An assessment of methods for monitoring entrance surface dose in fluoroscopically guided interventional procedures

In the light of a growing awareness of the risks of inducing skin injuries as a consequence of fluoroscopically guided interventional procedures (FGIPs), this paper reports measurements of ESDs made during the period August 1998 to June 1999 on 137 patients undergoing cardiac, neurological and general FGIPs in the South London area. In addition, different methods suitable for use in a routine monitoring programme of ESD are discussed. Although the need for additional data is acknowledged, the results reported reinforce the need for routine assessments to be made of ESDs in FGIPs. At present, the most reliable and accurate form of ESD measurement would seem to be arrays of TLDs. However, transducer based methods although likely to be less accurate, have considerable advantages in relation to a continuous monitoring programme. It is also suggested that there may be the potential locally for threshold dose area product (DAP) values to be set for specific procedures. These could be used to provide early warning of the potential for skin injuries.