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RT Journal Article
SR Electronic
T1 Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in Neuroradiology
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 277
OP 282
DO 10.3174/ajnr.A3211
VO 34
IS 2
A1 Vano, E.
A1 Fernandez, J.M.
A1 Sanchez, R.M.
A1 Martinez, D.
A1 Ibor, L. Lopez
A1 Gil, A.
A1 Serna-Candel, C.
YR 2013
UL http://www.ajnr.org/content/34/2/277.abstract
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 &gt;3 Gy, air kerma at the patient entrance reference point &gt;5 Gy, kerma area product &gt;500 Gy · cm2, or fluoroscopy time &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