Calculating the peak skin dose resulting from fluoroscopically-guided interventions. Part II: case studies

Part II of this review article presents four case studies for which peak skin doses are calculated following the methods outlined in Part I of this review. The data available in the cases ranges from proprietary dose reports to fluoroscopy time and number of digital acquisition frames only. Flowcharts are provided for each case. These flowcharts outline the calculation steps and data sources used to estimate the peak skin dose. The accuracy that can be achieved using these methods depends on several factors, including the calibration accuracy of dosimetric equipment, accuracy of information reported in the DICOM header and proprietary dose reports, accuracy of quantities measured by the medical physicist, and procedural factors such as rotation of the C-arm during a fluoroscopically-guided procedure.