Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures
Само за регистроване кориснике
2018
Аутори
Jarvinen, HannuFarah, Jad
Siiskonen, Teemu
Ciraj-Bjelac, Olivera
Dabin, Jeremie
Carinou, Eleftheria
Domienik-Andrzejewska, Joanna
Kluszczynski, Dariusz
Knežević, Željka
Kopec, Renata
Majer, Marija
Malchair, Francoise
Negri, Anna
Pankowski, Piotr
Sarmento, Sandra
Trianni, Annalisa
Чланак у часопису (Објављена верзија)
Метаподаци
Приказ свих података о документуАпстракт
Purpose: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. Methods: Gafchromic (R) films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (K-a,K-r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and K-a,K-r, and uncertainty of MSD were calculated. Results: About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and K-a,K-r can be used as a dose i...ndicator for alert levels (Pearson correlation coefficient p mostly > 0.8), while fluoroscopy time is not suitable (p mostly < 0.6). Generic alert levels based on DAP (Gy cm(2)) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1). Conclusions: The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.
Кључне речи:
Interventional radiology / Maximum skin dose / Onlin / skin dose alert levelИзвор:
Physica Medica, 2018, 46, 67-74Финансирање / пројекти:
- European Radiation Dosimetry Group [EURADOS WG 12 - Dosimetry in Medical Imaging]
DOI: 10.1016/j.ejmp.2018.01.010
ISSN: 1120-1797; 1724-191X
PubMed: 29519411
WoS: 000427424700009
Scopus: 2-s2.0-85043282385
Колекције
Институција/група
VinčaTY - JOUR AU - Jarvinen, Hannu AU - Farah, Jad AU - Siiskonen, Teemu AU - Ciraj-Bjelac, Olivera AU - Dabin, Jeremie AU - Carinou, Eleftheria AU - Domienik-Andrzejewska, Joanna AU - Kluszczynski, Dariusz AU - Knežević, Željka AU - Kopec, Renata AU - Majer, Marija AU - Malchair, Francoise AU - Negri, Anna AU - Pankowski, Piotr AU - Sarmento, Sandra AU - Trianni, Annalisa PY - 2018 UR - https://vinar.vin.bg.ac.rs/handle/123456789/7621 AB - Purpose: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. Methods: Gafchromic (R) films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (K-a,K-r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and K-a,K-r, and uncertainty of MSD were calculated. Results: About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and K-a,K-r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly > 0.8), while fluoroscopy time is not suitable (p mostly < 0.6). Generic alert levels based on DAP (Gy cm(2)) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1). Conclusions: The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach. T2 - Physica Medica T1 - Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures VL - 46 SP - 67 EP - 74 DO - 10.1016/j.ejmp.2018.01.010 ER -
@article{ author = "Jarvinen, Hannu and Farah, Jad and Siiskonen, Teemu and Ciraj-Bjelac, Olivera and Dabin, Jeremie and Carinou, Eleftheria and Domienik-Andrzejewska, Joanna and Kluszczynski, Dariusz and Knežević, Željka and Kopec, Renata and Majer, Marija and Malchair, Francoise and Negri, Anna and Pankowski, Piotr and Sarmento, Sandra and Trianni, Annalisa", year = "2018", abstract = "Purpose: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. Methods: Gafchromic (R) films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (K-a,K-r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and K-a,K-r, and uncertainty of MSD were calculated. Results: About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and K-a,K-r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly > 0.8), while fluoroscopy time is not suitable (p mostly < 0.6). Generic alert levels based on DAP (Gy cm(2)) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1). Conclusions: The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.", journal = "Physica Medica", title = "Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures", volume = "46", pages = "67-74", doi = "10.1016/j.ejmp.2018.01.010" }
Jarvinen, H., Farah, J., Siiskonen, T., Ciraj-Bjelac, O., Dabin, J., Carinou, E., Domienik-Andrzejewska, J., Kluszczynski, D., Knežević, Ž., Kopec, R., Majer, M., Malchair, F., Negri, A., Pankowski, P., Sarmento, S.,& Trianni, A.. (2018). Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. in Physica Medica, 46, 67-74. https://doi.org/10.1016/j.ejmp.2018.01.010
Jarvinen H, Farah J, Siiskonen T, Ciraj-Bjelac O, Dabin J, Carinou E, Domienik-Andrzejewska J, Kluszczynski D, Knežević Ž, Kopec R, Majer M, Malchair F, Negri A, Pankowski P, Sarmento S, Trianni A. Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. in Physica Medica. 2018;46:67-74. doi:10.1016/j.ejmp.2018.01.010 .
Jarvinen, Hannu, Farah, Jad, Siiskonen, Teemu, Ciraj-Bjelac, Olivera, Dabin, Jeremie, Carinou, Eleftheria, Domienik-Andrzejewska, Joanna, Kluszczynski, Dariusz, Knežević, Željka, Kopec, Renata, Majer, Marija, Malchair, Francoise, Negri, Anna, Pankowski, Piotr, Sarmento, Sandra, Trianni, Annalisa, "Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures" in Physica Medica, 46 (2018):67-74, https://doi.org/10.1016/j.ejmp.2018.01.010 . .