Influence of phantom model on peak skin dose mapping in pediatric interventional cardiology

Congress:

ECR 2019

Poster Number:

C-3715

Type:

Scientific Exhibit

Keywords:

Radioprotection / Radiation dose, Radiation physics, Interventional vascular, Fluoroscopy, Dosimetry, Radiation safety, Quality assurance

Authors:

M. Dehairs¹, N. Fitousi¹, F. Rogge¹, J. Jacobs¹, L. Struelens², H. Bosmans¹, N. Marshall¹; ¹Leuven/BE, ²Mol/BE

DOI:

10.26044/ecr2019/C-3715

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3715

Fig. 1: Positioning of the elliptical phantom consisting of 10 Plexiglas plates of 3 cm...

Fig. 2: Positioning of the 10yo CIRS phantom (provided by SCK-CEN) on the...

Fig. 3: Representation on a 3D phantom of the PSD map calculated in DOSE dose...

Fig. 4: Representation of the PSD map on a 10yo-sized 3D phantom as calculated and...

Fig. 5: The film that was irradiated with the 10yo CIRS phantom was used to validate...

Fig. 6: The PSD map as calculated and presented in DOSE for the 12 yo patient. The skin...

Fig. 7: Animated gif that shows how the PSD estimation on a baby phantom changes with...

Fig. 8: Animated gif that shows how the PSD estimation on a 10yo phantom changes with...

Fig. 9: Animated gif that shows how the PSD estimation on an adult phantom changes with...

Aims and objectives

Nowadays, interventional procedures are extensively used for diagnostic and therapeutic purpose. The use of ionizing radiation during these procedures involves the risk of high radiation dose on the patient’s skin which may lead to mild or severe skin reactions [1-2]. Especially in pediatric patients and when there is the need for repetitive procedures, like the case of congenital cardiac diseases, which requires complex cardiac catheterization and follow up [3], it is essential to estimate the skin dose in an accurate way. Additionally, the excess of...

Methods and materials

The first part of the study was to validate the PSD mapping of the dose management system DOSE that is used at the Radiology Department of the University Hospitals Leuven. Peak skin dose calculation in DOSE is an advanced tool that starts from the automatically received Radiation Dose Structured Report (RDSR) of the interventional procedure and uses the dosimetric and geometric parameters of each irradiation event in order to build the skin dose distribution map of the whole procedure. Other affecting factors like the backscatter...

Results

Firstly, the results of the validation are discussed. In the animated gif in Fig. 3 , the 3D representation of the PSD map, calculated by the dose management system DOSE for the plexiglas (adult) phantom (previously seen in Fig. 1 ), is displayed. The map was compared against the irradiated fields on the film and found to correspond well with the experimental measurements. The maximum geometrical difference was 2.2cm for the checked field dimensions and distances. The overestimation of the dimensions that was noticedin cases...

Conclusion

Skin dose mapping for pediatric interventional cardiology should use pediatric models in order to get a better estimation of the peak skin dose and the associated risks. Especially in techniques where lateral views are used, the differences between PSD estimation on an adult phantom and on the correctly sized phantom can be significant. By using a patient radiation dose management system with advanced peak skin dose calculation and availability of adult and pediatric phantoms of different sizes, the responsible physician can rely more on the...

Personal information

References

Stecker MS, Balter S, Towbin RB, et al. Guidelines for patient radiation dose management. J Vasc Interv Radiol 2009; 20: S263-S273. Balter S, Hopewell JW, Miller DL, et al. Fluoroscopically guided interventional procedures: A review of radiation effects on patients’ skin and hair. Radiology 2010; 254(2): 326-341. Hill KD. Et al. Radiation Safety in Children With Congenital and Acquired Heart Disease. A Scientific Position Statement on Multimodality Dose Optimization From the Image Gently Alliance. JACC Cardiovasc Imaging.2017 Jul;10(7):797-818. European Commission. Council Directive 2013/59/EURATOM of December...