Association of radiation-induced epilation and interventional neuroradiology procedures

The aim of this study is to quantify the association of temporary epilation following interventional neuroradiology (INR) procedures and compare the peak skin dose (D_skin,max) threshold to published values.

Gold Coast University Hospital (GCUH) is a major centre for INR with over 500 primarily interventional procedures performed every year. D_skin,max is calculated when the reference air kerma (K_a,r) exceeds 3 Gy. If the D_skin,max exceeds 3 Gy, the patient is followed up for any skin effects. An audit was undertaken of these results over a 2-year period.

From January 2020 to December 2021, 140 patients who underwent INR procedures had a K_a,r > 3 Gy, 66 resulted in a calculated D_skin,max >3 Gy, and 45 were successfully followed up. Twenty patients (44%) reported no skin effects and 25 (56%) reported skin effects, which were almost exclusively epilation. The mean (range) D_skin,max for patients with no reported skin effects and those with observed skin effects was 4.6 Gy (3.0-11.1 Gy) and 4.2 Gy (3.0-7.0 Gy), respectively.

These results demonstrate that temporary epilation was observed in 56% of patients, in a cohort of 45 patients who underwent an INR procedure with calculated D_skin,max >3 Gy and successful follow-up. The results support evidence in the literature that suggests the approximate threshold for temporary epilation reported by the International Commission on Radiological Protection (ICRP) may be too high for incidence of this effect, specifically on the scalp, when D_skin,max is calculated from K_a,r (using commonly used corrections and assumptions in the calculation).