Evaluating brain and lens radiation exposure in interventional neuroradiology

This study evaluated brain and lens radiation doses during interventional neuroradiology (INR) procedures, focusing on cumulative mean organ absorbed doses and risks of exceeding dose thresholds for tissue reactions.

A retrospective audit of adult INR procedures from January 2018 to June 2024 at a tertiary centre. Dose calculations were performed using the Dose Area Product (DAP), and organ doses were simulated per procedure. Regression analyses were used to determine the predictive value of DAP and Cumulative Air Kerma (CAK) for brain and lens doses.

A total of 2668 INR procedures were included. Dural arteriovenous fistula (dAVF) embolisation demonstrated the highest median brain doses, while diagnostic had the lowest. A considerable number of cases (13 %) exceeded the 0.5 Gy threshold for brain tissue, but much fewer (<1%) exceeded the lens threshold of 0.5 Gy. During the observation period, 18 % of patients exceeded the brain tissue dose threshold, while fewer than 1 % exceeded the lens threshold. Among those undergoing more than two procedures, 78 % surpassed the brain dose threshold, highlighting the cumulative impact of repeated exposures. DAP strongly predicted brain and lens doses, with an R² of 0.89 and 0.70, respectively.

INR procedures frequently approach or exceed dose thresholds for the brain, while the risk of exceeding the threshold for the lens remains low. DAP is a reliable metric for predicting organ doses and guiding risk assessments. Clinicians should consider cumulative exposure in justification and procedure planning. Further research is warranted to explore long-term outcomes and guide optimisation.