scholarly journals How to Measure/Calculate Radiation Dose in Patients?

2021 ◽  
Author(s):  
Reinhard Loose ◽  
Michael Wucherer
Keyword(s):  
Radiation Dose ◽  
Digital Imaging ◽  
Adverse Reactions ◽  
Management Systems ◽  
Skin Dose ◽  
Skin Injuries ◽  
Threshold Doses ◽  
Dose Management ◽  
Dose Levels ◽  
Peak Skin Dose

AbstractPatients in fluoroscopically guided interventions (FGI) may be exposed to substantial radiation dose levels (SRDL). The most commonly reported adverse reactions are skin injuries with erythema or necrosis. It is therefore important for the interventional radiologist to know deterministic effects with their threshold doses. If possible all relevant modality parameters should be displayed on the interventionalists screen. Dosimetric parameters should be displayed in digital imaging and communications in medicine (DICOM) units and stored as DICOM Radiation Dose Structured Report (RDSR). The peak skin dose (PSD) is the most relevant risk parameter for skin injuries. Dose management systems (DMS) help optimising radiation exposure of patients. However, their calculation of skin dose maps is only available after a FGI. Therefore, dose maps and PSD should preferably be calculated and displayed in real time by the modality.

TREATMENT OF INTERNAL CAROTID ANEURYSMS USING PIPELINE EMBOLIZATION DEVICES: MEASURING THE RADIATION DOSE OF THE PATIENT AND DETERMINING THE FACTORS AFFECTING IT

2020 ◽  
Vol 188 (3) ◽  
pp. 389-396 ◽  
Author(s):  
Satoru Kawauchi ◽  
Koichi Chida ◽  
Takashi Moritake ◽  
Yusuke Hamada ◽  
Yuji Matsumaru ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Radiation Dose ◽  
Odds Ratio ◽  
Internal Carotid ◽  
Skin Dose ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Deployment Time ◽  
Carotid Aneurysms ◽  
Peak Skin Dose

Abstract The purpose of this study was to measure the peak skin dose (PSD) and bilateral lens doses using radiophotoluminescence glass dosimeters and to determine the factors influencing the radiation dose in cases of cerebral aneurysm treated with pipeline embolization devices (PEDs). The cumulative dose, PSD and right and left lens doses were 3818.1 ± 1604.6, 1880.0 ± 723.0, 124.8 ± 49.2 and 180.7 ± 124.8 mGy, respectively. Using multivariate analysis, body mass index (p < 0.01; odds ratio (OR) = 1.806; 95% confidence interval (CI) = 1.007–3.238) and deployment time of PED (p < 0.05; OR = 1.107; 95% CI = 1.001–1.224) were found to be the independent predictors of PSD exceeding 2 Gy. Measures such as collimation of the radiation field and optimization of radiation dose should be taken to reduce the radiation to the patient.

scholarly journals Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in Neuroradiology

2012 ◽  
Vol 34 (2) ◽  
pp. 277-282 ◽  
Author(s):  
E. Vano ◽  
J.M. Fernandez ◽  
R.M. Sanchez ◽  
D. Martinez ◽  
L. Lopez Ibor ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Skin Injuries ◽  
Dose Management ◽  
Patient Radiation Dose

Experimental evaluation of a radiation dose management system-integrated 3D skin dose map by comparison with XR-RV3 Gafchromic® films

2019 ◽  
Vol 66 ◽  
pp. 77-87 ◽  
Author(s):  
Joël Greffier ◽  
Nicolas Grussenmeyer-Mary ◽  
Ahmed Larbi ◽  
Jean Goupil ◽  
Guillaume Cayla ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Experimental Evaluation ◽  
Management System ◽  
Skin Dose ◽  
Dose Management ◽  
3D Skin

Assessment of organ radiation dose associated with uterine artery embolization

2006 ◽  
Vol 47 (2) ◽  
pp. 179-185 ◽  
Author(s):  
O. Glomset ◽  
J. Hellesnes ◽  
N. Heimland ◽  
G. Hafsahl ◽  
H. J. Smith
Keyword(s):  
Statistical Analysis ◽  
Radiation Dose ◽  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Skin Dose ◽  
Artery Embolization ◽  
System A ◽  
Significant Difference ◽  
The Mean ◽  
Peak Skin Dose

Purpose: To evaluate the radiation dose to the skin, uterus, and ovaries during uterine artery embolization. Material and Methods: Guided uterine artery embolization for leiomyomata and two types of X-ray equipment with different dose levels were utilized during fluoroscopy in 20 women (ages ranging from 32 to 52 years, body weights from 55 to 68 kg). The first 13 women were treated using a non-pulsed system A, with 3.3 mm Al filtering and, for simplicity, a fixed peak voltage 80 kV. During treatment of the other 7 women, a pulsed system B with 5.4 mm Al filtering and an identical fixed voltage was used. The dose area product (DAP) was recorded. The vaginal dose of the first 13 patients and the peak skin dose of all patients were measured with thermoluminescent dosimeters (TLDs). TLDs were placed in the posterior vaginal fornix and on the skin at the beam entrance site. The uterine and ovarian doses were estimated based on the measured skin doses, normalized depth dose, and organ depth values. The effective dose (Deff) was estimated based on the observed DAP values. The measured vaginal doses and the corresponding estimated uterine doses were compared statistically, as were the DAP values from systems A and B. Results: For system A, the mean fluoroscopic time was 20.9 min (range 12.7–31.1), and for system B 35.9 min (range 16.4–55.4). The mean numbers of angiographic exposures for systems A and B were 82 (range 30–164) and 37 (range 20–72), respectively. The mean peak skin dose for system A was 601.5 mGy (range 279–1030) and for system B 453 mGy (range 257–875). The mean DAP for system A was 88.6 Gy·cm2 (range 41.4–161.0) and for system B 52.5 Gy·cm2 (range 20.1–107.9). Statistical analysis showed a significant difference between the DAP values, the DAP for system B being the lower one. The mean estimated effective doses from systems A and B were 32 mSv (range 15.1–58.4) and 22 mSv (range 9–46), respectively. The mean estimated maximum uterine and ovarian doses using system A were 81 mGy (range 30–247) and 85 mGy (range 24–207), respectively; when using system B, the respective doses were 101 mGy (range 45–182) and 105 mGy (range 31–246). The measured vaginal doses had a mean value of 52.5 mGy (range 12–124). Statistical analysis revealed a significant difference between the estimated uterine doses and the measured vaginal doses. Conclusion: A significant difference was found between the estimated uterine doses and the corresponding measured vaginal doses. This has to be kept in mind when using vaginal doses as a substitute for the uterine dose. There was also a significant difference between the DAP values from systems A and B. System B, with pulsed fluoroscopy and greater filtration, gave the lower exposure. The maximum skin dose indicates that skin injuries are unlikely to occur. The ovarian doses are also below the threshold for temporary or permanent sterility. The stochastic risk for radiation-induced cancer and genetic injury to the patient's future children is not considered as substantial.

Benefits and limitations for the use of radiation dose management systems in medical imaging. practical experience in a university hospital

2022 ◽  
Author(s):  
Eliseo Vano PhD ◽  
José M Fernández ◽  
José I. Ten ◽  
Roberto M. Sanchez
Keyword(s):  
Medical Imaging ◽  
Radiation Dose ◽  
Practical Experience ◽  
Patient Dose ◽  
Public Hospitals ◽  
University Hospital ◽  
Management Systems ◽  
Clinical Indication ◽  
High Dose ◽  
Dose Management

Objectives: Radiation dose management systems (DMS) are currently to help improve radiation protection in medical imaging and interventions. This study presents our experience using a homemade DMS called DOLQA (Dose On-Line for Quality Assurance). Methods: Our DMS is connected to 14 X-ray systems in a university hospital linked to the central data repository of a large network of 16 public hospitals in the Autonomous Community of Madrid, with 6.7 million inhabitants. The system allows us to manage individual patient dose data and groups of procedures with the same clinical indications, and compare them with diagnostic reference levels (DRLs). The system can also help to prioritize optimisation actions. Results: This study includes results of imaging examinations from 2020, with 3,7601 procedures and 28,6471 radiation events included in the radiation dose structured reports (RDSR), for computed tomography (CT), interventional procedures, positron emission tomography-CT (PET-CT) and mammography. Conclusions: The benefits of the system include: automatic registration and management of patient doses, creation of dose reports for patients, information on recurrent examinations, high dose alerts, and help to define optimisation actions. The system requires the support of medical physicists and implication of radiologists and radiographers. DMSs must undergo periodic quality controls and audit reports must be drawn up and submitted to the hospital’s quality committee. The drawbacks of DMSs include the need for continuous external support (medical physics experts, radiologists, radiographers, technical services of imaging equipment and hospital informatics services) and the need to include data on clinical indication for the imaging procedures. Advances in knowledge: DMS perform automatic management of radiation doses, produces patient dose reports, and registers high dose alerts to suggest optimisation actions. Benefits and limitations are derived from the practical experience in a large university hospital.

scholarly journals Patient doses in endovascular and hybrid revascularization of the lower extremities

2018 ◽  
Vol 91 (1091) ◽  
pp. 20180176
Author(s):  
Desislava D Kostova-Lefterova ◽  
Nadelin N Nikolov ◽  
Stefan S Stanev ◽  
Boyka B Stoyanova
Keyword(s):  
Vascular Access ◽  
Brachial Artery ◽  
Lower Extremities ◽  
Skin Dose ◽  
Hybrid Surgery ◽  
Skin Injuries ◽  
Surgical Methods ◽  
Hybrid Revascularization ◽  
Radiation Induced ◽  
Peak Skin Dose

Objective:Hybrid surgical methods such as remote endarterectomy and endovascular revascularization are fluoroscopy-guided procedures successfully replacing conventional open surgery for treatment of peripheral artery disease (PAD). The aim of this study was to: (1) evaluate the dose parameters describing exposure of patients undergoing endovascular or hybrid revascularization of the lower limb (below the inguinal ligament); (2) compare the data available in the literature with the evaluations of patients’ dose values and related factors for patients undergoing such procedures; (3) examine the correlation of doses with certain parameters; (4) estimate the peak skin dose and assess the potential for radiation-induced skin injuries during the procedures.Methods:Data for 259 patients were extracted retrospectively and analyzed. The procedures were grouped by type of intervention, vascular approach, and level of complexity. The analyses included the correlation of dose values with the operating team.Results:The air kerma-area product (KAP) and fluoroscopy time (FT) values greatly varied depending on the procedure type but also among patients undergoing the same procedure. The type of vascular access has the largest impact on patients’ doses. The KAP and FT values for brachial artery were: 347 Gy.cm2and FT: NA; for contralateral common femoral artery (CFA) approach: 207 Gy.cm2and 153 s; e.g. significantly higher than for ipsilateral CFA: 96 Gy.cm2and 78 s; for hybrid surgery: 77 Gy.cm2and 41 s; and for ipsilateral retrograde popliteal approach: 61 Gy.cm2and 53 s. The same tendency is observed for the peak skin dose (PSD) values: the highest are for brachial artery (2053 mGy) and contralateral CFA (1325 mGy) approach, followed by the ipsilateral CFA (748 mGy), hybrid surgery (649 mGy), and ipsilateral retrograde popliteal approach (566 mGy).Conclusion:Registered dose values and FT for the different procedures do not exceed the International Atomic Energy Agency (IAEA) proposed trigger values for patients’ follow-up for radiation-induced skin injuries. The type of vascular access has the highest negative impact on radiation dose levels and resultant KAP, PSD, and FT values. There is a significant increase of the dose values with increase of the number of inserted stents and the level of complexity. This should be considered in planning, especially for patients who undergo multiple diagnostic and therapeutic procedures.Advances in knowledge:This study gives a systematic understanding for patient radiation exposure in endovascular and hybrid revascularization of the lower extremities, thus far absent in the literature.

scholarly journals Optimization of the Maximum Skin Dose Measurement Technique Using Digital Imaging and Communication in Medicine—Radiation Dose Structured Report Data for Patients Undergoing Cerebral Angiography

Diagnostics ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 14
Author(s):  
Koichi Morota ◽  
Takashi Moritake ◽  
Keisuke Nagamoto ◽  
Satoru Matsuzaki ◽  
Koichi Nakagami ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Cerebral Angiography ◽  
Digital Imaging ◽  
Conversion Factor ◽  
Quadratic Function ◽  
Skin Dose ◽  
Estimation Model ◽  
Data Set ◽  
Structured Report ◽  
R Ratio

Understanding the maximum skin dose is important for avoiding tissue reactions in cerebral angiography. In this study, we devised a method for using digital imaging and communication in medicine—radiation dose structured report (DICOM-RDSR) data to accurately estimate the maximum skin dose from the total air kerma at the patient entrance reference point (Total Ka,r). Using a test data set (n = 50), we defined the mean ratio of the maximum skin dose obtained from measurements with radio-photoluminescence glass dosimeters (RPLGDs) to the Total Ka,r as the conversion factor, CFKa,constant, and compared the accuracy of the estimated maximum skin dose obtained from multiplying Total Ka,r by CFKa,constant (Estimation Model 1) with that of the estimated maximum skin dose obtained from multiplying Total Ka,r by the functional conversion factor CFKa,function (Estimation Model 2). Estimation Model 2, which uses the quadratic function for the ratio of the fluoroscopy Ka,r to the Total Ka,r (Ka,r ratio), provided an estimated maximum skin dose closer to that obtained from direct measurements with RPLGDs than compared with that determined using Estimation Model 1. The same results were obtained for the validation data set (n = 50). It was suggested the quadratic function for the Ka,r ratio provides a more accurate estimate of the maximum skin dose in real time.

EVALUATION OF OCCUPATIONAL RADIATION EXPOSURE IN A RADIO-DIAGNOSTIC FACILITY IN KATSINA- NIGERIA

2020 ◽  
Vol 4 (2) ◽  
pp. 722-729
Author(s):  
Usman Sani ◽  
Bashir Gide Muhammad ◽  
Dimas Skam Joseph ◽  
D. Z. Joseph
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Short Exposure ◽  
Skin Dose ◽  
Continuous Training ◽  
Short Exposure Time ◽  
Occupational Dose ◽  
Dose Limits ◽  
Radiation Workers ◽  
Occupational Radiation

Poor implementation of quality assurance programs in the radiation industry has been a major setback in our locality. Several studies revealed that occupational workers are exposed to many potential hazards of ionizing radiation during radio-diagnostic procedures, yet radiation workers are often not monitored. This study aims to evaluate the occupational exposure of the radiation workers in Federal Medical Centre Katsina, and to compare the exposure with recommended occupational radiation dose limits. The quarterly readings of 20 thermo-luminescent dosimeters (TLDs') used by the radiation workers from January to December, 2019 were collected from the facility's radiation monitoring archive, and subsequently assessed and analyzed. The results indicate that the average annual equivalent dose per occupational worker range from 0.74 to 1.20 mSv and 1.28 to 2.21 mSv for skin surface and deep skin dose, measured at 10 mm and 0.07 mm tissue depth respectively. The occupational dose was within the recommended national and international limits of 5 mSv per annum or an average of 20 mSv in 5 years. Therefore, there was no significant radiation exposure to all the occupational workers in the study area. Though, the occupational radiation dose is within recommended limit, this does not eliminate stochastic effect of radiation. The study recommended that the occupational workers should adhere and strictly comply with the principles of radiation protection which includes distance, short exposure time, shielding and proper monitoring of dose limits. Furthermore, continuous training of the radiation workers is advised.

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