Where should we measure the entrance air kerma rate during acceptance testing of the automatic dose control of a fluoroscopic system?

Abstract

In Japan, the entrance air kerma rate (EAKR) to a patient cannot exceed 50 mGy/min in conventional fluoroscopy. However, it is unclear where the EAKR should be measured. We obtained the tube potential and tube current as a function of polymethylmethacrylate (PMMA) thickness, and the EAKR at the interventional reference point (IRP) was measured from the trajectory. The EAKR at the point established by the U.S. Food and Drug Administration (FDA) was calculated from EAKR at the IRP. The EAKR at the IRP exceeded the limit at a PMMA thickness of 22–28 cm. However, the EAKR did not exceed the limit at the FDA point. If the EAKR to a patient is being verified to meet the recent Japanese ruling, the EAKR should be measured at the FDA point, and if the EAKR is being evaluated for determination of the skin dose, it should be monitored at the IRP.

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References

  1. 1.

    Japanese medical law enforcement http://law.e-gov.go.jp/htmldata/S23/S23F03601000050.html (accessed May 22, 2011) (Japanese).

  2. 2.

    International Electrotechnical Commission (2000) IEC report 60601. Medical electrical equipment—Part 2–43: particular requirements for the safety of X-ray equipment for interventional procedures. International Electrotechnical Commission, Geneva.

  3. 3.

    21CFR1020.32, Code of Federal Regulations, Title 21, Volume 8, Revised as of April 2006, DHHS, FDA.

  4. 4.

    Safety guideline to prevent radiation-induced skin injury in interventional radiology. http://www.fujita-hu.ac.jp/~ssuzuki/bougo/book/ivr.pdf (accessed May 22, 2011) (Japanese).

  5. 5.

    Maximum dose rate measurements in fluoroscopy equipment in service manual. M516-2029B. Shimadzu Corporation, Kyoto, Japan (Japanese).

  6. 6.

    Kwon D, Little MP, Miller DL. Reference air kerma and kerma-area product as estimators of peak skin dose for fluoroscopically guided interventions. Med Phys. 2011;38(7):4196–204.

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Conflict of interest

The authors declare that we have no conflict of interest in this study.

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Correspondence to Atsushi Fukuda.

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Fukuda, A., Miyati, T. & Matsubara, K. Where should we measure the entrance air kerma rate during acceptance testing of the automatic dose control of a fluoroscopic system?. Radiol Phys Technol 6, 313–316 (2013). https://doi.org/10.1007/s12194-013-0202-9

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Keywords

  • Entrance air kerma to patient
  • Medical law enforcement
  • Acceptance testing
  • IRP
  • FDA point
  • Interventional radiology