title: [Multicenter Study on Evaluation of the Entrance Skin Dose by a Direct Measurement Method in Cardiac Interventional Procedures].
abstract: Deterministic effects have been reported in cardiac interventional procedures. To prevent radiation skin injuries in percutaneous coronary intervention (PCI), it is necessary to measure accurate patient entrance skin dose (ESD) and maximum skin absorbed dose (MSD). We measured the MSD on 62 patients in four facilities by using the Chest-RADIREC(Ⓡ) system. The correlation between MSD and fluoroscopic time, dose area product (DAP), and cumulative air kerma (AK) showed good results, with the correlation between MSD and AK being the strongest. The regression lines using MSD as an outcome value (y) and AK as predictor variables (x) was y=1.18x (R(2)=0.787). From the linear regression equation, MSD is estimated to be about 1.18 times that of AK in real time. The Japan diagnostic reference levels (DRLs) 2015 for IVR was established by the use of dose rates using acrylic plates (20- cm thick) at the interventional reference point. Preliminary reference levels proposed by International Atomic Energy Agency (IAEA) were provided using DAP. In this study, AK showed good correlation most of all. Hence we think that Japanese DRLs for IVR should reconsider by clinical patients' exposure dose such as AK.
authors.affiliation: Department of Radiology, Research Institute for Brain and Blood Vessels-Akita.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kato
authors.forename: Koichi
authors.initials: K
authors.lastname: Chida
authors.forename: Takashi
authors.initials: T
authors.lastname: Moritake
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Koguchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kaga
authors.forename: Hajime
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tsukamoto
authors.forename: Satoru
authors.initials: S
authors.lastname: Kawauchi
authors.forename: Kazuma
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Matsumura
authors.forename: Hajime
authors.initials: H
authors.lastname: Oosaka
authors.forename: Hideto
authors.initials: H
authors.lastname: Toyoshima
mesh_terms: D006801:Humans; D062645:Percutaneous Coronary Intervention; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods*; D012867:Skin / Q000528:radiation effects*