Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in Neuroradiology

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Fig 1.
Distributions of dose area product values (Gy · cm²) for cerebral embolizations during 2009 and 2010 (frontal and lateral planes together). Median and third quartile values are indicated in Table 1.
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Fig 2.
Cumulative skin dose distributions (Gy) for cerebral embolizations during 2009 and 2010 (frontal and lateral planes together). Median and third quartile values are indicated in Table 1.

Table 2:

Values of DAP and skin dose for cerebral embolizations

Authors and Reference	Year	Sample	DAP (Gy · cm²) Mean	SD	Skin Dose in Gy Mean Values^{^a}	SD	Comments
Mamourian et al⁷	2010	8	NA	NA	0.9	NA	Average skin dose
Moritake et al⁸	2008	32	NA	NA	1.8	1.3	Peak skin dose
Suzuki et al⁹	2008	103	257	150	1.9	1.1	Maximum entrance skin dose
D'Ercole et al¹⁰	2007	42	413	NA	1.2		Maximum skin dose
Moskowitz et al¹¹	2010	46	NA	NA	10.4	4.2	Cumulative skin dose
Miller et al¹²	2003	356	320	NA	3.8	NA	Cumulative dose
D'Ercole et al¹³	2012	82	383	176	NA	NA	No skin dose reported. Median value of DAP: 352
This article	2012	172	305	211	2.7	1.6	Cumulative skin dose. Median value of DAP: 256

Table 3:

Dose reduction in entrance surface dose rate (with backscatter) measured with a PMMA phantom

	Low-Mode Fluoroscopy (mGy/min)	Normal-Mode Fluoroscopy (mGy/min)	DSA (mGy/image)
Normal dose (15 p/s in fluoro.) procedure	9.9	25.2	5.9
Low-dose (7.5 p/s in fluoro.) procedure	7.0	16.6	3.1
Dose reduction % (low dose/normal dose)	30	34	47

Note:—PMMA indicates polymethylmethacrylate. Focus-phantom distance: 67 cm; Focus image detector; 104 cm. 20-cm thickness of PMMA; FOV 31.1 cm. The dose per pulse in the new low-dose fluoroscopy mode has been increased in comparison with the “normal” one to reduce the noise.