title: A practical method for skin dose estimation in interventional cardiology based on fluorographic DICOM information.
abstract: A practical method for skin dose estimation for interventional cardiology patients has been developed to inform pre-procedure planning and post-procedure patient management. Absorbed dose to the patient skin for certain interventional radiology procedures can exceed thresholds for deterministic skin injury, requiring documentation within the patient notes and appropriate patient follow-up. The primary objective was to reduce uncertainty associated with current methods, particularly surrounding field overlap. This was achieved by considering rectangular field geometry incident on a spherical patient model in a polar coordinate system. The angular size of each field was quantified at surface of the sphere, i.e. the skin surface. Computer-assisted design software enabled the modelling of a sufficient dataset that was subsequently validated with radiochromic film. Modelled overlap was found to agree with overlap measured using film to within 2.2° ± 2.0°, showing that the overall error associated with the model was < 1 %. Mathematical comparison against exposure data extracted from procedural Digital Imaging and Communication in Medicine files was used to generate a graphical skin dose map, demonstrating the dose distribution over a sphere centred at the interventional reference point. Dosimetric accuracy of the software was measured as between 3.5 and 17 % for different variables.
authors.affiliation: Clinical & Radiation Physics, Plymouth Hospitals NHS Trust, Derriford Hospital, Derriford Road, Plymouth PL6 8DH, UK lucy.mather1@nhs.net.
authors.forename: Lucy
authors.initials: L
authors.lastname: Matthews
authors.affiliation: Clinical & Radiation Physics, Plymouth Hospitals NHS Trust, Derriford Hospital, Derriford Road, Plymouth PL6 8DH, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Dixon
authors.affiliation: Clinical & Radiation Physics, Plymouth Hospitals NHS Trust, Derriford Hospital, Derriford Road, Plymouth PL6 8DH, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Rowles
authors.affiliation: Clinical & Radiation Physics, Plymouth Hospitals NHS Trust, Derriford Hospital, Derriford Road, Plymouth PL6 8DH, UK.
authors.forename: Greg
authors.initials: G
authors.lastname: Stevens
mesh_terms: D002309:Cardiology; D017076:Computer-Aided Design; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000379:methods*; D011835:Radiation Protection; D015642:Radiology, Interventional; D012867:Skin / Q000528:radiation effects*; D012984:Software