Skin dose mapping for fluoroscopically guided interventions.

Area of Science:

• Medical Physics
• Radiology
• Medical Imaging

Background:

• Accurate assessment of patient skin dose is crucial in interventional fluoroscopy to prevent radiation-induced injuries.
• Current methods for dose estimation may lack precision, particularly with complex patient anatomies and varying fluoroscopic procedures.

Purpose of the Study:

• To introduce a novel skin dose mapping software system for interventional fluoroscopy.
• To evaluate the accuracy and benefits of patient-phantom matching in dose assessment.
• To analyze the limitations of different phantom matching techniques.

Main Methods:

• Developed a software system to visualize patient skin dose by translating reference point air kerma to a computational skin model.
• Utilized geometric parameters from the radiation dose structured report (RDSR) and in-clinic measurements for model orientation.
• Calculated peak skin dose using 26 patient-specific models and compared results with reference, patient-dependent, and patient-sculpted models.

Main Results:

• Patient-dependent and patient-sculpted phantoms significantly improved dose accuracy, especially in left lateral and anterior-posterior projections, reducing percent difference by up to 17% compared to reference models.
• Under-table tube configurations generally yielded errors less than 5% due to consistent source-to-skin distance.
• A prototype display system was successfully integrated into an interventional fluoroscopy control room monitor.

Conclusions:

• The developed skin dose mapping software is a valuable, nonproprietary tool for interventional physicians.
• The system provides crucial information for optimizing radiation dose management in real-time or near real-time.
• Future work will focus on clinical implementation, workflow optimization, and real-time capability analysis.