Entrances skin dose distribution maps for interventional neuroradiological procedures: a preliminary study

Dose estimation in interventional neuroradiology can be useful to limit skin radiation injuries. The purpose of this study was to evaluate the role of entrance skin dose (ESD) maps in planning exposure condition optimisation. Thirteen cerebral angiography and five embolisation procedures were monitored, measuring ESD, dose-area product (DAP) and other operational parameters. A transmission ionisation chamber, simultaneously measuring air kerma and DAP, measured dose-related quantities. Data acquisition software collected dosimetric and geometrical data during the interventional procedure and provided a distribution map of ESD on a standard phantom digital image, with maximum value estimation. Values of 88-1710 mGy for maximum skin dose and 16.7-343 Gy cm2 for DAP were found. These data confirm the possibility of deterministic effects during therapeutic interventional neuroradiological procedures like cerebral embolisation. ESD maps are useful to retrospectively study the exposure characteristics of a procedure and plan patient exposure optimisation.