D'Ercole L, Mantovani L, Thyrion F Zappoli, Bocchiola M, Azzaretti A, Di Maria F, Saluzzo C Massa, Quaretti P, Rodolico G, Scagnelli P, Andreucci L
Department of Medical Physics, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo Hospital, Pavia, Italy.
AJNR Am J Neuroradiol. 2007 Mar;28(3):503-7.
It is essential to measure the skin dose of radiation received by patients during interventional neuroradiologic procedures performed under fluoroscopic guidance, such as embolization of cerebral aneurysms, which is regarded as a high-dose interventional radiology procedure. In this study, we report a method for evaluating maximum skin dose (MSD), an ideal marker of radiation-induced effects, based on an innovative use of radiochromic films.
Forty-eight procedures were studied in 42 patients undergoing embolization of cerebral aneurysms. Fluoroscopic and digital dose-area product (DAP), fluoroscopy time, and total number of acquired images were recorded for all procedures. The MSD was measured using Gafchromic XR type R films.
The MSD was measured in one group of 21 procedures. The coefficient (kappa) of the interpolation line between the skin dose and the DAP (kappa = 0.0029 cm(-2)) was determined. An approximate value of MSD from the DAP for the remaining 27 procedures was estimated by means of an interpolation line. The mean MSD was found to be 1.16 Gy (range, 0.23-3.20 Gy).
The use of radiochromic XR type R films was shown to be an effective method for measuring MSD. These films have the advantage of supplying information on both the maximum dose and the distribution of the dose: this satisfies the most stringent interpretation of Food and Drug Administration, American College of Radiology, and international recommendations for recording skin dose.
在透视引导下进行的介入神经放射学手术（如脑动脉瘤栓塞术，这被视为高剂量介入放射学手术）中，测量患者所接受的皮肤辐射剂量至关重要。在本研究中，我们报告了一种基于放射变色胶片的创新应用来评估最大皮肤剂量（MSD）的方法，MSD是辐射诱导效应的理想指标。
对42例行脑动脉瘤栓塞术的患者的48例手术进行了研究。记录了所有手术的透视和数字剂量面积乘积（DAP）、透视时间以及采集图像的总数。使用Gafchromic XR型R胶片测量MSD。
在一组21例手术中测量了MSD。确定了皮肤剂量与DAP之间插值线的系数（kappa）（kappa = 0.0029 cm(-2)）。通过插值线估计了其余27例手术从DAP得出的MSD近似值。发现平均MSD为1.16 Gy（范围为0.23 - 3.20 Gy）。
使用放射变色XR型R胶片被证明是测量MSD的有效方法。这些胶片的优点是能提供最大剂量和剂量分布两方面的信息：这符合美国食品药品监督管理局、美国放射学会以及记录皮肤剂量的国际建议中最严格的解释。
