Patient dosimetry in diagnostic and interventional radiology: a practical approach using trigger levels

Area of Science:

• Medical Physics
• Radiology
• Radiation Protection

Background:

• Patient dosimetry is crucial in radiology to evaluate deterministic injury risks and stochastic effect probabilities.
• A key challenge is that no single dosimetric quantity accurately assesses both risks simultaneously.
• Current practices in cardiology and interventional radiology utilize distinct dosimetry approaches.

Purpose of the Study:

• To address the limitations of current patient dosimetry methods in radiology and interventional radiology.
• To explore the utility of dose-area product (DAP) in assessing patient radiation exposure.
• To propose a framework for using DAP as a trigger for investigating potential deterministic effects.

Main Methods:

• Review of existing patient dosimetry practices in radiology and interventional radiology.
• Analysis of the correlation between effective dose and dose-area product (DAP).
• Evaluation of DAP's correlation with maximum skin dose for predicting deterministic injuries.

Main Results:

• Effective dose correlates well with stochastic effect risk but not with maximum skin dose.
• Dose-area product (DAP) does not correlate with maximum skin dose, a predictor of deterministic injuries.
• DAP readings can serve as effective trigger levels for investigating maximum skin entrance dose.

Conclusions:

• A single quantity cannot adequately assess both stochastic and deterministic risks in patient dosimetry.
• Dose-area product (DAP) is valuable for monitoring and managing patient radiation exposure in interventional procedures.
• Proposed trigger levels for DAP can enhance patient safety by prompting investigations into potential skin injuries.