Cumulative Radiation Dose in Patients Admitted with Subarachnoid Hemorrhage: A Prospective Study Using a Self-Developing Film Badge

Abstract

BACKGROUND AND PURPOSE:While considerable attention has been directed to reducing the x-ray dose of individual imaging studies, there is little information available on the cumulative dose during imaging-intensive hospitalizations. We used a radiation-sensitive badge on 12 patients admitted with SAH to determine if this approach was feasible and to measure the extent of their x-ray exposure.

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

“…We reported cumulative skin doses, obtained from the cumulative air kerma at the patient entrance reference point and displayed by most of the modern x-ray systems, 13 while other authors have measured or estimated peak skin doses. [7][8][9][10][11][12][13] Table 2 (adapted by the authors) compares the results reported by several authors. Our cumulative skin doses and DAPs are in the range of other published values.…”

“…6 Several evaluations of cumulative skin dose have been made in interventional neuroradiology procedures. [7][8][9][10][11][12][13] Radiation-induced skin injuries can sometimes occur after a clinically complex procedure, but may also, on other occasions, result from the use of inappropriate equipment or poor operational techniques. The ICRP states that acute radiation doses may cause erythema at 2 Gy and delayed skin necrosis at 12 Gy.…”

Patient Organ Radiation Doses During Treatment for Aneurysmal Subarachnoid Hemorrhage

“…We did not directly measure patient doses by using a dosimeter on each patient's head, as was undertaken for example by Mamourian et al [7] in their prospective study. In our retrospective study, however, we included a larger number of patients, and took advantage of the very detailed individual PACS/RIS patient dose records and used anthropomorphic phantoms to mimic real CT and coiling procedures for estimation of organ equivalent doses in inner organs as well.…”

“…Mamourian et al [7] measured the cumulated skin dose in 12 patients admitted with SAH using a self-developing film badge placed behind the right ear. They found good correlation between the measured dose and the number of CT examinations and length of stay in the ICU.…”

“…Gelfand and Josephson [6] estimated effective doses to patients with SAH but did not estimate inner organ doses, which may be essential as the dose gradient can be large during the intervention, but also in CT. Mamourian et al [7] and Moskowitz et al [8] measured the dose to the skin of SAH patients. However, neither of these studies estimated both skin dose and inner organ dose to organs at risk, such as the brain, salivary glands, oral mucosa and thyroid using a range of different imaging equipment for which tabulated organ doses are not readily available.…”