Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose. (June 2017)

• Record Type: Journal Article
• Authors: Greffier, J.; Van Ngoc Ty, C.; Bonniaud, G.; Moliner, G.; Ledermann, B.; Schmutz, L.; Cornillet, L.; Cayla, G.; Beregi, J.P.; Pereira, F.
• Is Part Of: Physica medica. Volume 38(2017)
• Page Start: 16
• Page End: 22
• Publication Date: 2017-06
• Subjects: Interventional cardiology -- Radiochromic film -- Peak skin dose -- Radiation protection; 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.2017.05.044
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: Peak skin dose (PSD) may exceed 2 Gy during cardiac interventional procedures. Gafchromic film is the most widely-used prospective technique to measure PSD. Em.dose software is a retrospective technique to compute PSD. PSD computed with em.dose is strongly correlated to PSD measured by film. Em.dose software is a good alternative to Gafchromic film to evaluate PSD. Abstract: Objective: To compare the use of a dose mapping software to Gafchromic film measurement for a simplified peak skin dose (PSD) estimation in interventional cardiology procedure. Methods: The study was conducted on a total of 40 cardiac procedures (20 complex coronary angioplasty of chronic total occlusion (CTO) and 20 coronary angiography and coronary angioplasty (CA-PTCA)) conducted between January 2014 to December 2015. PSD measurement (PSDFilm ) was obtained by placing XR-RV3 Gafchromic under the patient's back for each procedure. PSD (PSDem.dose ) was computed with the software em.dose©. The calculation was performed on the dose metrics collected from the private dose report of each procedure. Two calculation methods (method A: fluoroscopic kerma equally spread on cine acquisition and B: fluoroscopic kerma is added to one air Kerma cine acquisition that contributes to the PSD) were used to calculate the fluoroscopic dose contribution as fluoroscopic data were not recorded in our interventional room. Statistical analyses were carried out to compare PSDFilm and PSDem.dose . Results: The PSDFilm median (1st quartile; 3rd quartile) was 0.251(0.190;0.336) Gy for CA-PTCA and 1.453(0.767;2.011) Gy for CTO. For method-A, the PSDem.dose was 0.248(0.182;0.369) Gy for CA-PTCA and 1.601(0.892;2.178) Gy for CTO, and 0.267(0.223;0.446) Gy and 1.75 (0.912;2.584) Gy for method-B, respectively. For the two methods, the correlation between PSDFilm and PSDem.dose was strong. For all cardiology procedures investigated, the mean deviation between PSDFilm and PSDem.dose was 3.4 ± 21.1% for method-A and 17.3% ± 23.9% for method-B. Conclusion: The dose mapping software is convenient to calculate peak skin dose in interventional cardiology.