Neil S, Padgham C, Martin C J
Health Physics, Gartnavel Royal Hospital, Glasgow, UK.
J Radiol Prot. 2010 Dec;30(4):659-72. doi: 10.1088/0952-4746/30/4/002. Epub 2010 Dec 8.
A study of peak skin doses (PSDs) during neuroradiology and cardiology interventional procedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made from squares held in cling film has allowed doses to the head to be mapped successfully. The displayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrance surface dose (CESD) and results indicate that this can provide a reliable indicator of the PSD in neuroradiology. Results linking PSD to CESD for interventional cardiology were variable, but CAK is still considered to provide the best option for use as an indicator of potential radiation-induced effects. A CESD exceeding 3 Gy is considered a suitable action level for triggering follow-up of patients in neuroradiology and cardiology for possible skin effects. Application of dose action levels defined in this way would affect 8% of neurological embolisation procedures and 5% of cardiology ablation and multiple stent procedures at the hospitals where the investigations were carried out. A close relationship was observed between CESD and dose-area product (DAP) for particular types of procedure, and DAPs of 200-300 Gy cm(2) could be used as trigger levels where CAK readings were not available. The DAP value would depend on the mean field size and would need to be determined for each application.
已使用Gafchromic XR-RV2胶片对神经放射学和心脏病学介入手术期间的皮肤峰值剂量（PSD）进行了研究。使用由保鲜膜包裹的方块制成的拼接图可以成功绘制头部的剂量。所显示的累积空气比释动能（CAK）已根据累积入射表面剂量（CESD）进行校准，结果表明，这可以为神经放射学中的PSD提供可靠指标。介入心脏病学中PSD与CESD之间的关联结果各不相同，但CAK仍被认为是用作潜在辐射诱发效应指标的最佳选择。CESD超过3 Gy被认为是触发对神经放射学和心脏病学患者进行随访以检查可能的皮肤效应的合适行动水平。以这种方式定义的剂量行动水平的应用将影响进行调查的医院中8%的神经栓塞手术以及5%的心脏病学消融和多支架手术。对于特定类型的手术，观察到CESD与剂量面积乘积（DAP）之间存在密切关系，在无法获得CAK读数的情况下，200 - 300 Gy cm²的DAP值可作为触发水平。DAP值将取决于平均视野大小，并且每种应用都需要确定该值。
