Estimating radiation doses to the skin from interventional radiology procedures for a patient population with cancer Journal Article

  


Authors: Dauer, L. T.; Thornton, R.; Erdi, Y.; Ching, H.; Hamacher, K. A.; Boylan, D. C.; Williamson, M. J.; Balter, S.; St. Germain, J.
Article Title: Estimating radiation doses to the skin from interventional radiology procedures for a patient population with cancer
Abstract: Purpose: To estimate the peak radiation skin doses for interventional radiology cases performed at a cancer center, identify procedure types likely to result in skin doses exceeding the American College of Radiology's 3 Gy follow-up level, and determine a kerma area product (P<sub>KA</sub>) for use in monitoring. Materials and Methods: A single-center retrospective study was performed to estimate doses from consecutive procedures performed during 2006. Of 6,598 procedures, 3,925 (60%) had P<sub>KA</sub> recorded and were included. Forty-three procedure types are represented. Results: The median estimated peak skin dose was 39 mGy (third quartile, 205 mGy). In 2.6% of the cases, the estimated skin dose exceeded 3 Gy. No procedures resulted in skin doses greater than 15 Gy, and 94% of the cases resulted in skin doses less than 1 Gy. Procedure types with instances of skin doses greater than 1 Gy included hepatic, portal, and other arterial embolizations; diagnostic arteriography; biliary drainages; stent placements and catheter exchanges; nephrostomy/nephroureterostomy; urinary catheter exchanges; inferior vena cava filters; foreign body retrieval; abscess drainage; catheter exchange; and fistulography. Hepatic embolizations, nonhepatic arterial embolizations, and biliary drain/stent procedures were most likely to result in skin doses greater than 1 Gy. Significant variations in skin dose were noted within the same procedure type. No patients were noted to have developed any sequelae from radiation. Conclusions: It is unlikely that typical cases in an oncologic interventional radiology practice would exceed the Joint Commission's "reviewable sentinel event" skin dose level of 15 Gy. A P<sub>KA</sub> trigger of 300 Gycm<sup>2</sup> could be used in the authors' clinic to identify follow-up requirements. © 2009 SIR.
Keywords: adolescent; adult; child; controlled study; preschool child; school child; aged; aged, 80 and over; child, preschool; middle aged; retrospective studies; young adult; major clinical study; artificial embolism; cancer radiotherapy; radiation dose; neoplasms; radiation dosage; skin; nephrostomy; arteriography; radiometry; relative biological effectiveness; body burden; abscess drainage; biliary tract drainage; fistulography; inferior cava vein; liver hilus; urinary catheter; new york; radiology, interventional; skin physiological phenomena
Journal Title: Journal of Vascular and Interventional Radiology
Volume: 20
Issue: 6
ISSN: 1051-0443
Publisher: Elsevier Science, Inc.  
Date Published: 2009-06-01
Start Page: 782
End Page: 788
Language: English
DOI: 10.1016/j.jvir.2009.03.009
PUBMED: 19395276
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-67349165898&partnerID=40&md5=c30aa15e8b7090082004bde48ecfdf28
Notes: --- - "Export Date: 30 November 2010" - "CODEN: JVIRE" - "Source: Scopus"
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MSK Authors
  1. Raymond H Thornton
    84 Thornton
  2. Lawrence Dauer
    170 Dauer
  3. Yusuf E Erdi
    118 Erdi
  4. Jean M St Germain
    61 St Germain
  5. Stephen Balter
    1 Balter
  6. Klaus A Hamacher
    14 Hamacher
  7. Matthew Williamson
    27 Williamson
  8. Daniel C Boylan
    4 Boylan
  9. Hung Ching
    3 Ching
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