介入心脏病学中皮肤峰值剂量的评估：Gafchromic薄膜与剂量测定软件em.dose的比较

Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose.

作者信息

Greffier J, Van Ngoc Ty C, Bonniaud G, Moliner G, Ledermann B, Schmutz L, Cornillet L, Cayla G, Beregi J P, Pereira F

机构信息

Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France.

Esprimed SAS, 1, mail du Pr Georges Mathé, 94800 Villejuif, France.

出版信息

Phys Med. 2017 Jun;38:16-22. doi: 10.1016/j.ejmp.2017.05.044. Epub 2017 May 8.

DOI:10.1016/j.ejmp.2017.05.044

PMID:28610693

Abstract

OBJECTIVE

To compare the use of a dose mapping software to Gafchromic film measurement for a simplified peak skin dose (PSD) estimation in interventional cardiology procedure.

METHODS

The study was conducted on a total of 40 cardiac procedures (20 complex coronary angioplasty of chronic total occlusion (CTO) and 20 coronary angiography and coronary angioplasty (CA-PTCA)) conducted between January 2014 to December 2015. PSD measurement (PSD) was obtained by placing XR-RV3 Gafchromic under the patient's back for each procedure. PSD (PSD) was computed with the software em.dose©. The calculation was performed on the dose metrics collected from the private dose report of each procedure. Two calculation methods (method A: fluoroscopic kerma equally spread on cine acquisition and B: fluoroscopic kerma is added to one air Kerma cine acquisition that contributes to the PSD) were used to calculate the fluoroscopic dose contribution as fluoroscopic data were not recorded in our interventional room. Statistical analyses were carried out to compare PSD and PSD.

RESULTS

The PSD median (1st quartile; 3rd quartile) was 0.251(0.190;0.336)Gy for CA-PTCA and 1.453(0.767;2.011)Gy for CTO. For method-A, the PSD was 0.248(0.182;0.369)Gy for CA-PTCA and 1.601(0.892;2.178)Gy for CTO, and 0.267(0.223;0.446)Gy and 1.75 (0.912;2.584)Gy for method-B, respectively. For the two methods, the correlation between PSD and PSD was strong. For all cardiology procedures investigated, the mean deviation between PSD and PSD was 3.4±21.1% for method-A and 17.3%±23.9% for method-B.

CONCLUSION

The dose mapping software is convenient to calculate peak skin dose in interventional cardiology.

摘要

目的

比较剂量映射软件与Gafchromic胶片测量法在介入心脏病学手术中简化皮肤峰值剂量（PSD）估计的应用。

方法

本研究共纳入2014年1月至2015年12月期间进行的40例心脏手术（20例慢性完全闭塞病变（CTO）的复杂冠状动脉血管成形术和20例冠状动脉造影及冠状动脉血管成形术（CA-PTCA））。在每次手术中，通过将XR-RV3 Gafchromic胶片置于患者背部下方来获取PSD测量值（PSD）。使用软件em.dose©计算PSD（PSD）。计算基于从每次手术的专用剂量报告中收集的剂量指标进行。由于我们的介入手术室未记录透视数据，因此使用两种计算方法（方法A：透视比释动能均匀分布于电影采集；方法B：将透视比释动能加到对PSD有贡献的一次空气比释动能电影采集中）来计算透视剂量贡献。进行统计分析以比较PSD和PSD。

结果

CA-PTCA的PSD中位数（第1四分位数；第3四分位数）为0.251（0.190；0.336）Gy，CTO为1.453（0.767；2.011）Gy。对于方法A，CA-PTCA的PSD为0.248（0.182；0.369）Gy，CTO为1.601（0.892；2.178）Gy；对于方法B，分别为0.267（0.223；0.446）Gy和1.75（0.912；2.584）Gy。对于这两种方法，PSD与PSD之间的相关性很强。对于所有研究的心脏病手术，方法A中PSD与PSD之间的平均偏差为3.4±21.1%，方法B为17.3%±23.9%。