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Patient Organ Radiation Doses During Treatment for Aneurysmal Subarachnoid Hemorrhage

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Abstract

Purpose

The aim of this retrospective study was to estimate risk organ doses and to estimate radiation risks during the imaging work-up and treatment for aneurysmal subarachnoid hemorrhage (SAH).

Methods

The imaging procedures comprised computed tomography and digital subtraction angiography studies for diagnosis or endovascular interventional procedures in 50 consecutive patients. Equivalent organ doses (HT) to skin, brain, eye lens, salivary glands, thyroid and oral mucosa were measured using thermoluminescence dosimeters in an anthropomorphic head phantom. Picture archiving and communication system (PACS) and radiological information system (RIS) records were analyzed and the frequency of each imaging procedure was recorded as well as the registered individual kerma-length product (PKL) and the kerma-area product (PKA). The doses were computed by multiplying the recorded PKL and PKA values by the conversion coefficients HT/PKL and HT/PKA from the head phantom.

Results

The mean fluoroscopy time, PKL and PKA were 38 min, 7269 mGy cm and 286 Gy cm2, respectively. The estimated mean equivalent doses were as follows: skin 2.51 Sv, brain 0.92 Sv, eye lens 0.43 Sv and salivary glands 0.23 Sv. Maximum organ doses were 2.3–3.5 times higher than the mean. Interventional procedures contributed 66 % to skin dose, 55 % to brain dose and 25 % to eye lens dose. Of the patients with an estimated skin dose exceeding 6 Sv, only 1 developed temporary epilation.

Conclusion

The risk for radiation-induced cancer for SAH patients is low (2–3 cases per 1,000 patients, of which 90 % are expected to be benign types) compared with the risk of tissue reactions on the head such as skin erythema and epilation (1 temporary epilation per 50 patients).

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Acknowledgements

The authors thank Magnus Gårdestig and Gudrun Alm Carlsson for calibrating the TLD and for giving valuable comments on the manuscript, respectively. Miriam Rodriguez Catarino, MD, PhD, performed some of the endovascular procedures. This work was supported by the regional ALF-research fund in Sweden.

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Authors and Affiliations

  1. Department for Medical and Health Sciences, Medical Physics, Centre for Medical Image Science and Visualization (CMIV), Linköping University, County Council of Östergötland, 58185, Linköping, Sweden

    M. Sandborg PhD, J. Nilsson Althén & H. Pettersson PhD

  2. Linköping University, 58185, Linköping, Sweden

    M. Sandborg PhD

  3. Department of Neurosurgery, University Hospital, 58185, Linköping, Sweden

    S. Rossitti MD, PhD

Authors
  1. M. Sandborg PhD
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  2. J. Nilsson Althén
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  3. H. Pettersson PhD
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  4. S. Rossitti MD, PhD
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Correspondence to M. Sandborg PhD.

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Sandborg, M., Nilsson Althén, J., Pettersson, H. et al. Patient Organ Radiation Doses During Treatment for Aneurysmal Subarachnoid Hemorrhage. Clin Neuroradiol 22, 315–325 (2012). https://doi.org/10.1007/s00062-012-0147-0

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  • DOI: https://doi.org/10.1007/s00062-012-0147-0

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