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Absorbed dose and deterministic effects to patients from interventional neuroradiology
R B Mooney1, C S McKinstry, H A Kamel
1Northern Ireland Regional Medical Physics Agency, Forster Green Hospital, Belfast, UK.
The British Journal of Radiology
|November 23, 2000
Summary
Radiation doses from interventional neuroradiology, including glue embolisation for intracranial arteriovenous malformations (AVMs), can cause skin effects. Doses up to 5 Gy were estimated, prompting equipment upgrades and patient counseling.
Area of Science:
- Interventional Neuroradiology
- Medical Physics
- Radiation Oncology
Background:
- Interventional neuroradiology procedures, particularly those involving glue embolisation for intracranial arteriovenous malformations (AVMs), can lead to significant radiation exposure.
- Observed radiation-induced skin effects in patients undergoing AVM treatment necessitated further investigation into absorbed doses during neuroradiological procedures.
Purpose of the Study:
- To measure and estimate the absorbed radiation dose to the skin and skull during interventional neuroradiological procedures.
- To correlate estimated radiation doses with observed skin effects in patients treated for intracranial AVMs.
Main Methods:
- Thermoluminescent dosemeters were used to measure absorbed skin dose during various interventional neuroradiological procedures with long fluoroscopy times.
- Fluoroscopy time and digital runs were recorded to estimate maximum absorbed skin dose for patients undergoing glue embolisation of intracranial AVMs.
- Absorbed doses to the skull and outer table of the skull were also estimated.
Main Results:
- Maximum absorbed skin dose measured during procedures was 4 Gy, with an estimated maximum of 5 Gy for AVM patients, consistent with temporary epilation and erythema.
- Estimated maximum absorbed dose to the skull was 45 Gy, and to the outer table of the skull was 55 Gy.
- The fluoroscopy unit's image intensifier was found to be suboptimal in performance, necessitating replacement.
Conclusions:
- While serious long-term skin effects are unlikely for AVM patients, uncertainty remains regarding potential long-term skull effects.
- The suboptimal performance of the fluoroscopy unit highlighted the need for modern X-ray equipment for interventional radiology.
- Awareness of radiation risks in complex interventional neuroradiology is crucial; procedures should be optimized, and patients counseled on potential symptoms and risks.
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