title: SKIN DOSE, EFFECTIVE DOSE AND RELATED RISK IN TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) PROCEDURES: IS THE CANCER RISK ACCEPTABLE FOR YOUNGER PATIENTS?
abstract: The aim of this study was to estimate conversion coefficients for maximum entrance skin dose (MESD) and effective dose (E) for patients undergoing transcatheter aortic valve implantation (TAVI) and to evaluate the risk of exposure-induced cancer death (REID) for prospectively younger patients. Effective doses and risks were estimated for 22 patients using PCXMC whereas MESDs were estimated for a sub-group of 15 patients using Gafchromic film. The estimated conversion coefficients for skin dose [CCS = MESD/dose-area product (DAP)] and E (CCE = E/DAP) were 9.7±1.5 and 0.24±0.02 mSv/Gy cm(2), respectively. The REID ranged from 1:9900 to 1:1400 and by decreasing the age of examination to 40-50 y of age, the REID increased with a factor of 2 for females and 1.5 for males. The organ at risk was the lung. Currently, the patient population is elderly with radiation-induced skin injuries as the main risk. The risk of cancer induction should additionally be considered if younger patient populations are to be treated.
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden angeliki.karambatsakidou@karolinska.se.
authors.forename: A
authors.initials: A
authors.lastname: Karambatsakidou
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Omar
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Chehrazi
authors.affiliation: Department of Cardiology, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Rück
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Scherp Nilsson
authors.affiliation: Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Fransson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000009:adverse effects*; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005373:Film Dosimetry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000517:prevention & control; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology; D015641:Radiography, Interventional / Q000009:adverse effects*; D011874:Radiometry / Q000379:methods*; D012867:Skin / Q000528:radiation effects*; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*; D014965:X-Rays