Skin dose mapping for fluoroscopically guided interventions
Skin dose mapping for fluoroscopically guided interventions
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DOI：
10.1118/1.3633935
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发表时间：
2011-10-01
期刊：
影响因子：
3.8
通讯作者：
Bolch, Wesley E.
中科院分区：
文献类型：
--
作者：
Johnson, Perry B.;Borrego, David;Bolch, Wesley E.
目的：介绍一种新的用于介入透视剂量评估的皮肤剂量测绘软件系统，并分析患者-幻影匹配的优点和局限性。方法：在本研究中，开发了一种新的软件系统，用于在介入透视过程中显示患者皮肤剂量。该系统的工作原理是将参考点air kerma转换为患者皮肤的位置，该位置由计算模型表示。为了使模型与x射线源定向，在辐射剂量结构化报告（RDSR）中发现的几何参数与有限数量的临床测量一起使用。该系统的输出是一个视觉指示的皮肤剂量映射到一个拟人化的模型，分辨率为5毫米。为了确定患者依赖模型和患者雕刻模型是否能提高准确性，我们计算了26种患者特异性模型中的每种模型的峰值皮肤剂量，并与使用椭圆风格化模型、参考混合模型、匹配的患者依赖模型和一个患者雕刻模型计算的剂量进行了比较。使用使用患者特异性模型作为真实标准计算的剂量，以百分比差异来分析结果。结果：人体测量匹配，包括使用患者依赖和患者雕刻的幻影，对左外侧和前后投影最有利。在这些情况下，使用参考模型的百分比差异在8%到20%之间，使用患者依赖模型的百分比差异在7%到15%之间，使用患者雕刻模型的百分比差异在3%到7%之间。在大多数情况下，由于工作台和垫的压平影响，表下管配置产生的误差小于5%，并且工作台高度是这些配置的源到皮肤距离的主要决定因素。除了这些结果之外，还制作了几个皮肤剂量图，并将原型显示系统放置在介入性透视系统的临床监视器上。结论：本研究中开发的皮肤剂量测绘程序代表了一种新的工具，随着RDSR通过自动导出或实时流传输变得可用，可以为介入医生提供必要的信息，以便在临床上适当时修改行为。该程序是非专有的和可转让的，并且独立于已经安装在控制室工作站上的软件系统。下一步将是临床实施，其中将优化工作流程并进一步分析实时功能。(C) 2011年美国医学物理学家协会。(DOI: 10.1118/1.3633935)
Purpose: To introduce a new skin dose mapping software system for interventional fluoroscopy dose assessment and to analyze the benefits and limitations of patient-phantom matching.Methods: In this study, a new software system was developed for visualizing patient skin dose during interventional fluoroscopy procedures. The system works by translating the reference point air kerma to the location of the patient's skin, which is represented by a computational model. In order to orient the model with the x-ray source, geometric parameters found within the radiation dose structured report (RDSR) are used along with a limited number of in-clinic measurements. The output of the system is a visual indication of skin dose mapped onto an anthropomorphic model at a resolution of 5 mm. In order to determine if patient-dependent and patient-sculpted models increase accuracy, peak skin dose was calculated for each of 26 patient-specific models and compared with doses calculated using an elliptical stylized model, a reference hybrid model, a matched patient-dependent model and one patient-sculpted model. Results were analyzed in terms of a percent difference using the doses calculated using the patient-specific model as the true standard.Results: Anthropometric matching, including the use of both patient-dependent and patient-sculpted phantoms, was shown most beneficial for left lateral and anterior-posterior projections. In these cases, the percent difference using a reference model was between 8 and 20%, using a patient-dependent model between 7 and 15%, and using a patient-sculpted model between 3 and 7%. Under the table tube configurations produced errors less than 5% in most situations due to the flattening affects of the table and pad, and the fact that table height is the main determination of source-to-skin distance for these configurations. In addition to these results, several skin dose maps were produced and a prototype display system was placed on the in-clinic monitor of an interventional fluoroscopy system.Conclusions: The skin dose mapping program developed in this work represents a new tool that, as the RDSR becomes available through automated export or real-time streaming, can provide the interventional physician information needed to modify behavior when clinically appropriate. The program is nonproprietary and transferable, and also functions independent to the software systems already installed on the control room workstation. The next step will be clinical implementation where the workflow will be optimized along with further analysis of real-time capabilities. (C) 2011 American Association of Physicists in Medicine. [DOI: 10.1118/1.3633935]