Variations of Patient Doses in Interventional Examinations at Different Angiographic Units
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We analyzed doses for various angiographic procedures using different X-ray systems in order to assess dose variations.
Dose-area product (DAP), skin doses from thermoluminescent dosimeters and air kerma measurements of 308 patients (239 diagnostic and 69 interventional) were assessed for five different angiographic units. All fluoroscopic and radiographic exposure parameters were recorded online for single and multiprojection studies. Radiation outputs of each X-ray system were also measured for all the modes of exposure using standard protocols for such measurements.
In general, the complexity of the angiographic procedure was found to be the most important reason for high radiation doses. Skill of the radiologist, management of the exposure parameters and calibration of the system are the other factors to be considered. Lateral cerebral interventional studies carry the highest risk for deterministic effects on the lens of the eye. Effective doses were calculated from DAP measurements and maximum fatal cancer risk factors were found for carotid studies.
Interventional radiologists should measure patient doses for their examinations. If there is a lack of necessary instrumentation for this purpose, then published dose reports should be used in order to predict the dose levels from some of the exposure parameters. Patient dose information should include not only the measured quantity but also the measured radiation output of the X-ray unit and exposure parameters used during radiographic and fluoroscopic exposures.
KeywordsDose-area product Dosimetry Interventional radiology
- 3.International Electrotechnical Commission (2000) Medical electrical equipment. Part 2-43: Particular requirements for the safety of X-ray equipment for interventional procedures. IEC report 60601. Geneva, 606012–43Google Scholar
- 6.Institute of Physics and Engineering in Medicine (1997) Recommended standards for the routine performance testing of diagnostic X-ray imaging systems. IPEM report no. 77. YorkGoogle Scholar
- 8.Jones DG, Wall BF (1985) Organ doses from medical X-ray examinations calculated using Monte Carlo techniques. NRPB report 186. HMSO, LondonGoogle Scholar
- 9.Hart D, Jones DG, Wall BF (1994) Normalized organ doses for medical X-ray examinations calculated using Monte Carlo techniques. NRPB report NRPB-SR 262. HMSO, LondonGoogle Scholar
- 10.Le Heron JC (1994) XDOSE X-ray radiography dosimetry program using NRPB SR-262 Organ Doses. National Radiation Laboratory, Christchurch. Ministry of Health, New Zealand.Google Scholar
- 13.European Commission (1996) European guidelines on quality criteria for diagnostic radiographic images. EUR 16260-EN Office for Official Publications of the European Communities, Luxembourg.Google Scholar
- 14.European Commission (1998) Radiation protection in interventional radiology. ERPET (European Radiation Protection Education and Training Course). Complutense University and CIEMAT. Proceedings published by the EC (Ref. XII-237–98)Google Scholar
- 29.O’Dea TJ, Geise RA (1997) Potential for radiation induced skin damage in neurological procedures: a review of 522 cases using automated dosimetry. Med Phys 24:969–970.Google Scholar
- 32.International Commission on Radiological Protection (1991) 1990 recommendations of the International Commission on Radiological Protection. ICRP Publication 60. Ann ICRP 21–3Google Scholar