title: Validation and initial clinical use of automatic peak skin dose localization with fluoroscopic and interventional procedures.
abstract: OBJECTIVE
  To assess the accuracy and initial clinical use of a software tool that automatically maps and records values of skin dose, including peak skin dose (PSD), administered to patients undergoing fluoroscopically guided interventional procedures.
  
  
  METHODS
  In this retrospective study, the institutional review board determined that this HIPAA-compliant study met the criteria as a quality assurance investigation. Informed consent was waived. After the initial validation and accuracy tests, distributed skin dose and PSD estimates were obtained for fluoroscopically guided interventional procedures performed in the radiology, cardiology, and gastroenterology practice areas between January and October 2011. A total of 605 procedures were performed in 520 patients (64% men; age range, 20-95 years). The accuracy of a skin dose tool to estimate patient dose distribution was verified with phantom studies by using an external dosimeter and direct exposure film. PSD distribution, PSD according to procedure type, and PSD for individual physician operators were assessed.
  
  
  RESULTS
  Calculated PSD values agreed within ±9% of that measured by using film dosimetry under the condition of matched-phantom geometry. The area receiving the highest dose (greater than 95% of peak) agreed within ±17%. Of 605 patient procedures, 15 demonstrated PSD greater than 2 Gy, with a maximum PSD of 5.6 Gy.
  
  
  CONCLUSIONS
  Knowledge of the patient skin dose can help direct treatment of patients who were administered relatively high skin dose and may be used to plan future procedures.
  
  
  BACKGROUND
  http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112295/-/DC1.
authors.affiliation: School of Computing, Informatics and Decision Systems Engineering, Arizona State University, 699 S Mill Ave, Tempe AZ 85281, USA.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Khodadadegan
authors.forename: Muhong
authors.initials: M
authors.lastname: Zhang
authors.forename: William
authors.initials: W
authors.lastname: Pavlicek
authors.forename: Robert G
authors.initials: RG
authors.lastname: Paden
authors.forename: Brian
authors.initials: B
authors.lastname: Chong
authors.forename: Eric A
authors.initials: EA
authors.lastname: Huettl
authors.forename: Beth A
authors.initials: BA
authors.lastname: Schueler
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Fetterly
authors.forename: Steve G
authors.initials: SG
authors.lastname: Langer
authors.forename: Teresa
authors.initials: T
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001822:Body Burden; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012879:Skin Physiological Phenomena; D012984:Software