Relationship Between Fluoroscopic Time, Dose–Area Product, Body Weight, and Maximum Radiation Skin Dose in Cardiac Interventional Procedures

Chida, Koichi; Saito, Haruo; Otani, Hiroki; Kohzuki, Masahiro; Takahashi, Satoshi; Yamada, Satoshi; Shirato, Kunio; Zuguchi, Masayuki

doi:10.2214/ajr.04.1653

Cited by 173 publications

(119 citation statements)

References 20 publications

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“…As obtained by Chida et al [12] for PCI, we also found a correlation between maximum skin dose, ESD skin,max and kerma-area product, P KA in all three examinations (r 2 =0.94, 0.74 and 0.85 in angiography, coiling and embolisation respectively), but poorer correlation with fluoroscopy time (r 2 =0.09, 0.57, 0.57). A reason for the more significant correlation between ESD skin,max and P KA in our work compared to, for example, Balter et al [17] may be that in our work the large majority of the procedures were performed by one very experienced radiologist.…”

Section: Tablesupporting

confidence: 86%

“…As P KA is nowadays readily available, one approach to assessing local skin dose is to measure P KA and correlate its value to the maximum skin dose. Chida et al [12] found a strong correlation between P KA and maximum skin dose in percutaneous coronary interventions (PCI). This is not always the case [13] since the same P KA but different local skin dose can be obtained using a small intense beam or a larger less intense one.…”

Section: Introductionmentioning

confidence: 99%

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Local skin and eye lens equivalent doses in interventional neuroradiology

2009

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Abstract:The aim of this work was to assess patient skin and eye lens doses in interventional neuroradiology and to assess both stochastic and deterministic radiation risks. Kerma-area product, P KA was recorded and skin doses measured using thermoluminescence dosimeters. Estimated dose at interventional reference point, IRP, was compared with measured absorbed doses. The average and maximum fluoroscopy times were 32 and 189 min for coiling and 40 and 144min for embolisation. The average and maximum P KA for coiling were 121 and 436 Gycm 2 respectively and 189 and 677 Gycm 2 for embolisation. The average and maximum values of the measured maximum absorbed skin doses were 0.72 and 3.0Sv respectively for coiling and 0.79 and 2.1Sv for embolisation. Two out of the 52 patients received skin doses in excess of 2Sv. The average and maximum doses to the eye lens (left eye) were 51 and 51mSv (coiling) and 71 and 289mSv (embolisation). The ratio between the measured dose and the dose at the IRP was 0.44±0.18mSv/mGy indicating that the dose displayed by the x-ray unit overestimates the maximum skin dose but is still a valuable indication of the dose. The risk in our hospital skin erythema and lens cataract is therefore small.

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Section: Tablesupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Local skin and eye lens equivalent doses in interventional neuroradiology

2009

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“…The forth, exposure to the radiation scattered from patients and surroundings can add to direct radiation exposure. Wearing lead gloves and using the shielding panels or screens to prevent these scattered beams when conducting cerebral or cardiac intervention therapy can be good methods for reducing exposure, but these have many technical difficulties 2,4,12,13) . A fifth approach involves using spinal navigation systems.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty

Choi

2011

J Korean Neurosurg Soc

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“…Interventional radiology (IVR) confers a higher risk of radiation‐related injury to both the patient and physician compared with other types of X‐ray examination 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 . Even today, there are case reports of injuries (such as radiation‐induced erythema) caused by the radiation from IVR X‐ray systems 13 , 14 , 15 .…”

Section: Introductionmentioning

confidence: 99%

A cross‐sectional study of the radiation dose and image quality of X‐ray equipment used in IVR

Inaba

Chida

Kobayashi

et al. 2016

J Applied Clin Med Phys

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There are case reports of injuries caused by the radiation from interventional radiology (IVR) X‐ray systems. Therefore, the management of radiation doses in IVR is important. However, no detailed report has evaluated image quality for a large number of IVR X‐ray systems. As a result, it is unclear whether the image quality of the X‐ray equipment currently used in IVR procedures is optimal. We compared the entrance surface doses and image quality of multiple IVR X‐ray systems. This study was conducted in 2014 at 13 medical facilities using 18 IVR X‐ray systems. We evaluated image quality and simultaneously measured the radiation dose. Entrance surface doses for fluoroscopy (duration, 1 min) and cineradiography (duration, 10 s) are measured using a 20‐cm‐thick acrylic plate and skin dose monitor. The image quality (such as spatial resolution and low‐contrast detectability) of both fluoroscopy and cineradiography was evaluated using a QC phantom. For fluoroscopy, the average entrance surface dose using the 20‐cm‐thick acrylic plate was 13.9 (range 2.1–28.2) mGy/min. For cineradiography, the average entrance surface dose was 24.6 (range 5.1–49.3) mGy/10 s. We found positive correlations between radiation doses and image quality scores, in general, especially for fluoroscopy. The differences in surface dose among the 18 IVR X‐ray systems were high (max/min, 9.7‐fold for cineradiography; 13.4‐fold for fluoroscopy). The differences in image quality scores (spatial resolution, low‐contrast detectability, and dynamic range) were also very large. In general, there tended to be a correlation between radiation dose and image quality. Periodical measurements of the radiation dose and image quality of the X‐ray equipment used for cineradiography and fluoroscopy in IVR are necessary. The need to minimize patient exposure requires that the dose be reduced to the minimum level that will generate an image with an acceptable degree of noise.PACS number(s): 87.57.C, 87.57.uq, 87.59.B, 87.59.bf, 87.59.C, 87.59.cf, 87.59.Dj

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Relationship Between Fluoroscopic Time, Dose–Area Product, Body Weight, and Maximum Radiation Skin Dose in Cardiac Interventional Procedures

Cited by 173 publications

References 20 publications

Local skin and eye lens equivalent doses in interventional neuroradiology

Local skin and eye lens equivalent doses in interventional neuroradiology

Fluoroscopic Radiation Exposure during Percutaneous Kyphoplasty

A cross‐sectional study of the radiation dose and image quality of X‐ray equipment used in IVR

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