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Radiation Doses in Interventional Radiology Procedures: The RAD-IR Study Part II: Skin Dose
Journal article   Peer reviewed

Radiation Doses in Interventional Radiology Procedures: The RAD-IR Study Part II: Skin Dose

Donald L. Miller, Stephen Balter, Patricia E. Cole, Hollington T. Lu, Alejandro Berenstein, Robin Albert, Beth A. Schueler, Jeffrey D. Georgia, Patrick T. Noonan, Eric J. Russell, …
Journal of vascular and interventional radiology, v 14(8), pp 977-990
2003
DOI: https://doi.org/10.1097/01.RVI.0000084601.43811.CB
PMID: 12902555
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

PSD CD RAD-IR DAP FDA IEC IRP IVC TLD TIPS
To determine peak skin dose (PSD), a measure of the likelihood of radiation-induced skin effects, for a variety of common interventional radiology and interventional neuroradiology procedures, and to identify procedures associated with a PSD greater than 2 Gy. An observational study was conducted at seven academic medical centers in the United States. Sites prospectively contributed demographic and radiation dose data for subjects undergoing 21 specific procedures in a fluoroscopic suite equipped with built-in dosimetry capability. Comprehensive physics evaluations and periodic consistency checks were performed on each unit to verify the stability and consistency of the dosimeter. Seven of 12 fluoroscopic suites in the study were equipped with skin dose mapping software. Over a 3-year period, skin dose data were recorded for 800 instances of 21 interventional radiology procedures. Wide variation in PSD was observed for different instances of the same procedure. Some instances of each procedure we studied resulted in a PSD greater than 2 Gy, except for nephrostomy, pulmonary angiography, and inferior vena cava filter placement. Some instances of transjugular intrahepatic portosystemic shunt (TIPS) creation, renal/visceral angioplasty, and angiographic diagnosis and therapy of gastrointestinal hemorrhage produced PSDs greater than 3 Gy. Some instances of hepatic chemoembolization, other tumor embolization, and neuroembolization procedures in the head and spine produced PSDs greater than 5 Gy. In a subset of 709 instances of higher-dose procedures, there was good overall correlation between PSD and cumulative dose ( r = 0.86; P < .000001) and between PSD and dose–area–product ( r = 0.85, P < .000001), but there was wide variation in these relationships for individual instances. There are substantial variations in PSD among instances of the same procedure and among different procedure types. Most of the procedures observed may produce a PSD sufficient to cause deterministic effects in skin. It is suggested that dose data be recorded routinely for TIPS creation, angioplasty in the abdomen or pelvis, all embolization procedures, and especially for head and spine embolization procedures. Measurement or estimation of PSD is the best method for determining the likelihood of radiation-induced skin effects. Skin dose mapping is preferable to a single-point measurement of PSD.

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226 citations in Web of Science
251 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Peripheral Vascular Disease
Radiology, Nuclear Medicine & Medical Imaging
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