Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures.

2.50
Hdl Handle:
http://hdl.handle.net/10146/618225
Title:
Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures.
Authors:
Jarvinen, Hannu; Farah, Jad; Siiskonen, Teemu; Ciraj-Bjelac, Olivera; Dabin, Jérémie; Carinou, Eleftheria; Domienik-Andrzejewska, Joanna; Kluszczynski, Dariusz; Knežević, Željka; Kopec, Renata; Majer, Marija; Malchair, Francoise; Negri, Anna; Pankowski, Piotr; Sarmento, Sandra; Trianni, Annalisa
Abstract:
The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries.; Gafchromic® films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (Ka,r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and Ka,r, and uncertainty of MSD were calculated.; About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and Ka,r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly >0.8), while fluoroscopy time is not suitable (p mostly <0.6). Generic alert levels based on DAP (Gy cm2) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1).; The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.
Affiliation:
Nofer Institute of Occupational Medicine
Citation:
Phys Med 2018, 46:67-74
Journal:
Physica Medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)
Issue Date:
Feb-2018
URI:
http://hdl.handle.net/10146/618225
DOI:
10.1016/j.ejmp.2018.01.010
PubMed ID:
29519411
Type:
Article
Language:
en
ISSN:
1724-191X
Sponsors:
This work was supported by the European Radiation Dosimetry Group (EURADOS WG 12 – Dosimetry in Medical Imaging). Authors would like to acknowledge all patients, health professionals and hospitals who took part in this project.
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Full metadata record

DC FieldValue Language
dc.contributor.authorJarvinen, Hannuen
dc.contributor.authorFarah, Jaden
dc.contributor.authorSiiskonen, Teemuen
dc.contributor.authorCiraj-Bjelac, Oliveraen
dc.contributor.authorDabin, Jérémieen
dc.contributor.authorCarinou, Eleftheriaen
dc.contributor.authorDomienik-Andrzejewska, Joannaen
dc.contributor.authorKluszczynski, Dariuszen
dc.contributor.authorKnežević, Željkaen
dc.contributor.authorKopec, Renataen
dc.contributor.authorMajer, Marijaen
dc.contributor.authorMalchair, Francoiseen
dc.contributor.authorNegri, Annaen
dc.contributor.authorPankowski, Piotren
dc.contributor.authorSarmento, Sandraen
dc.contributor.authorTrianni, Annalisaen
dc.date.accessioned2018-12-03T10:36:00Z-
dc.date.available2018-12-03T10:36:00Z-
dc.date.issued2018-02-
dc.identifier.citationPhys Med 2018, 46:67-74en
dc.identifier.issn1724-191X-
dc.identifier.pmid29519411-
dc.identifier.doi10.1016/j.ejmp.2018.01.010-
dc.identifier.urihttp://hdl.handle.net/10146/618225-
dc.description.abstractThe feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries.en
dc.description.abstractGafchromic® films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (Ka,r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and Ka,r, and uncertainty of MSD were calculated.en
dc.description.abstractAbout 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and Ka,r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly >0.8), while fluoroscopy time is not suitable (p mostly <0.6). Generic alert levels based on DAP (Gy cm2) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1).en
dc.description.abstractThe generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.en
dc.description.sponsorshipThis work was supported by the European Radiation Dosimetry Group (EURADOS WG 12 – Dosimetry in Medical Imaging). Authors would like to acknowledge all patients, health professionals and hospitals who took part in this project.en
dc.language.isoenen
dc.rightsArchived with thanks to Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)en
dc.subjectInterventional radiologyen
dc.subjectMaximum skin doseen
dc.subjectOnline dose indicatoren
dc.subjectSkin dose alert levelen
dc.subject.meshFeasibility Studies-
dc.subject.meshFluoroscopy-
dc.subject.meshHumans-
dc.subject.meshSkin-
dc.subject.meshSurgery, Computer-Assisted-
dc.subject.meshThermoluminescent Dosimetry-
dc.titleFeasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures.en
dc.typeArticleen
dc.contributor.departmentNofer Institute of Occupational Medicineen
dc.identifier.journalPhysica Medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)en

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