High fluoroscopy doses may be delivered to patients’ skin during neuro-interventional procedures. Depending on patient radio-sensitivity, radiation doses between 2-5 Gy at the skin may produce transient erythema, doses between 5 and 10 Gy can result in permanent erythema and/or epilation, and doses between 10-15 Gy may produce dermal atrophy and telangiectasia. With doses greater than 15 Gy, surgical interventions are likely to be required to treat the skin [1,2]. Some therapeutic neuro-interventional procedures may require several interventions in the same patient at intervals of...

The skin dose optimization system is applied in the neuroradiology department at the Hospital Clínico San Carlos (Madrid, Spain). It consists of one biplane C-arm model Allura Xper (Philips Health Care) connected to a homemade dose management system called “DOLQA” that receives, processes and records the dose information reports sent by the modality as DICOM Radiation Dose Structured Reports (RDSR) [12]. The RDSR contain relevant information for skin dose calculation at event level, among which generator settings (kV, mA, ms), kerma at patient entrance reference...

Table 1 shows the main dosimetric parameters for the cases presented. In cases 1 and 2, it is possible to see how a similar KPERP may produce quite different peak skin doses. This stresses the importance of providing an accurate estimation of PSD to the interventionalists, which appears to be more efficient than basing the follow-up decision on the kerma value at the patient entrance reference point. Figure 2 shows the skin dose distribution for the three cases. Figure 3 shows the highest dose case...

It is appropriate to provide accurate estimations of peak skin dose delivered in high dose interventional neuroradiology procedures to properly manage the patient doses, to establish an efficient follow-up program and to prepare successive interventions in some of the patients. The prototype DIDo permits the estimation of skin dose distribution and peak skin doses for patients who need one or several interventional neuroradiology procedures.

This work has been partially funded by the Spanish Ministry of Economy and Competitiveness (Carlos III Health Institute) and European Development Fund (ERDF) under the project MEDICI number PI16/01413.

1. ICRP publication 85. Avoidance of radiation injuries from medical interventional procedures, ICRP Publication 85. J Valentin - Annals of the ICRP, 2000. 2. Balter, Hopewell, Miller, Wagner and Zelefsky. Fluoroscopically Guided Interventional Procedures: A Review of Radiation Effects on Patients’ Skin and Hair. Radiology (2010): Volume 254:326-41. 3. Michael S. Stecker, MD, Stephen Balter, PhD, Richard B. Towbin et al. Guidelines for Patient Radiation Dose Management. J Vasc Interv Radiol 2009; 20:S263–S273. 4. Kwon, D., Little, M. P. and Miller, D. L. Reference air...