AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on April 3, 2008
doi: 10.3174/ajnr.A1045
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Patient Skin Dose during Neuroembolization by Multiple-Point Measurement Using a Radiosensitive Indicator

S. Suzukia, S. Furuia, Y. Matsumarub, S. Nobuyukic, M. Ebarad, T. Abee and D. Itohf

a Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
b Department of Endovascular Neurosurgery, Toranomon Hospital, Tokyo, Japan
c Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
d Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan
e Department of Radiology, Kurume University School of Medicine, Fukuoka, Japan
f Department of Radiology, University of Tokyo Graduate School of Medicine and Faculty of Medicine, Tokyo, Japan


Figure 1
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  		Fig 1. Photograph of indicators. A total of 44 indicators were adhered to a cap (right aspect, n = 19; left aspect, n = 19; and parietal aspect, n = 6) at intervals of 5 cm.


Figure 2
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  		Fig 2. Effects of tube voltage, filtration, and dose rate on the color difference of the indicator. A, Indicators were irradiated at the dose of 1 Gy by using 4 tube voltages (50, 75, 100, and 125 kV) and 4 types of filtration (2.2 mm of aluminum, 5.2 mm of aluminum, 3.7 mm of aluminum + 0.1 mm of copper; and 3.7 mm of aluminum + 0.4 mm of copper) with a 20-mA tube current. The difference in the color difference was within 2.20. B, The effect of the dose rate was also evaluated by using 2 tube currents (5 and 20 mA) for the 4 types of filtration at the dose of 1 Gy with tube voltage of 75 kVp. For each filtration, the difference in the color between the 2 dose rates was within 0.79. Al indicates aluminum; Cu, copper.


Figure 3
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  		Fig 3. Maximum ESD distribution of each procedure. The maximum ESD of the patients exceeded 1 Gy in 84 procedures, 3 Gy in 20 procedures, and 5 Gy in 2 procedures.


Figure 4
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  		Fig 4. Scatterplot of DAP and maximum ESD with regression line.


Figure 5
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  		Fig 5. Distribution of ESDs in a patient with radiation skin injury. Neuroembolization for internal carotid-posterior communicating aneurysm was performed for a 43-year-old woman. The FOV mainly used was 14 cm. Total fluoroscopic time and DAP were 75.0 minutes and 182 Gy x cm2, respectively; 4° left anterior oblique with 17° cranial angulation view was mostly used. Exposed skin area was localized to the occipital region with the maximum ESD of 3.0 Gy. Temporary epilation was detected at the maximum exposure part (slanted lines) at 2 weeks and 3 months of follow-up. The number in the open square represents the ESD (Gy) at the point. — in the open square means the ESD at the point was less than 0.3 Gy.





Copyright © 2008 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X