Radiation doses to patients from digital subtraction angiography

Area of Science:

• Radiology and Medical Imaging
• Radiation Dosimetry

Background:

• Digital subtraction angiography (DSA) is a crucial imaging technique.
• Accurate patient dose assessment is essential for radiation safety in interventional radiology.

Purpose of the Study:

• To determine patient radiation doses during various DSA procedures.
• To compare measured dose-area product (DAP) and entrance surface air kerma (ESAK) values with established safety limits and published data.

Main Methods:

• Analysis of fluoroscopy time, DAP, and ESAK from 263 DSA examinations.
• Classification of examinations into seven distinct procedural categories.
• Comparison of obtained dose metrics with existing literature and erythema dose limits.

Main Results:

• Median DAP values varied significantly across the seven DSA categories, ranging from 2.6 to 105.7 Gy cm².
• Most entrance surface air kerma (ESAK) values were below 2 Gy, the threshold for skin erythema.
• DAP values were comparable to published data for some categories but higher for others; data for three categories were not previously reported.

Conclusions:

• Patient doses in DSA procedures are generally within acceptable ranges, with ESAK rarely approaching erythema thresholds.
• Specific DSA procedural types exhibit distinct radiation dose profiles.
• Further investigation and establishment of reference dose levels are needed for less common DSA categories.