Non-vascular interventional procedures: effective dose to patient and equivalent dose to abdominal organs by means of DICOM images and Monte Carlo simulation

Abstract

This study evaluates X-ray exposure in patient undergoing abdominal extra-vascular interventional procedures by means of Digital Imaging and COmmunications in Medicine (DICOM) image headers and Monte Carlo simulation. The main aim was to assess the effective and equivalent doses, under the hypothesis of their correlation with the dose area product (DAP) measured during each examination. This allows to collect dosimetric information about each patient and to evaluate associated risks without resorting to in vivo dosimetry. The dose calculation was performed in 79 procedures through the Monte Carlo simulator PCXMC (A PC-based Monte Carlo program for calculating patient doses in medical X-ray examinations), by using the real geometrical and dosimetric irradiation conditions, automatically extracted from DICOM headers. The DAP measurements were also validated by using thermoluminescent dosemeters on an anthropomorphic phantom. The expected linear correlation between effective doses and DAP was confirmed with an R(2) of 0.974. Moreover, in order to easily calculate patient doses, conversion coefficients that relate equivalent doses to measurable quantities, such as DAP, were obtained.

Review of air kerma‐area product, effective dose and dose conversion coefficients for non‐cardiac interventional fluoroscopy procedures

“…Some of the literature uses very specific categories, based on the specific type and anatomic location of procedures, and sometimes on the indication for the procedure . Other literature uses more general categories . Some of the literature uses both specific and general categories, depending on the procedure .…”

“…3,[6][7][8][9][10][11][12][13][14][15][16] Other literature uses more general categories. [17][18][19][20][21][22] Some of the literature uses both specific and general categories, depending on the procedure. 3,5,23 The categories used in this paper to determine estimates of procedure doses are shown in Table I.…”

“…DC E values (Table III) have been published in the literature and are generally calculated in the same fashion as E by using computational models of human anatomy and Monte Carlo radiation transport simulations [18][19][20]23,34,48 or direct measurements with an anthropomorphic phantom. 35,41,44,49 When both P KA and E were reported but DC E was not, DC E was derived by simple division.…”

“…An additional issue is the variability in naming and grouping interventional procedures in the literature. Some reports provide very granular categorization of procedures, 6,7,9,10,12,16,30,84 while others group similar procedures 20,31 and still others combine the two approaches. 5,13,24 With highly granular categories, fewer data points are included in each category.…”