TY  - JOUR
AU  - Siiskonen, Teemu
AU  - Ciraj-Bjelac, Olivera
AU  - Dabin, Jeremie
AU  - Diklić, Ana
AU  - Domienik-Andrzejewska, Joanna
AU  - Farah, Jad
AU  - Fernandez, Jose Miguel
AU  - Gallagher, Aoife
AU  - Hourdakis, Constantine J.
AU  - Jurković, Slaven
AU  - Jarvinen, Hannu
AU  - Jarvinen, J.
AU  - Knežević, Željka
AU  - Koukorava, Christina
AU  - Maccia, Carlo
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Riccardi, Lucia
AU  - Rizk, C.
AU  - Sanchez, Roberto Mariano
AU  - Sandborg, Michael
AU  - Merce, Marta Sans
AU  - Segota, D.
AU  - Sierpowska, Joanna
AU  - Simantirakis, George
AU  - Sukupova, Lucie
AU  - Thrapsanioti, Zoi
AU  - Vano, Eliseo
PY  - 2018
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7889
AB  - Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm2), percutaneous coronary intervention (PCI, 85 Gy cm2), transcatheter aortic valve implantation (TAVI, 130 Gy cm2), electrophysiological procedures (12 Gy cm2) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm2) and dual chamber (3.5 Gy cm2) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm2). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology. © 2018 Associazione Italiana di Fisica Medica
T2  - Physica Medica
T1  - Establishing the European diagnostic reference levels for interventional cardiology
VL  - 54
SP  - 42
EP  - 48
DO  - 10.1016/j.ejmp.2018.09.012
ER  - 

@article{
author = "Siiskonen, Teemu and Ciraj-Bjelac, Olivera and Dabin, Jeremie and Diklić, Ana and Domienik-Andrzejewska, Joanna and Farah, Jad and Fernandez, Jose Miguel and Gallagher, Aoife and Hourdakis, Constantine J. and Jurković, Slaven and Jarvinen, Hannu and Jarvinen, J. and Knežević, Željka and Koukorava, Christina and Maccia, Carlo and Majer, Marija and Malchair, Francoise and Riccardi, Lucia and Rizk, C. and Sanchez, Roberto Mariano and Sandborg, Michael and Merce, Marta Sans and Segota, D. and Sierpowska, Joanna and Simantirakis, George and Sukupova, Lucie and Thrapsanioti, Zoi and Vano, Eliseo",
year = "2018",
abstract = "Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm2), percutaneous coronary intervention (PCI, 85 Gy cm2), transcatheter aortic valve implantation (TAVI, 130 Gy cm2), electrophysiological procedures (12 Gy cm2) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm2) and dual chamber (3.5 Gy cm2) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm2). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology. © 2018 Associazione Italiana di Fisica Medica",
journal = "Physica Medica",
title = "Establishing the European diagnostic reference levels for interventional cardiology",
volume = "54",
pages = "42-48",
doi = "10.1016/j.ejmp.2018.09.012"
}

Siiskonen, T., Ciraj-Bjelac, O., Dabin, J., Diklić, A., Domienik-Andrzejewska, J., Farah, J., Fernandez, J. M., Gallagher, A., Hourdakis, C. J., Jurković, S., Jarvinen, H., Jarvinen, J., Knežević, Ž., Koukorava, C., Maccia, C., Majer, M., Malchair, F., Riccardi, L., Rizk, C., Sanchez, R. M., Sandborg, M., Merce, M. S., Segota, D., Sierpowska, J., Simantirakis, G., Sukupova, L., Thrapsanioti, Z.,& Vano, E.. (2018). Establishing the European diagnostic reference levels for interventional cardiology. in Physica Medica, 54, 42-48.
https://doi.org/10.1016/j.ejmp.2018.09.012

Siiskonen T, Ciraj-Bjelac O, Dabin J, Diklić A, Domienik-Andrzejewska J, Farah J, Fernandez JM, Gallagher A, Hourdakis CJ, Jurković S, Jarvinen H, Jarvinen J, Knežević Ž, Koukorava C, Maccia C, Majer M, Malchair F, Riccardi L, Rizk C, Sanchez RM, Sandborg M, Merce MS, Segota D, Sierpowska J, Simantirakis G, Sukupova L, Thrapsanioti Z, Vano E. Establishing the European diagnostic reference levels for interventional cardiology. in Physica Medica. 2018;54:42-48.
doi:10.1016/j.ejmp.2018.09.012 .

Siiskonen, Teemu, Ciraj-Bjelac, Olivera, Dabin, Jeremie, Diklić, Ana, Domienik-Andrzejewska, Joanna, Farah, Jad, Fernandez, Jose Miguel, Gallagher, Aoife, Hourdakis, Constantine J., Jurković, Slaven, Jarvinen, Hannu, Jarvinen, J., Knežević, Željka, Koukorava, Christina, Maccia, Carlo, Majer, Marija, Malchair, Francoise, Riccardi, Lucia, Rizk, C., Sanchez, Roberto Mariano, Sandborg, Michael, Merce, Marta Sans, Segota, D., Sierpowska, Joanna, Simantirakis, George, Sukupova, Lucie, Thrapsanioti, Zoi, Vano, Eliseo, "Establishing the European diagnostic reference levels for interventional cardiology" in Physica Medica, 54 (2018):42-48,
https://doi.org/10.1016/j.ejmp.2018.09.012 . .

TY  - 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 . .

TY  - JOUR
AU  - Dabin, Jeremie
AU  - Negri, A.
AU  - Farah, Jad
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - De Angelis, C.
AU  - Domienik, Joanna
AU  - Jarvinen, Hannu
AU  - Kopec, R.
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Novak, L.
AU  - Siiskonen, Teemu
AU  - Vanhavere, Filip
AU  - Trianni, A.
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/860
AB  - Purpose: Point detectors are frequently used to measure patients maximum skin dose (MSD) in fluoroscopically-guided interventional procedures (IP). However, their performance and ability to detect the actual MSD are rarely evaluated. The present study investigates the sampling uncertainty associated with the use of grids of point detectors to measure MSD in IP. Method: Chemoembolisation of the liver (CE), percutaneous coronary intervention (PCI) and neuroembolisation (NE) procedures were studied. Spatial dose distributions were measured with XR-RV3 Gafchromic (R) films for 176 procedures. These distributions were used to simulate measurements performed using grids of detectors such as thermoluminescence detectors, with detector spacing from 1.4 up to 10 cm. Results: The sampling uncertainty was the highest in PCI and NE procedures. With 40 detectors covering the film area (36 cm x 44 cm), the maximum dose would be on average 86% and 63% of the MSD measured with Gafchromic (R) films in CE and PCI procedures, respectively. In NE procedures, with 27 detectors covering the film area (14 cm x 35 cm), the maximum dose measured would be on average 82% of the MSD obtained with the Gafchromic (R) films. Conclusion: Thermoluminescence detectors show good energy and dose response in clinical beam qualities. However the poor spatial resolution of such point-like dosimeters may far outweigh their good dosimetric properties. The uncertainty from the sampling procedure should be estimated when point detectors are used in IP because it may lead to strong underestimation of the MSD. (C) 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
PB  - Elsevier
T2  - Physica Medica
T1  - Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures
VL  - 31
IS  - 8
SP  - 1112
EP  - 1117
DO  - 10.1016/j.ejmp.2015.08.006
ER  - 

@article{
author = "Dabin, Jeremie and Negri, A. and Farah, Jad and Ciraj-Bjelac, Olivera and Clairand, Isabelle and De Angelis, C. and Domienik, Joanna and Jarvinen, Hannu and Kopec, R. and Majer, Marija and Malchair, Francoise and Novak, L. and Siiskonen, Teemu and Vanhavere, Filip and Trianni, A. and Knežević, Željka",
year = "2015",
abstract = "Purpose: Point detectors are frequently used to measure patients maximum skin dose (MSD) in fluoroscopically-guided interventional procedures (IP). However, their performance and ability to detect the actual MSD are rarely evaluated. The present study investigates the sampling uncertainty associated with the use of grids of point detectors to measure MSD in IP. Method: Chemoembolisation of the liver (CE), percutaneous coronary intervention (PCI) and neuroembolisation (NE) procedures were studied. Spatial dose distributions were measured with XR-RV3 Gafchromic (R) films for 176 procedures. These distributions were used to simulate measurements performed using grids of detectors such as thermoluminescence detectors, with detector spacing from 1.4 up to 10 cm. Results: The sampling uncertainty was the highest in PCI and NE procedures. With 40 detectors covering the film area (36 cm x 44 cm), the maximum dose would be on average 86% and 63% of the MSD measured with Gafchromic (R) films in CE and PCI procedures, respectively. In NE procedures, with 27 detectors covering the film area (14 cm x 35 cm), the maximum dose measured would be on average 82% of the MSD obtained with the Gafchromic (R) films. Conclusion: Thermoluminescence detectors show good energy and dose response in clinical beam qualities. However the poor spatial resolution of such point-like dosimeters may far outweigh their good dosimetric properties. The uncertainty from the sampling procedure should be estimated when point detectors are used in IP because it may lead to strong underestimation of the MSD. (C) 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.",
publisher = "Elsevier",
journal = "Physica Medica",
title = "Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures",
volume = "31",
number = "8",
pages = "1112-1117",
doi = "10.1016/j.ejmp.2015.08.006"
}

Dabin, J., Negri, A., Farah, J., Ciraj-Bjelac, O., Clairand, I., De Angelis, C., Domienik, J., Jarvinen, H., Kopec, R., Majer, M., Malchair, F., Novak, L., Siiskonen, T., Vanhavere, F., Trianni, A.,& Knežević, Ž.. (2015). Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. in Physica Medica
Elsevier., 31(8), 1112-1117.
https://doi.org/10.1016/j.ejmp.2015.08.006

Dabin J, Negri A, Farah J, Ciraj-Bjelac O, Clairand I, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Novak L, Siiskonen T, Vanhavere F, Trianni A, Knežević Ž. Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. in Physica Medica. 2015;31(8):1112-1117.
doi:10.1016/j.ejmp.2015.08.006 .

Dabin, Jeremie, Negri, A., Farah, Jad, Ciraj-Bjelac, Olivera, Clairand, Isabelle, De Angelis, C., Domienik, Joanna, Jarvinen, Hannu, Kopec, R., Majer, Marija, Malchair, Francoise, Novak, L., Siiskonen, Teemu, Vanhavere, Filip, Trianni, A., Knežević, Željka, "Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures" in Physica Medica, 31, no. 8 (2015):1112-1117,
https://doi.org/10.1016/j.ejmp.2015.08.006 . .

TY  - JOUR
AU  - Farah, Jad
AU  - Trianni, A.
AU  - Carinou, Eleftheria
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - Dabin, Jeremie
AU  - De Angelis, C.
AU  - Domienik, Joanna
AU  - Jarvinen, Hannu
AU  - Kopec, R.
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Negri, A.
AU  - Novak, L.
AU  - Siiskonen, Teemu
AU  - Vanhavere, Filip
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7068
AB  - To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of GT 3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.
T2  - Radiation Protection Dosimetry
T1  - Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds
VL  - 164
IS  - 1-2
SP  - 138
EP  - 142
DO  - 10.1093/rpd/ncu314
ER  - 

@article{
author = "Farah, Jad and Trianni, A. and Carinou, Eleftheria and Ciraj-Bjelac, Olivera and Clairand, Isabelle and Dabin, Jeremie and De Angelis, C. and Domienik, Joanna and Jarvinen, Hannu and Kopec, R. and Majer, Marija and Malchair, Francoise and Negri, A. and Novak, L. and Siiskonen, Teemu and Vanhavere, Filip and Knežević, Željka",
year = "2015",
abstract = "To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of GT 3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.",
journal = "Radiation Protection Dosimetry",
title = "Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds",
volume = "164",
number = "1-2",
pages = "138-142",
doi = "10.1093/rpd/ncu314"
}

Farah, J., Trianni, A., Carinou, E., Ciraj-Bjelac, O., Clairand, I., Dabin, J., De Angelis, C., Domienik, J., Jarvinen, H., Kopec, R., Majer, M., Malchair, F., Negri, A., Novak, L., Siiskonen, T., Vanhavere, F.,& Knežević, Ž.. (2015). Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. in Radiation Protection Dosimetry, 164(1-2), 138-142.
https://doi.org/10.1093/rpd/ncu314

Farah J, Trianni A, Carinou E, Ciraj-Bjelac O, Clairand I, Dabin J, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Negri A, Novak L, Siiskonen T, Vanhavere F, Knežević Ž. Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. in Radiation Protection Dosimetry. 2015;164(1-2):138-142.
doi:10.1093/rpd/ncu314 .

Farah, Jad, Trianni, A., Carinou, Eleftheria, Ciraj-Bjelac, Olivera, Clairand, Isabelle, Dabin, Jeremie, De Angelis, C., Domienik, Joanna, Jarvinen, Hannu, Kopec, R., Majer, Marija, Malchair, Francoise, Negri, A., Novak, L., Siiskonen, Teemu, Vanhavere, Filip, Knežević, Željka, "Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds" in Radiation Protection Dosimetry, 164, no. 1-2 (2015):138-142,
https://doi.org/10.1093/rpd/ncu314 . .

TY  - JOUR
AU  - Farah, Jad
AU  - Trianni, A.
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - De Angelis, C.
AU  - Delle Canne, S.
AU  - Hadid, L.
AU  - Huet, C.
AU  - Jarvinen, Hannu
AU  - Negri, A.
AU  - Novak, L.
AU  - Pinto, M.
AU  - Siiskonen, Teemu
AU  - Waryn, M. J.
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/647
AB  - Purpose: To investigate the optimal use of XR-RV3 GafChromic (R) films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment. Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach. The considered sources of uncertainties include scanner, film, and fitting-related errors. The work focused on studying film behavior with clinical high-dose-rate pulsed beams (previously unavailable in the literature) together with reference standard laboratory beams. Results: First, the performance analysis of six different scanner models has shown that scan uniformity perpendicular to the lamp motion axis and that long term stability are the main sources of scanner-related uncertainties. These could induce errors of up to 7% on the film readings unless regularly checked and corrected. Typically, scan uniformity correction matrices and reading normalization to the scanner-specific and daily background reading should be done. In addition, the analysis on multiple film batches has shown that XR-RV3 films have generally good uniformity within one batch ( LT 1.5%), require 24 h to stabilize after the irradiation and their response is roughly independent of dose rate ( LT 5%). However, XR-RV3 films showed large variations (up to 15%) with radiation quality both in standard laboratory and in clinical conditions. As such, and prior to conducting patient skin dose measurements, it is mandatory to choose the appropriate calibration beam quality depending on the characteristics of the x-ray systems that will be used clinically. In addition, yellow side film irradiations should be preferentially used since they showed a lower dependence on beam parameters compared to white side film irradiations. Finally, among the six different fit equations tested in this work, typically used third order polynomials and more rational and simplistic equations, of the form dose inversely proportional to pixel value, were both found to provide satisfactory results. Fitting-related uncertainty was clearly identified as a major contributor to the overall film dosimetry uncertainty with up to 40% error on the dose estimate. Conclusions: The overall uncertainty associated with the use of XR-RV3 films to determine skin dose in the interventional environment can realistically be estimated to be around 20% (k = 1). This uncertainty can be reduced to within 5% if carefully monitoring scanner, film, and fitting-related errors or it can easily increase to over 40% if minimal care is not taken. This work demonstrates the importance of appropriate calibration, reading, fitting, and other film-related and scan-related processes, which will help improve the accuracy of skin dose measurements in interventional procedures. (C) 2015 American Association of Physicists in Medicine.
T2  - Medical Physics
T1  - Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors
VL  - 42
IS  - 7
SP  - 4211
EP  - 4226
DO  - 10.1118/1.4922132
ER  - 

@article{
author = "Farah, Jad and Trianni, A. and Ciraj-Bjelac, Olivera and Clairand, Isabelle and De Angelis, C. and Delle Canne, S. and Hadid, L. and Huet, C. and Jarvinen, Hannu and Negri, A. and Novak, L. and Pinto, M. and Siiskonen, Teemu and Waryn, M. J. and Knežević, Željka",
year = "2015",
abstract = "Purpose: To investigate the optimal use of XR-RV3 GafChromic (R) films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment. Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach. The considered sources of uncertainties include scanner, film, and fitting-related errors. The work focused on studying film behavior with clinical high-dose-rate pulsed beams (previously unavailable in the literature) together with reference standard laboratory beams. Results: First, the performance analysis of six different scanner models has shown that scan uniformity perpendicular to the lamp motion axis and that long term stability are the main sources of scanner-related uncertainties. These could induce errors of up to 7% on the film readings unless regularly checked and corrected. Typically, scan uniformity correction matrices and reading normalization to the scanner-specific and daily background reading should be done. In addition, the analysis on multiple film batches has shown that XR-RV3 films have generally good uniformity within one batch ( LT 1.5%), require 24 h to stabilize after the irradiation and their response is roughly independent of dose rate ( LT 5%). However, XR-RV3 films showed large variations (up to 15%) with radiation quality both in standard laboratory and in clinical conditions. As such, and prior to conducting patient skin dose measurements, it is mandatory to choose the appropriate calibration beam quality depending on the characteristics of the x-ray systems that will be used clinically. In addition, yellow side film irradiations should be preferentially used since they showed a lower dependence on beam parameters compared to white side film irradiations. Finally, among the six different fit equations tested in this work, typically used third order polynomials and more rational and simplistic equations, of the form dose inversely proportional to pixel value, were both found to provide satisfactory results. Fitting-related uncertainty was clearly identified as a major contributor to the overall film dosimetry uncertainty with up to 40% error on the dose estimate. Conclusions: The overall uncertainty associated with the use of XR-RV3 films to determine skin dose in the interventional environment can realistically be estimated to be around 20% (k = 1). This uncertainty can be reduced to within 5% if carefully monitoring scanner, film, and fitting-related errors or it can easily increase to over 40% if minimal care is not taken. This work demonstrates the importance of appropriate calibration, reading, fitting, and other film-related and scan-related processes, which will help improve the accuracy of skin dose measurements in interventional procedures. (C) 2015 American Association of Physicists in Medicine.",
journal = "Medical Physics",
title = "Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors",
volume = "42",
number = "7",
pages = "4211-4226",
doi = "10.1118/1.4922132"
}

Farah, J., Trianni, A., Ciraj-Bjelac, O., Clairand, I., De Angelis, C., Delle Canne, S., Hadid, L., Huet, C., Jarvinen, H., Negri, A., Novak, L., Pinto, M., Siiskonen, T., Waryn, M. J.,& Knežević, Ž.. (2015). Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. in Medical Physics, 42(7), 4211-4226.
https://doi.org/10.1118/1.4922132

Farah J, Trianni A, Ciraj-Bjelac O, Clairand I, De Angelis C, Delle Canne S, Hadid L, Huet C, Jarvinen H, Negri A, Novak L, Pinto M, Siiskonen T, Waryn MJ, Knežević Ž. Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. in Medical Physics. 2015;42(7):4211-4226.
doi:10.1118/1.4922132 .

Farah, Jad, Trianni, A., Ciraj-Bjelac, Olivera, Clairand, Isabelle, De Angelis, C., Delle Canne, S., Hadid, L., Huet, C., Jarvinen, Hannu, Negri, A., Novak, L., Pinto, M., Siiskonen, Teemu, Waryn, M. J., Knežević, Željka, "Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors" in Medical Physics, 42, no. 7 (2015):4211-4226,
https://doi.org/10.1118/1.4922132 . .

TY  - JOUR
AU  - Hourdakis, Constantine J.
AU  - Csete, I.
AU  - Daures, J.
AU  - Jarvinen, Hannu
AU  - Mihailescu, L-C
AU  - Sochor, V.
AU  - Novak, L.
AU  - Pedersen, M.
AU  - Kosunen, A.
AU  - Toroi, P.
AU  - Denoziere, M.
AU  - Buermann, L.
AU  - Megzifene, A.
AU  - Einarsson, G.
AU  - Ferrari, P.
AU  - dePooter, J.
AU  - Bjerke, H.
AU  - Brodecki, M.
AU  - Cardoso, J.
AU  - Bercea, S.
AU  - Ciraj-Bjelac, Olivera
AU  - Compel, J.
AU  - Glavič-Cindro, Denis
AU  - Ginjaume, Merce
AU  - Persson, L.
AU  - Grindborg, J-E
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/2749
AB  - The EURAMET #1177 project, identified as EURAMET RI(I)-S9 comparison, was the first EURAMET wide scale supplementary comparison in the field of diagnostic radiology for air kerma area product, P-KA, and air kerma, K. It was conducted with the goal of testing the measurement and calibration capabilities for P-KA and K, as well as of supporting the relevant CMCs of the participating laboratories. Two commercial KAP meters and an ionization chamber were selected as transfer instruments and circulated between the 22 European participants. The measurements were performed from April 2011 until July 2012. The stability and the performance of the transfer instruments were tested by the pilot laboratory (IRCL/GAEC-EIM) and few other laboratories as well. The test results revealed that the energy (radiation quality), Q, irradiation area, A, and air kerma rate, K dependences of response of the transfer KAP meters influence the comparison of the results when different measurement conditions were pertained and therefore, appropriate correction factors were obtained and applied to the reported calibration results of the laboratories, when necessary. The comparison reference values (CRVs) for each instrument were determined as the weighted mean of the calibration coefficients of the three participating primary laboratories. The relative standard uncertainty of the CRVs were in the range of (0.4-1.6)% depending on the transfer instruments and beam qualities. The comparison result as the ratio of the corrected calibration coefficient of participant and the respective CRV, and its uncertainty were calculated for all beam qualities and transfer instruments. The informative degrees of equivalence (DoE) were calculated for the refrence RQR 5 beam quality. In case of air kema area product measurements the results for the RADCAL PDC KAP meter were used. The 216 KAP meter calibration results of the two different transfer instruments in terms of air kerma area product were consistent within 5% except 40 results of 8 participants. The 103 air kerma calibration results were consistent within 1.7%, except 10 results of 4 participants.
T2  - Metrologia
T1  - Comparison of air kerma area product and air kerma meter calibrations for X-ray radiation qualities used in diagnostic radiology
VL  - 52
DO  - 10.1088/0026-1394/52/1A/06024
ER  - 

@article{
author = "Hourdakis, Constantine J. and Csete, I. and Daures, J. and Jarvinen, Hannu and Mihailescu, L-C and Sochor, V. and Novak, L. and Pedersen, M. and Kosunen, A. and Toroi, P. and Denoziere, M. and Buermann, L. and Megzifene, A. and Einarsson, G. and Ferrari, P. and dePooter, J. and Bjerke, H. and Brodecki, M. and Cardoso, J. and Bercea, S. and Ciraj-Bjelac, Olivera and Compel, J. and Glavič-Cindro, Denis and Ginjaume, Merce and Persson, L. and Grindborg, J-E",
year = "2015",
abstract = "The EURAMET #1177 project, identified as EURAMET RI(I)-S9 comparison, was the first EURAMET wide scale supplementary comparison in the field of diagnostic radiology for air kerma area product, P-KA, and air kerma, K. It was conducted with the goal of testing the measurement and calibration capabilities for P-KA and K, as well as of supporting the relevant CMCs of the participating laboratories. Two commercial KAP meters and an ionization chamber were selected as transfer instruments and circulated between the 22 European participants. The measurements were performed from April 2011 until July 2012. The stability and the performance of the transfer instruments were tested by the pilot laboratory (IRCL/GAEC-EIM) and few other laboratories as well. The test results revealed that the energy (radiation quality), Q, irradiation area, A, and air kerma rate, K dependences of response of the transfer KAP meters influence the comparison of the results when different measurement conditions were pertained and therefore, appropriate correction factors were obtained and applied to the reported calibration results of the laboratories, when necessary. The comparison reference values (CRVs) for each instrument were determined as the weighted mean of the calibration coefficients of the three participating primary laboratories. The relative standard uncertainty of the CRVs were in the range of (0.4-1.6)% depending on the transfer instruments and beam qualities. The comparison result as the ratio of the corrected calibration coefficient of participant and the respective CRV, and its uncertainty were calculated for all beam qualities and transfer instruments. The informative degrees of equivalence (DoE) were calculated for the refrence RQR 5 beam quality. In case of air kema area product measurements the results for the RADCAL PDC KAP meter were used. The 216 KAP meter calibration results of the two different transfer instruments in terms of air kerma area product were consistent within 5% except 40 results of 8 participants. The 103 air kerma calibration results were consistent within 1.7%, except 10 results of 4 participants.",
journal = "Metrologia",
title = "Comparison of air kerma area product and air kerma meter calibrations for X-ray radiation qualities used in diagnostic radiology",
volume = "52",
doi = "10.1088/0026-1394/52/1A/06024"
}

Hourdakis, C. J., Csete, I., Daures, J., Jarvinen, H., Mihailescu, L., Sochor, V., Novak, L., Pedersen, M., Kosunen, A., Toroi, P., Denoziere, M., Buermann, L., Megzifene, A., Einarsson, G., Ferrari, P., dePooter, J., Bjerke, H., Brodecki, M., Cardoso, J., Bercea, S., Ciraj-Bjelac, O., Compel, J., Glavič-Cindro, D., Ginjaume, M., Persson, L.,& Grindborg, J.. (2015). Comparison of air kerma area product and air kerma meter calibrations for X-ray radiation qualities used in diagnostic radiology. in Metrologia, 52.
https://doi.org/10.1088/0026-1394/52/1A/06024

Hourdakis CJ, Csete I, Daures J, Jarvinen H, Mihailescu L, Sochor V, Novak L, Pedersen M, Kosunen A, Toroi P, Denoziere M, Buermann L, Megzifene A, Einarsson G, Ferrari P, dePooter J, Bjerke H, Brodecki M, Cardoso J, Bercea S, Ciraj-Bjelac O, Compel J, Glavič-Cindro D, Ginjaume M, Persson L, Grindborg J. Comparison of air kerma area product and air kerma meter calibrations for X-ray radiation qualities used in diagnostic radiology. in Metrologia. 2015;52.
doi:10.1088/0026-1394/52/1A/06024 .

Hourdakis, Constantine J., Csete, I., Daures, J., Jarvinen, Hannu, Mihailescu, L-C, Sochor, V., Novak, L., Pedersen, M., Kosunen, A., Toroi, P., Denoziere, M., Buermann, L., Megzifene, A., Einarsson, G., Ferrari, P., dePooter, J., Bjerke, H., Brodecki, M., Cardoso, J., Bercea, S., Ciraj-Bjelac, Olivera, Compel, J., Glavič-Cindro, Denis, Ginjaume, Merce, Persson, L., Grindborg, J-E, "Comparison of air kerma area product and air kerma meter calibrations for X-ray radiation qualities used in diagnostic radiology" in Metrologia, 52 (2015),
https://doi.org/10.1088/0026-1394/52/1A/06024 . .