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

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 SPOT REGION OF INTEREST IMAGING: A NOVEL FUNCTIONALITY AIMED AT X-RAY DOSE REDUCTION IN NEUROINTERVENTIONAL PROCEDURES

2020 ◽  
Vol 188 (3) ◽  
pp. 322-331
Author(s):  
Ljubisa Borota ◽  
Andreas Patz
Keyword(s):  
Dose Reduction ◽  
Region Of Interest ◽  
Skin Dose ◽  
X Ray ◽  
Dose Area Product ◽  
Dose Saving ◽  
Area Product ◽  
Anatomical Area ◽  
Neurointerventional Procedures ◽  
Peak Skin Dose

Abstract Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.

Skin dose and dose–area product values for interventional cardiology procedures

2001 ◽  
Vol 74 (877) ◽  
pp. 48-55 ◽  
Author(s):  
E Vano ◽  
L Gonzalez ◽  
J I Ten ◽  
J M Fernandez ◽  
E Guibelalde ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Dose Area Product ◽  
Area Product

scholarly journals Assessment of Patient Dose with Special Look at Pediatrics during Cardiovascular Imaging

2018 ◽  
Author(s):  
P Mehnati ◽  
M Asghari Jafarabadi ◽  
L Danaee
Keyword(s):  
Interventional Cardiology ◽  
Cardiovascular Imaging ◽  
Patient Dose ◽  
Fluoroscopy Time ◽  
Skin Dose ◽  
Dose Area Product ◽  
Number Of Children ◽  
Imaging Center ◽  
High Fluorescence ◽  
Area Product

Aim: During interventional cardiology processes, patients especially women and children receive high radiation doses due to their sensitivities. In this study, we evaluated a pediatric patient dose separately in those undergone intervention cardiac procedure.Methods: In a public hospital with 252 patients, Entrance Skin Dose (ESD) and Dose-Area Product (DAP) were recorded. Prior to the beginning of fluoroscopic procedure, the chest thickness and Body Mass Index (BMI) of patients were measured. Furthermore, kV, mAs, an angle of tube and time of angiography and angioplasty were recorded.Results: Children ratio to all patients underwent the cardiovascular imaging was 1.8. The means of patients' ESD, DAP and fluoroscopy time were 178.3±17 mGy, 1123.6±11 μGym2 and 281.4±181.2 s, respectively for coronary angiography. In coronary angioplasty, the increase in ESD, DAP and fluoroscopy times were observed. In children with congenital heart disease, ESD mean, DAP and fluoroscopy time were 24.0±9.8 mGy, 147.8±62 μGym2, and 552±72s, respectively. The females were 96.8 under 30 years and their dose mean was 276±37 mGy, 368±24 μGym2 for ESD and DAP received, respectively with 376s fluoroscopy time. More than 37% of patients had (25-30) BMI. The relation between the patients’ BMI and DAP was significant (p=0.0001). Mean mAs was 359±34 and kV was 71.23±2.7. Above all, a direct and significant correlation was found between the patients’ chest thickness with variation kV (p=0.037, r=0.11) and mAs (p<0/001, r =0/28).Conclusion: The results demonstrated that the number of children referred to the cardiologic part of the heart and the also dose rate received by them during this test were higher than the data provided for children in developing countries, thus the factors causing such diseases require more attention. Moreover, the number of women was more than twice the referred patients to the heart imaging center, the doses received by these women can be causes of maternal diseases in children. Paying attention to the children's perception of high-fluorescence time is necessary in comparison with total angiography time in order to reduce the number of radiation injuries among pediatrics.

AN ASSESSMENT OF RADIATION EXPOSURE DOSES IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION BASED ON ANGIOGRAPHIC RECORDS

2018 ◽  
Vol 183 (4) ◽  
pp. 475-482 ◽  
Author(s):  
M Maghbool ◽  
M A Hosseini
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Dose ◽  
Primary Percutaneous Coronary Intervention ◽  
Standard Dose ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Dose Area Product ◽  
Percutaneous Coronary ◽  
Using Data ◽  
Area Product

Abstract The stochastic and non-stochastic (deterministic) effects of radiation dose in patients undergoing primary percutaneous coronary intervention (PPCI) have been investigated using data recorded by an angiographic monitoring system. A total of 132 patients with acute myocardial infarction referred to the angiography department of Vali-Asr hospital, Fasa, Iran, during the second half of 2016 were recruited. Quantities like dose–area product (DAP), total air kerma (Ka,r) and fluoroscopy time (FT) were calculated and converted into effective dose (ED) and peak skin dose (PSD). The values for Ka,r, DAP and FT equaled 80 399.20 ± 63 312 mGy cm2, 1392.80 ± 1155.373 mGy and 524.11 ± 423.057 s, respectively, which were within the ranges reported in previous studies. After considering standard dose thresholds for Ka,r and PSD, it was revealed that only a small portion of patients had reached these thresholds and exceeded them (<3%). Moreover, ED < 20 mSv for the majority of patients was fairly consistent with results from a recent research in eight Belgian hospitals. It was shown that angiographic records are reliable for assessing radiation dose in patients.

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

scholarly journals A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital: Analysis of preliminary results

2009 ◽  
Vol 13 (2) ◽  
pp. 24
Author(s):  
T Nyathi ◽  
M L Pule ◽  
P Segone ◽  
D G Van der Merwe ◽  
S P Rapoho
Keyword(s):  
South Africa ◽  
Dose Optimization ◽  
Skin Dose ◽  
Radiation Doses ◽  
Voiding Cystourethrogram ◽  
Academic Hospital ◽  
Reference Levels ◽  
Large Variability ◽  
Dose Area Product ◽  
Area Product

Purpose: To retrospectively analyze the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP). Materials and Methods: The subjects of this study were patients who underwent fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital, South Africa during the period August 2007 to March 2008. The skin dose and dose-area product values were obtained from a built-in DAP-meter installed on a digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy unit. The following cases were analyzed namely barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram. Results: An analysis of three hundred and thirty one examinations is presented. From the recorded data the following quantities were deduced: the mean- and range of the skin doses and DAPs, mean screening time and mean fluoroscopy duration. An analysis of the screening time for the various examinations showed a weak correlation (r = 0.59) between skin dose and screening time, while a poor correlation (r = 0.42) was deduced between DAP reading and screening time. Conclusion: There is a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered proves that fluoroscopic examinations stand to gain from dose optimization. The usefulness and potential use of DAP meters with regards to dose optimization in radiology is shown. In line with efforts to optimize dose from diagnostic radiography examinations the authors recommend the establishment of diagnostic reference levels (DRLs) in South Africa for the most frequent examinations in general radiography, fluoroscopy, mammography and computed tomography. Keywords: patient dose, genetic risk, dose optimization, dose reference levels

CONTEMPORARY RADIATION DOSES IN INTERVENTIONAL CARDIOLOGY: A NATIONWIDE STUDY OF PATIENT SKIN DOSES IN FINLAND

2019 ◽  
Vol 188 (2) ◽  
pp. 181-190
Author(s):  
Jukka Järvinen ◽  
Joanna Sierpowska ◽  
Teemu Siiskonen ◽  
Minna Husso ◽  
Hannu Järvinen ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Local Skin ◽  
Transcatheter Aortic Valve ◽  
Percutaneous Coronary ◽  
Data Points ◽  
To Come ◽  
Skin Doses ◽  
Area Product ◽  
Related Harm

Abstract In contemporary interventional cardiology, for typical elderly patients, the most severe radiation-related harm to patients can be considered to come from skin exposures. In this paper, maximum local skin doses in cardiological procedures are explored with Gafchromic film dosimetry. Film and reader calibrations and reading were performed at the Secondary Standards Dosimetry Laboratory of the Radiation and Nuclear Safety Authority (STUK), and data were gathered from seven hospitals in Finland. As alert levels for early transient erythema, 200 Gycm2 kerma area product (KAP) and 2000 mGy air kerma levels for transcatheter aortic valve implantations (TAVI) procedures are proposed. The largest doses were measured in TAVI (4158.8 mGy) and percutaneous coronary interventions (PCI) (941.68 mGy). Accuracies of the GE DoseWatch and Siemens CareMonitor skin dose estimates were reasonable, but more results are needed to reliably assess and validate the tools’ capabilities and reliabilities. Uncertainty of the Gafchromic dosimetry was estimated as 9.1% for a calibration with seven data points and 19.3% for a calibration with five data points.

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