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VERIFICATION OF INDICATED SKIN ENTRANCE AIR KERMA FOR CARDIAC X-RAY-GUIDED INTERVENTION USING GAFCHROMIC FILM.

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This study found that the GE Innova IGS 520 imaging system underestimates patient entrance surface air kerma (ESAK) by 32%. This finding leads to a reduced threshold for follow-up procedures to 1.4 Gy.

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Area of Science:

  • Medical Physics
  • Radiological Imaging
  • Radiation Dosimetry

Background:

  • Cardiac interventional procedures involve significant radiation exposure.
  • Accurate monitoring of entrance surface air kerma (ESAK) is crucial for patient safety.
  • Existing imaging systems' dose estimation models require verification.

Purpose of the Study:

  • To verify the indicated maximum ESAK of a GE Innova IGS 520 system.
  • To compare indicated ESAK with patient measurements during cardiac procedures.
  • To assess the accuracy of the imaging system's dose map model.

Main Methods:

  • Utilized Gafchromic XR RV3 films for patient ESAK measurements.
  • Employed thermoluminescent dosemeters and an anthropomorphic phantom for backscatter factor assessment.
  • Calibrated films and compared measured backscatter factors with Monte Carlo simulations and system values.

Main Results:

  • The measured backscatter factor (1.53) exceeded the system's value (1.20).
  • The GE Innova system's indicated maximum ESAK was, on average, 32% lower than measured values (median ratio 0.68).
  • The system's dose map model significantly underestimates patient radiation dose.

Conclusions:

  • The GE Innova IGS 520 imaging system requires recalibration for accurate ESAK estimation.
  • A revised, lower threshold of 1.4 Gy for ESAK is proposed for follow-up procedures.
  • Improved dose monitoring is essential to prevent patient skin injuries.