Abstract
A study of peak skin doses (PSDs) during neuroradiology and cardiology interventionalprocedures has been carried out using Gafchromic XR-RV2 film. Use of mosaics made fromsquares held in cling film has allowed doses to the head to be mapped successfully. Thedisplayed cumulative air kerma (CAK) has been calibrated in terms of cumulative entrancesurface dose (CESD) and results indicate that this can provide a reliable indicator of thePSD in neuroradiology. Results linking PSD to CESD for interventional cardiologywere variable, but CAK is still considered to provide the best option for use asan indicator of potential radiation-induced effects. A CESD exceeding 3 Gy isconsidered a suitable action level for triggering follow-up of patients in neuroradiologyand cardiology for possible skin effects. Application of dose action levels definedin this way would affect 8% of neurological embolisation procedures and 5% ofcardiology ablation and multiple stent procedures at the hospitals where theinvestigations were carried out. A close relationship was observed between CESD anddose–area product (DAP) for particular types of procedure, and DAPs of 200–300 Gy cm2 could be used as trigger levels where CAK readings were not available. The DAP valuewould depend on the mean field size and would need to be determined for eachapplication.
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