Monitoring neurointerventional radiation doses using dose-tracking software: implications for the establishment of local diagnostic reference levels

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dc.contributor.author Acton, Holly
dc.contributor.author James, Karl
dc.contributor.author Kavanagh, Richard G.
dc.contributor.author O'Tuathaigh, Colm M. P.
dc.contributor.author Moloney, Deirdre
dc.contributor.author Wyse, Gerald
dc.contributor.author Fanning, Noel
dc.contributor.author Maher, Michael M.
dc.contributor.author O'Connor, Owen J.
dc.date.accessioned 2018-08-15T15:53:25Z
dc.date.available 2018-08-15T15:53:25Z
dc.date.issued 2018-04-12
dc.identifier.citation Acton, H., James, K., Kavanagh, R. G., O’Tuathaigh, C., Moloney, D., Wyse, G., Fanning, N., Maher, M. and O’Connor, O. J. (2018) 'Monitoring neurointerventional radiation doses using dose-tracking software: implications for the establishment of local diagnostic reference levels', European Radiology, 28(9), pp. 3669-3675. doi: 10.1007/s00330-018-5405-3 en
dc.identifier.volume 28 en
dc.identifier.issued 9 en
dc.identifier.startpage 3669 en
dc.identifier.endpage 3675 en
dc.identifier.issn 1432-1084
dc.identifier.uri http://hdl.handle.net/10468/6617
dc.identifier.doi 10.1007/s00330-018-5405-3
dc.description.abstract Objectives: There is potential for high radiation exposure during neurointerventional procedures. Increasing regulatory requirements mandate dose monitoring of patients and staff, and justification of high levels of radiation exposure. This paper demonstrates the potential to use radiation dose-tracking software to establish local diagnostic reference levels. Methods: Consecutive neurointerventional procedures, performed in a single institution within a one-year period, were retrospectively studied. Dose area product (DAP) data were collected using dose-tracking software and clinical data obtained from a prospectively generated patient treatment database. Results: Two hundred and sixty-four procedures met the selection criteria. Median DAP was 100 Gy.cm2 for aneurysm coiling procedures, 259 Gy.cm2 for arteriovenous malformation (AVM) embolisation procedures, 87 Gy.cm2 for stroke thrombolysis/thrombectomy, and 74 Gy.cm2 for four-vessel angiography. One hundred and nine aneurysm coiling procedures were further studied. Six significant variables were assessed using stepwise regression analysis to determine effect on DAP. Aneurysm location (anterior vs posterior circulation) had the single biggest effect (p = 0.004). Conclusions: This paper confirms variable radiation exposures during neurointerventional procedures. The 75th percentile (used to define diagnostic reference levels) of DAP measurements represents a reasonable guidance metric for monitoring purposes. Results indicate that aneurysm location has the greatest impact on dose during coiling procedures and that anterior and posterior circulation coiling procedures should have separate diagnostic reference levels. Key Points: Dose-tracking software is useful for monitoring patient radiation dose during neurointerventional procedures; This paper provides a template for methodology applicable to any interventional suite; Local diagnostic reference levels were defined by using the 75th percentile of DAP as per International Commission on Radiological Protection recommendations; Aneurysm location is the biggest determinant of radiation dose during coiling procedures.; Anterior and posterior circulation coiling procedures should have separate diagnostic reference levels. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Springer Verlag en
dc.relation.uri https://doi.org/10.1007/s00330-018-5405-3
dc.rights © European Society of Radiology 2018. Published by Springer Verlag. This is a pre-print of an article published in European Radiology. The final authenticated version is available online at: https://doi.org/10.1007/s00330-018-5405-3 en
dc.subject Radiation exposure en
dc.subject Intracranial aneurysm en
dc.subject Cerebral angiography en
dc.subject Intracranial arteriovenous malformation en
dc.subject Thrombectomy en
dc.title Monitoring neurointerventional radiation doses using dose-tracking software: implications for the establishment of local diagnostic reference levels en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Owen O'Connor, Medicine , University College Cork, Cork, Ireland. +353-21-490-3000 Email: oj.oconnor@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2018-08-15T15:45:58Z
dc.description.version Submitted Version en
dc.internal.rssid 449640972
dc.description.status Peer reviewed en
dc.identifier.journaltitle European Radiology en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress oj.oconnor@ucc.ie en


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