Brain Radiation Doses to Patients in an Interventional Neuroradiology Laboratory

Sanchez, Roberto Mariano; Fernández, J.; Moreu, Manuel; López-Ibor, L.

doi:10.3174/ajnr.a3884

Cited by 34 publications

(25 citation statements)

References 15 publications

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“…Operator-dependent maneuvers such as maximizing the distance between the X-ray tube and the patient, minimizing the distance between the patient and the detector, avoiding magnification, use of collimation, and lower frame/pulse rates are manipulations that can be performed by the operator for effectively reducing the intraprocedural dose (92021). Non-operator-dependent default factors include filtration, focal spot size, and image reconstruction algorithms, which are either set up as a routine protocol or built into the system and are difficult to manipulate during a procedure (8222324).…”

Section: Discussionmentioning

confidence: 99%

Radiation Dose Reduction without Compromise to Image Quality by Alterations of Filtration and Focal Spot Size in Cerebral Angiography

et al. 2017

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ObjectiveDifferent angiographic protocols may influence the radiation dose and image quality. In this study, we aimed to investigate the effects of filtration and focal spot size on radiation dose and image quality for diagnostic cerebral angiography using an in-vitro model and in-vivo patient groups.Materials and MethodsRadiation dose and image quality were analyzed by varying the filtration and focal spot size on digital subtraction angiography exposure protocols (1, inherent filtration + large focus; 2, inherent + small; 3, copper + large; 4, copper + small). For the in-vitro analysis, a phantom was used for comparison of radiation dose. For the in-vivo analysis, bilateral paired injections, and patient cohort groups were compared for radiation dose and image quality. Image quality analysis was performed in terms of contrast, sharpness, noise, and overall quality.ResultsIn the in-vitro analysis, the mean air kerma (AK) and dose area product (DAP)/frame were significantly lower with added copper filtration (protocols 3 and 4). In the in-vivo bilateral paired injections, AK and DAP/frame were significantly lower with filtration, without significant difference in image quality. The patient cohort groups with added filtration (protocols 3 and 4) showed significant reduction of total AK and DAP/patient without compromise to the image quality. Variations in focal spot size showed no significant differences in radiation dose and image quality.ConclusionAddition of filtration for angiographic exposure studies can result in significant total radiation dose reduction without loss of image quality. Focal spot size does not influence radiation dose and image quality. The routine angiographic protocol should be judiciously investigated and implemented.

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Section: Discussionmentioning

confidence: 99%

Radiation Dose Reduction without Compromise to Image Quality by Alterations of Filtration and Focal Spot Size in Cerebral Angiography

et al. 2017

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“…The radiation dose parameter associated with the risk of stochastic effects is effective dose. KAP has been used to estimate both effective dose and peak skin dose in previous studies, although the conversion factors normally entail a degree of uncertainty or error (11,14,19,21,22,23). PSD was calculated from a published dose conversion formula for interventional procedures as follows: PSD (mGy) = 249 + 5.2 x KAP (Gy•cm 2 ) (21,24).…”

Section: Methodsmentioning

confidence: 99%

“…KAP can also be used to estimate the effect of ionizing radiation on patients, by calculating ED and PSD (17). Previously published study has shown that for cerebral embolization, average brain dose was 500 mGy and third quartile was 856 mGy, while for cerebral angiography, the average brain dose was 100 mGy (11). This study didn't show the exact formula or conversion factor from KAP to ED, but cite the website that was used for calculation (11,18).…”

Section: Introductionmentioning

confidence: 98%

“…The International Commission on Radiologic Protection (ICRP) proposed that threshold for dose absorbed by patients' brain should be 0.5 Gy (11,12). It was also suggested that such high doses could be avoided by real-time observation of doses by the INR specialists, following proper consultation to their patients and optimization of the risk factors (13).…”

Section: Introductionmentioning

confidence: 99%

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Radiation exposure during neurointerventional procedures in modern angiographic systems: A single center experience

et al. 2020

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Background/Aim. Interventional neuroradiology procedures expose patients to ionizing radiation. The aim of this study was to assess the doses received by patients during interventional neuroradiology procedures and to establish dose range with an estimate of risk from adverse consequences of irradiation. Methods. Our study describes series of patients submitted to diagnostic and/or therapeutic procedures at the Department of Interventional Neuroradiology, Clinical Center Kragujevac, Serbia, from December the 1 st 2014 to December the 1 st 2016. The following variables were considered for this study: kerma-area product, air kerma and fluoroscopy exposure time; peak skin dose and effective dose were calculated from the kerma-area product. Results. Median kerma-area product was (87.802 Gy•cm 2 , 78.567 Gy•cm 2 , 117.626 Gy•cm 2), effective dose (12.731 mSv, 11.392 mSv, 17.056 mSv) peak skin dose (0.456 Gy, 0.409 Gy, 0.612 Gy) and estimated brain dose (254.62 mGy, 227.84 mGy, 341.12 mGy) for diagnostic, therapeutic and combined procedures, respectively. Conclusion. Interventional neuroradiology procedures show significant variability in radiation dose, due to patient constitution, radiologist expertise and equipment factors. Knowing the doses can have a great benefit for the patients and medical and paramedical stuff in terms of prevention of possible deterministic and stochastic effects of the radiation.

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“…Over the past decade, 13 published studies on the estimated doses during adult vascular angiographic procedures, the majority from neurovascular laboratories, were identified in the literature [8][9][10][11][12][13][14][15][16][17][18][19][20]. During the same time period, the estimated doses surveyed at seven pediatric cardiac catheterization departments were reported [21][22][23][24][25][26][27], and three different groups reported estimated patient doses during pediatric neurointerventions [28][29][30].…”

mentioning

confidence: 99%

Estimates of Diagnostic Reference Levels for Pediatric Peripheral and Abdominal Fluoroscopically Guided Procedures

Strauss

Racadio²,

Johnson³

et al. 2015

American Journal of Roentgenology

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Brain Radiation Doses to Patients in an Interventional Neuroradiology Laboratory

Cited by 34 publications

References 15 publications

Radiation Dose Reduction without Compromise to Image Quality by Alterations of Filtration and Focal Spot Size in Cerebral Angiography

Radiation Dose Reduction without Compromise to Image Quality by Alterations of Filtration and Focal Spot Size in Cerebral Angiography

Radiation exposure during neurointerventional procedures in modern angiographic systems: A single center experience

Estimates of Diagnostic Reference Levels for Pediatric Peripheral and Abdominal Fluoroscopically Guided Procedures

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