title: Influence of exposure and geometric parameters on absorbed doses associated with common neuro-interventional procedures.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects of routine exposure parameters on patient's dose during neuro-interventional radiology procedures.
  
  
  METHODS
  We scrutinized the routine radiological exposure parameters during 58 clinical neuro-interventional procedures such as, exposure direction, magnification, frame rate, and distance between image receptor to patient's body and evaluate their effects on patient's dose using an anthropomorphic phantom. Radiation dose received by the occipital region, ears and eyes of the phantom were measured using MOSkin detectors.
  
  
  RESULTS
  DSA imaging technique is a major contributor to patient's dose (80.9%) even though they are used sparingly (5.3% of total frame number). The occipital region of the brain received high dose largely from the frontal tube constantly placed under couch (73.7% of the total KAP). When rotating the frontal tube away from under the couch, the radiation dose to the occipital reduced by 40%. The use of magnification modes could increase radiation dose by 94%. Changing the image receptor to the phantom surface distance from 10 to 40cm doubled the radiation dose received by the patient's skin at the occipital region.
  
  
  CONCLUSIONS
  Our findings provided important insights into the contribution of selected fluoroscopic exposure parameters and their impact on patient's dose during neuro-interventional radiology procedures. This study showed that the DSA imaging technique contributed to the highest patient's dose and judicial use of exposure parameters might assist interventional radiologists in effective skin and eye lens dose reduction for patients undergoing neuro-interventional procedures.
authors.affiliation: Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Safari
authors.affiliation: Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: jeannie_wong80@um.edu.my.
authors.forename: Jeannie Hsiu Ding
authors.initials: JHD
authors.lastname: Wong
authors.affiliation: Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wei Loong
authors.initials: WL
authors.lastname: Jong
authors.affiliation: Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Nathan
authors.initials: N
authors.lastname: Thorpe
authors.affiliation: Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Dean
authors.initials: D
authors.lastname: Cutajar
authors.affiliation: Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: Anatoly
authors.initials: A
authors.lastname: Rosenfeld
authors.affiliation: Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kwan Hoong
authors.initials: KH
authors.lastname: Ng
mesh_terms: D005471:Fluoroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006257:Head; D006801:Humans; D008953:Models, Anatomic; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000517:prevention & control; D011835:Radiation Protection / Q000379:methods; D015642:Radiology, Interventional / Q000295:instrumentation / Q000379:methods*
keywords: Neuro-interventional radiology; Patient dose monitoring; Radiological exposure parameters; Skin and eye lens dose