Validation and Initial Clinical Use of Automatic Peak Skin Dose Localization with Fluoroscopic and Interventional Procedures
Validation and Initial Clinical Use of Automatic Peak Skin Dose Localization with Fluoroscopic and Interventional Procedures
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DOI：
10.1148/radiol.12112295
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发表时间：
2013-01-01
期刊：
影响因子：
19.7
通讯作者：
Wu, Teresa
中科院分区：
文献类型：
--
作者：
Khodadadegan, Yasaman;Zhang, Muhong;Wu, Teresa
目的：评估自动绘制和记录皮肤剂量值（包括峰值皮肤剂量（PSD））的软件工具的准确性和初步临床应用，该软件工具用于接受透视引导的介入手术的患者。材料和方法：在这项回顾性研究中，机构审查委员会确定这项符合hipaa的研究符合质量保证调查的标准。知情同意被放弃。经过初步验证和准确性测试，获得了2011年1月至10月期间在放射科、心脏病学和胃肠病学实践领域进行的透视引导介入手术的分布皮肤剂量和PSD估计。520例患者共进行605次手术（64%为男性，年龄范围20-95岁）。皮肤剂量工具估计患者剂量分布的准确性通过使用外部剂量计和直接暴露膜的幻影研究得到验证。评估PSD分布、手术类型的PSD和个体医师操作人员的PSD。结果：计算出的PSD值与使用膜剂量学在匹配模体几何条件下测量的值一致，在+/- 9%以内。接受最高剂量的区域（大于峰值的95%）在+/- 17%范围内一致。在605例患者手术中，15例显示PSD大于2 Gy，最大PSD为5.6 Gy。结论：了解患者皮肤剂量可以帮助指导高皮肤剂量患者的治疗，并可用于计划未来的治疗。(C)RSNA, 2012。补充资料：http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112295/-/DC1
Purpose: To assess the accuracy and initial clinical use of a software tool that automatically maps and records values of skin dose, including peak skin dose (PSD), administered to patients undergoing fluoroscopically guided interventional procedures.Materials and Methods: In this retrospective study, the institutional review board determined that this HIPAA-compliant study met the criteria as a quality assurance investigation. Informed consent was waived. After the initial validation and accuracy tests, distributed skin dose and PSD estimates were obtained for fluoroscopically guided interventional procedures performed in the radiology, cardiology, and gastroenterology practice areas between January and October 2011. A total of 605 procedures were performed in 520 patients (64% men; age range, 20-95 years). The accuracy of a skin dose tool to estimate patient dose distribution was verified with phantom studies by using an external dosimeter and direct exposure film. PSD distribution, PSD according to procedure type, and PSD for individual physician operators were assessed.Results: Calculated PSD values agreed within +/- 9% of that measured by using film dosimetry under the condition of matched-phantom geometry. The area receiving the highest dose (greater than 95% of peak) agreed within +/- 17%. Of 605 patient procedures, 15 demonstrated PSD greater than 2 Gy, with a maximum PSD of 5.6 Gy.Conclusion: Knowledge of the patient skin dose can help direct treatment of patients who were administered relatively high skin dose and may be used to plan future procedures. (C)RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112295/-/DC1