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PT  - JOURNAL ARTICLE
AU  - Vano, E.
AU  - Fernandez, J.M.
AU  - Sanchez, R.M.
AU  - Martinez, D.
AU  - Ibor, L. Lopez
AU  - Gil, A.
AU  - Serna-Candel, C.
TI  - Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in Neuroradiology
AID  - 10.3174/ajnr.A3211
DP  - 2013 Feb 01
TA  - American Journal of Neuroradiology
PG  - 277--282
VI  - 34
IP  - 2
4099  - http://www.ajnr.org/content/34/2/277.short
4100  - http://www.ajnr.org/content/34/2/277.full
SO  - Am. J. Neuroradiol.2013 Feb 01; 34
AB  - BACKGROUND AND PURPOSE: Radiation exposure from neurointerventional procedures can be substantial, with risk of radiation injuries. We present the results of a follow-up program applied to potential skin injuries in interventional neuroradiology based on North American and European guidelines. MATERIALS AND METHODS: The following guidelines approved in 2009 by SIR and CIRSE have been used over the last 2 years to identify patients with potential skin injuries requiring clinical follow-up: peak skin dose &amp;gt;3 Gy, air kerma at the patient entrance reference point &amp;gt;5 Gy, kerma area product &amp;gt;500 Gy · cm2, or fluoroscopy time &amp;gt;60 minutes. RESULTS: A total of 708 procedures (325 in 2009 and 383 in 2010) were included in the study. After analyzing each dose report, 19 patients (5.9%) were included in a follow-up program for potential skin injuries in 2009, while in 2010, after introducing several optimizing actions and refining the selection criteria, only 4 patients (1.0%) needed follow-up. Over the last 2 years, only 3 patients required referral to a dermatology service. CONCLUSIONS: The application of the guidelines to patient radiation dose management helped standardize the selection criteria for including patients in the clinical follow-up program of potential skin radiation injuries. The peak skin dose resulted in the most relevant parameter. The refinement of selection criteria and the introduction of a low-dose protocol in the x-ray system, combined with a training program focused on radiation protection, reduced the number of patients requiring clinical follow-up. CIRSECardiovascular and Interventional Radiology Society of EuropeDAPdose-area productDOLIRdose on-line for interventional radiologyICRPInternational Commission on Radiologic ProtectionSIRSociety of Interventional Radiology