Influence of exposure and geometric parameters on absorbed doses associated with common neuro-interventional procedures. (March 2017)

• Record Type: Journal Article
• Authors: Safari, Mohammad Javad; Wong, Jeannie Hsiu Ding; Jong, Wei Loong; Thorpe, Nathan; Cutajar, Dean; Rosenfeld, Anatoly; Ng, Kwan Hoong
• Is Part Of: Physica medica. Volume 35(2017)
• Page Start: 66
• Page End: 72
• Publication Date: 2017-03
• Subjects: Neuro-interventional radiology -- Patient dose monitoring -- Radiological exposure parameters -- Skin and eye lens dose; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2017.02.002
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: The impact of selected fluoroscopic exposure parameters on patient dose is investigated. Real-time monitoring helps interventional operators to monitor patient's dose. DSA contributed to the largest amount of dose to patient during neuro-interventions. Abstract: Purpose: The purpose of this study was to investigate the effects of routine exposure parameters on patient's dose during neuro-interventional radiology procedures. Methods: We scrutinized the routine radiological exposure parameters during 58 clinical neuro-interventional procedures such as, exposure direction, magnification, frame rate, and distance between image receptor to patient's body and evaluate their effects on patient's dose using an anthropomorphic phantom. Radiation dose received by the occipital region, ears and eyes of the phantom were measured using MO Skin detectors. Results: DSA imaging technique is a major contributor to patient's dose (80.9%) even though they are used sparingly (5.3% of total frame number). The occipital region of the brain received high dose largely from the frontal tube constantly placed under couch (73.7% of the total KAP). When rotating the frontal tube away from under the couch, the radiation dose to the occipital reduced by 40%. The use of magnification modes could increase radiation dose by 94%. Changing the image receptor to the phantom surface distance from 10 to 40 cm doubled the radiation dose received by the patient's skin at the occipital region. Conclusion: Our findings provided important insights into the contribution of selected fluoroscopic exposure parameters and their impact on patient's dose during neuro-interventional radiology procedures. This study showed that the DSA imaging technique contributed to the highest patient's dose and judicial use of exposure parameters might assist interventional radiologists in effective skin and eye lens dose reduction for patients undergoing neuro-interventional procedures.