title: Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds.
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 >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.
authors.affiliation: Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France jad.farah@irsn.fr.
authors.forename: J
authors.initials: J
authors.lastname: Farah
authors.affiliation: Udine University Hospital (AOUD), Ple S. Maria della Misericordia, 15, Udine 33100, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Trianni
authors.affiliation: Greek Atomic Energy Commission (GAEC), PO Box 60092, Ag. Paraskevi, Athens 15310, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Carinou
authors.affiliation: VINCA Institute of Nuclear Sciences (VINCA), PO Box 522, Belgrade 11001, Serbia.
authors.forename: O
authors.initials: O
authors.lastname: Ciraj-Bjelac
authors.affiliation: Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France.
authors.forename: I
authors.initials: I
authors.lastname: Clairand
authors.affiliation: Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Dabin
authors.affiliation: Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome 00161, Italy.
authors.forename: C
authors.initials: C
authors.lastname: De Angelis
authors.affiliation: Nofer Institute of Occupational Medicine (NIOM), 8 Sw. Teresy, Str., Łódź 91-348, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Domienik
authors.affiliation: Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Jarvinen
authors.affiliation: Institute of Nuclear Physics (IFJ PAN), ul Radzikowskiego 152, Kraków PL-31-342, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Kopec
authors.affiliation: Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Majer
authors.affiliation: Centre Hospitalier Universitaire de Liège (CHUL), Avenue de l'Hôpital, Liège 4000, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Malchair
authors.affiliation: Istituto Oncologico Veneto (IOV), Via Gattamelata 64, Padova 35124, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Negri
authors.affiliation: National Radiation Protection Institute (NRPI), Bartoškova 28, Prague 4 140 00, Czech Republic.
authors.forename: L
authors.initials: L
authors.lastname: Novák
authors.affiliation: Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Siiskonen
authors.affiliation: Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium.
authors.forename: F
authors.initials: F
authors.lastname: Vanhavere
authors.affiliation: Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia.
authors.forename: Ž
authors.initials: Ž
authors.lastname: Knežević
mesh_terms: D065638:Absorption, Radiation; D013504:Cardiovascular Surgical Procedures / Q000379:methods*; D006801:Humans; D008452:Maximum Allowable Concentration; D015641:Radiography, Interventional / Q000379:methods*; D011874:Radiometry / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012867:Skin / Q000000981:diagnostic imaging*; D012879:Skin Physiological Phenomena / Q000528:radiation effects; D014965:X-Rays