SKIN DOSE MAPPING IN INTERVENTIONAL CARDIOLOGY: A PRACTICAL SOLUTION

2020 ◽  
Vol 188 (4) ◽  
pp. 508-515 ◽  
Author(s):  
M Krajinović ◽  
M Dobrić ◽  
O Ciraj-Bjelac
Keyword(s):  
Interventional Cardiology ◽  
Mean Deviation ◽  
Skin Dose ◽  
Suitable Alternative ◽  
Gafchromic Film ◽  
Radiation Induced ◽  
The Mean ◽  
Dose Mapping ◽  
Tissue Reactions ◽  
Peak Skin Dose

Abstract Numerous cases of radiation-induced tissue reactions following interventional cardiology (IC) procedures have been reported, resulting in the need for an optimized and personalized dosimetry. At present, there are many fluoroscopy units without Digital Imaging and Communications in Medicine (DICOM) Radiation Dose Structured Report globally installed. Many of these have not been updated yet, and may never be, therefore, the main objectives of this paper are to develop an offline skin dose mapping application, which uses DICOM headers for the peak skin dose (PSD) assessment and to compare the PSD assessment results to XR-RV3 Gafchromic film for common IC procedures. The mean deviation between the measured and the calculated PSD was 8.7 ± 26.3%. Simulated skin dose map showed good matching with XR-RV3 Gafchromic film. The skin dose mapping application presented in this paper is an elegant solution and a suitable alternative to XR-RV3 Gafchromic film.

Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose

2017 ◽  
Vol 38 ◽  
pp. 16-22 ◽  
Author(s):  
J. Greffier ◽  
C. Van Ngoc Ty ◽  
G. Bonniaud ◽  
G. Moliner ◽  
B. Ledermann ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Gafchromic Film ◽  
Peak Skin Dose

RADIATION DOSE TO PATIENTS IN CORONARY INTERVENTIONAL PROCEDURES: A SURVEY

2018 ◽  
Vol 184 (1) ◽  
pp. 1-4 ◽  
Author(s):  
A Brindhaban
Keyword(s):  
Interventional Procedures ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Radiation Doses ◽  
Dose Area Product ◽  
Maximum Value ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Area Product ◽  
Peak Skin Dose

Abstract The objective of this study was to evaluate dose–area product (DAP) and peak skin dose (PSD) for coronary angiography (CA) and percutaneous coronary intervention (PCI). The DAP and PSD of 300 randomly selected patients who were referred to CA and/or PCI, over a period of 3 months were recorded and analyzed. The mean DAP of 32 Gy cm2 and mean PSD of 412 mGy for CA were lower than 118 Gy cm2 and 857 mGy, respectively, for PCI. The DAP range of 2–84 Gy cm2 for CA and 12–378 mGy for PCI were also established. The maximum value of PSD for PCI procedures reached above the 2 Gy threshold for erythema. However, these values are similar to those available in literature. Periodic surveys may be required to monitor and/or reduce radiation doses in coronary interventional procedures.

A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures

2015 ◽  
Vol 8 (10) ◽  
pp. 1052-1055 ◽  
Author(s):  
Diogo C Haussen ◽  
Imramsjah Martijn John Van Der Bom ◽  
Raul G Nogueira
Keyword(s):  
Radiation Exposure ◽  
Radiation Protection ◽  
Protection System ◽  
Skin Dose ◽  
Lead Apron ◽  
Dose Area Product ◽  
Primary Operator ◽  
The Mean ◽  
Area Product ◽  
Peak Skin Dose

Background and purposeWe aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures.Materials and methodsRadiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot.ResultsThe two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators’ cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator.ConclusionsThe ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection.

scholarly journals Patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures

2015 ◽  
Vol 04 (01) ◽  
pp. 7-12 ◽  
Author(s):  
Antar E. Aly ◽  
Ibrahim M. Duhaini ◽  
Samia M. Manaa ◽  
Sayed M. Tarique ◽  
Shehim E. Kuniyil ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Dose Area Product ◽  
Area Product ◽  
Peak Skin Dose

Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project

2021 ◽  
pp. 028418512110620
Author(s):  
Joelle Ann Feghali ◽  
Julie Delépierre ◽  
Olivera Ciraj Belac ◽  
Jérémie Dabin ◽  
Marine Deleu ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Predictive Models ◽  
A Priori ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Skin Dose ◽  
A Posteriori ◽  
Tube Voltage ◽  
Percutaneous Coronary ◽  
Peak Skin Dose

Background Optimizing patient exposure in interventional cardiology is key to avoid skin injuries. Purpose To establish predictive models of peak skin dose (PSD) during percutaneous coronary intervention (PCI), chronic total occlusion percutaneous coronary intervention (CTO), and transcatheter aortic valve implantation (TAVI) procedures. Material and Methods A total of 534 PCI, 219 CTO, and 209 TAVI were collected from 12 hospitals in eight European countries. Independent associations between PSD and clinical and technical dose determinants were examined for those procedures using multivariate statistical analysis. A priori and a posteriori predictive models were built using stepwise multiple linear regressions. A fourfold cross-validation was performed, and models’ performance was evaluated using the root mean square error (RMSE), mean absolute percentage error (MAPE), coefficient of determination (R²), and linear correlation coefficient (r). Results Multivariate analysis proved technical parameters to overweight clinical complexity indices with PSD mainly affected by fluoroscopy time, tube voltage, tube current, distance to detector, and tube angulation for PCI. For CTO, these were body mass index, tube voltage, and fluoroscopy contribution. For TAVI, these parameters were sex, fluoroscopy time, tube voltage, and cine acquisitions. When benchmarking the predictive models, the correlation coefficients were r = 0.45 for the a priori model and r = 0.89 for the a posteriori model for PCI. These were 0.44 and 0.67, respectively, for the CTO a priori and a posteriori models, and 0.58 and 0.74, respectively, for the TAVI a priori and a posteriori models. Conclusion A priori predictive models can help operators estimate the PSD before performing the intervention while a posteriori models are more accurate estimates and can be useful in the absence of skin dose mapping solutions

scholarly journals C-arm rotation as a method for reducing peak skin dose in interventional cardiology

Open Heart ◽  
2014 ◽  
Vol 1 (1) ◽  
pp. e000141 ◽  
Author(s):  
Alexander S Pasciak ◽  
Austin C Bourgeois ◽  
A Kyle Jones
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Peak Skin Dose

scholarly journals A comparison of two peak skin dose metrics calculated by patient dose management systems: implications for clinical management

2021 ◽  
pp. 20200924
Author(s):  
Alisha Coates ◽  
Andy Rogers
Keyword(s):  
Angular Position ◽  
Absorbed Dose ◽  
Patient Dose ◽  
Mean Deviation ◽  
Skin Dose ◽  
Worst Case ◽  
Air Kerma ◽  
Dose Monitoring ◽  
Dose Metrics ◽  
Peak Skin Dose

Objective: The patient dose monitoring systems DoseWatch and DoseWise were compared to evaluate their reported patient Peak Skin Dose. Methods: 20 patients with the highest Peak Skin Dose on DoseWise were obtained; the values were converted to a Reference Point Air Kerma (RPAK) value and used for comparison. These patients were accessed in DoseWatch to obtain the recorded Worst Case RPAK. The co-ordinates for the position were obtained for each patient to find a primary and secondary angular position for the peak skin dose. The two positions produced by the two softwares were compared. Results: There is a mean deviation of over 0.5 Gy between the two software packages when comparing the calculated maximum skin air kerma Peak skin dose from DoseWise and the Worst Case RPAK from DoseWatch. Conclusion: We have shown mean deviations between these two systems. This difference is enough, for higher peak skin absorbed dose patients, to change the management of patients, so local services must understand their models to properly implement patient management. Advances in knowledge: Neither system is incorrect, but these differences show that a deeper understanding of the analysis limitations is required to properly inform post-procedural high-skin dose follow-up procedures.

BENCHMARKING THE DOSE MAP SOFTWARE FOR CLINICAL IMPLEMENTATION AND ESTABLISHMENT OF A LOCAL FOLLOW-UP PROTOCOL FOR THE MANAGEMENT OF SKIN INJURES FOLLOWING COMPLEX INTERVENTIONAL CARDIOLOGY PROCEDURES

2020 ◽  
Vol 190 (4) ◽  
pp. 392-399
Author(s):  
Chadia Rizk ◽  
Antoine Sarkis ◽  
Alice Bejjani ◽  
Jérémie Dabin ◽  
Jad Farah
Keyword(s):  
Confidence Interval ◽  
Interventional Cardiology ◽  
Skin Dose ◽  
Clinical Implementation ◽  
Average Deviation ◽  
Skin Exposure ◽  
Acceptable Accuracy ◽  
Peak Skin Dose ◽  
Thermoluminescent Dosemeters

Abstract This paper aims to validate the accuracy of the peak skin dose (Dskin,max) computed by the Dose Map software (DMS)—general electric and establish a local follow-up protocol for the management of patient skin injuries following complex interventional cardiology procedures (ICPs). Dskin,max was computed by the DMS and was simultaneously measured by a dense mesh of 72 thermoluminescent dosemeters for 20 ICP. Measured and computed Dskin,max were compared using Lin’s concordance coefficient (${\rho}_c$). The implementation of a local follow-up strategy was based on a computed Dskin,max of 2 Gy. After eliminating 2 outliers, the average deviation between the two methods was 6% (range: −36 to +40%). Concordance between the two methods was moderate with ${\rho}_c$ (confidence interval) of 0.9128 (0.8541–0.9486). DMS computes Dskin,max with an acceptable accuracy and can be used to setup an individual follow-up process for patients with high skin exposure and risks.

Evaluation of effective and peak skin dose of patients undergoing interventional cardiology procedures

2019 ◽  
Vol 68 ◽  
pp. 159
Author(s):  
Katerina Romanova ◽  
Desislava Ivanova ◽  
Velko Rangelov ◽  
Mitko Alyakov
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Peak Skin Dose
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