The potential for radiation-induced skin damage in interventional neuroradiological procedures: A review of 522 cases using automated dosimetry

The Food and Drug Administration (FDA) has recommended the monitoring of ra diation skin dose to patients during procedures having the potential for ra diation damage. Radiologists need information about typical radiation doses during interventional procedures. The skin doses to patients during 522 in terventional neuroradiological procedures have been monitored using an auto mated dosimetry system. Estimated entrance skin doses (ESD) were binned int o 0.5 Gy increments and compared to FDA recommended thresholds for inclusio n in the patient record. Percentages of procedures exceeding the above ment ioned thresholds are presented. In addition, the percentage of dose in each view and the percentage of dose in fluoroscopic and digital angiographic m odes are shown. Six percent of embolization procedures and one percent of c erebral angiograms are estimated to have potential for main erythema (ESD> 6 Gy). All types of procedures have potential for temporary erythema and ex ceed the threshold for inclusion in the patient record (ESD>I Gy) at the 95 % percentile. The types of procedures with most potential for skin damage a lso have significant percentages of dose in the digital angiographic mode. Thus, monitoring fluoroscopic time alone underestimates the potential for s kin injury. On the other hand, combining the doses in the posterior-anterio r and lateral views, tends to overestimate the potential for radiation inju ry. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99 )01809-X].