Eleni Theano Samara MS, Abstract Co-Author: Nothing to Disclose

Pierre Bize, Abstract Co-Author: Nothing to Disclose

Stefano Binaghi MD, Abstract Co-Author: Nothing to Disclose

Abbas Aroua PhD, Abstract Co-Author: Nothing to Disclose

Francis R. Verdun PhD, Presenter: Nothing to Disclose

Complex fluoroscopy-guided procedures may be associated with high radiation dose to patients that occasionally results into deterministic effects. To manage these short-term complications (such as erythema, skin burn, epilation) the cumulative dose measured at the Interventional Reference Point (IRP) is proposed as a dose indicator to estimate the absorbed dose to the skin. The purpose of our study is to estimate how close to the actual maximum skin dose the cumulative dose assessed at the IRP is for neurological and abdominal diagnostic and interventional procedures.

High-sensitivity MOSFET dosimeters (TN-1002RD, Best Medical Canada, Ltd) previously calibrated in RQA5, RQA7 and RQA9 beams were used to estimate patient skin dose during 15 fluoroscopy-guided procedures in neuroradiology (NR: vertebroplasty and cerebral angiography) and interventional radiology (IR: chemo-embolization and hepatic biopsy). Five dosimeters were placed on the skin of the patients in the x-ray beam where high radiation dose levels were expected and the cumulative dose was recorded for each procedure. Correlation between the two approaches was tested using SPSS 15 statistics software (SPSS Inc, Chicago, IL).

Measured skin dose varied between 0.08 and 3.41 Gy and 0.02 and 2.84 Gy for respectively abdominal and neurological procedures. The ratio between the measured and the indicated cumulative doses were respectively 0.8 (R2 = 0.70, p-value = 0.019) and 0.7 (R2 = 0.87, p-value = 0.001) indicating that the cumulative dose slightly overestimates the actual maximum skin dose.

Cumulative dose may differ from actual skin dose as it depends on the location of the IRP to patient skin and the number of gantry orientations used. Nevertheless, its use is valuable since it represents a reliable indicator for predicting deterministic effects. The work is still an on-going process.

Cumulative dose allows the development of a strategy to inform the patient about the short-term radiological complications to be expected.

Samara, E, Bize, P, Binaghi, S, Aroua, A, Verdun, F, Management of Radiological Short-term Complications in Interventional Radiology: How Reliable Is the Cumulative Dose?.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8007235.html