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Intra-arterial chemotherapy for retinoblastoma: the dosimetric impact

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

Purposes are (1) to measure main radiation parameters and (2) to propose a method to estimate the absorbed doses of internal organs starting from DAP values. Measuring the exposition of internal organs by repeated irradiations on an anthropomorphic phantom with the same settings used in vivo, we could establish correlations between (1) DAP and the dose recorded by a dosimeter placed along the X-ray beam entrance pathway; (2) the dose recorded by the same dosimeter and the absorbed dose in internal organs.

Methods

Forty-four consecutive patients (16 males, 28 females) (mean age 35.4 months) treated at our institution with IAC (216 procedures: 196 via the ICA and 20 into branches of the ECA) were included in this prospective study. IAC was divided into 5 phases. Fluoroscopic time, DAP, and ESD were measured.

Results

The mean DAP was 595 ± 445 cGy cm2 and the mean fluoroscopic time was 540 ± 403 s. ESD was on average 9.59 mGy (range 0.8–165 mGy). The absorbed dose was lower than 12.1 mGy in the left retina (the more exposed organ) in 75% of single treatments and lower than 25 mGy in 95% of treatments. In the cases of 3 and 6 sessions, the left retina of 75% of patients absorbed respectively less than 36.3 and 72.7 mGy, whereas the left retina of 95% of patients received less than 75.2 and 150.4 mGy. Other organs were less exposed.

Conclusion

This paper describes a method of absorbed dose estimation providing ranges used clinically in a single practice and the basis for further prospective studies.

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Abbreviations

IAC:

Intra-arterial chemotherapy

ICA:

Internal carotid artery

ECA:

External carotid artery

DAP:

Dose area product

ESD:

Entrance skin dose

OA:

Ophthalmic artery

SID:

Source-to-image receptor distance

FOV:

Field of view

TLD:

Thermoluminescence dosimeters

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Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Medical Physics, Azienda USL Toscana sud est, Siena, Italy

    Andrea Guasti

  2. Unit of Neuroimaging and Neurointervention, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Sara Leonini, Paola Gennari, Samuele Cioni, Ignazio Maria Vallone, Daniele Giuseppe Romano, Paolo Gambini Della Scala & Sandra Bracco

  3. Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy

    Eugenio Bertelli

  4. Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Roberta Baldi

  5. Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Siena, Italy

    Tommaso Casseri

  6. Department of Medical Physics, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Leonardo Guerrini & Annunziata Elena La Rocca

  7. Department of Medicine, Surgery and Neuroscience, Unit of Ophthalmology, Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Sonia De Francesco & Theodora Hadjistilianou

Authors
  1. Andrea Guasti
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  2. Sara Leonini
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  3. Eugenio Bertelli
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  4. Roberta Baldi
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  5. Paola Gennari
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  6. Samuele Cioni
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  7. Ignazio Maria Vallone
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  8. Daniele Giuseppe Romano
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  11. Annunziata Elena La Rocca
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  12. Paolo Gambini Della Scala
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  13. Sonia De Francesco
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  14. Theodora Hadjistilianou
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  15. Sandra Bracco
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Corresponding author

Correspondence to Sara Leonini.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Guasti, A., Leonini, S., Bertelli, E. et al. Intra-arterial chemotherapy for retinoblastoma: the dosimetric impact. Neuroradiology 61, 1083–1091 (2019). https://doi.org/10.1007/s00234-019-02260-7

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  • DOI: https://doi.org/10.1007/s00234-019-02260-7

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