation exposure in interventional cardiology. Strategies commonly undertaken to reduce radiation doses to both medical staff and patients during interventional cardiology procedures are discussed; optimisation of interventional cardiology procedures is highlighted.

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Patient dosimetry in diagnostic and interventional radiology: a practical approach using trigger levels

Cited by 10 publications

References 8 publications

A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

A study of the relationship between peak skin dose and cumulative air kerma in interventional neuroradiology and cardiology

Local skin and eye lens equivalent doses in interventional neuroradiology

Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

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