The study was conducted at the Pauls Stradins Clinical University hospital,
Institute of Diagnostic radiology during the period from November 2012 till April 2013.
Since the average radiation dose received during TACE substantially did not change for patients,
each study group were selected by 3 patients,
which characterizes the general situation,
without giving any other criteria of evaluation.
To calculate the patient received radiation dose (Gy),
the specific formula is used to recalculate the DAP (dose area product) to the absorbed dose.
The equivalent dose is equal to the absorbed dose multiplied by the radiation weighted factors.
X-rays,
this factor is 1.(Fig.3)
In the study we analyzed the radiation doses,
which were read from the DAP after each of the invasive radiology procedure and recalculated.
The results were grouped according to the selected therapies - TACE and aneurysm embolisation.
Patient radiation doses
Patient
|
Dose (mGy)
|
Total dose (mGy)
|
Average dose (mGy)
|
TACE Radiation dose
|
|
|
Patient 1
|
215.8
|
740.8
|
246.9
|
Patient 2
|
298.2
|
Patient 3
|
226.8
|
Aneurysm embolisation Radiation dose
|
|
Patient
|
Dose (mGy)
|
Total dose (mGy)
|
Average dose (mGy)
|
Patient 1
|
600.3
|
1933.3
|
644.4
|
Patient 2
|
518.8
|
Patient 3
|
814.2
|
TACE patient doses: Patient1 dose is 215.8mGy,
this is the lowest dose from these three patients.
Patient2 dose is 298.2mGy,
this is the highest dose in this group.
Patient3 dose is 226.8mGy,
this patient dose is closer to average doses.
Aneurysm embolisation patient doses: Patient1 dose is 600.3mGy,
this dose is almost average dose of group.
Patient2 dose is 518.8mGy,
this is the lowest dose.
Patient dose is 814.2mGy,
this is highest dose from all patients of study.
TACE average radiation dose – 246,9 mGy,
aneurysm embolisation average radiation dose - 644,4 mGy.
Summarizing and comparing the data obtained,
we revealed that the average radiation dose is higher during aneurysm embolisation than chemoembolisation (Fig.4).
During both procedures we use microcathethers and embolisation material,
however,
the treatment of intracranial pathology is more complex and extended procedure that also affects the received radiation dose.
Other European and international publications about TACE and radiation doses state that during embolisation three of Drug-eluting beads-Tandem,
DC Beads and HepaSphere are used as well as it was in our study.
Ishiguchi et al.
study from Japan showed average dose values 973mGy in population of 39 patients,
Hidajat et al.
approximately 500mGy in population of 65 patients in Germany.
Our study results with 246mGy are comparable with other studies and with less exposure of radiation to patient and staff that may be explained with duration of the procedure (in average 25 minutes),
patient's body composition,
vascular anatomy,
HCC and metastases localisation and physician style of work.
Although the average radiation dose after chemoembolisation and aneurysm embolisation is relatively high,
the individual patient dose do not exceed the threshold dose ranges from 0.1 SV to 0.5 Sv to acute whole-body exposure.