Assessment of Radiation Dose and Phantom Skin Dose in Transarterial Chemoembolization in a Single Center with 2 Digital Subtraction Angiography Units

Abstract

Objectives: This study aimed to assess and compare the radiation dose and phantom skin dose in transarterial chemoembolization (TACE) of two digital subtraction angiography (DSA) units (unit A: Philips Allura Xper FD20, unit B: Artis zee biplane)Material and Methods: The dose area product (DAP), reference air kerma (RAK), number of images (NI) and fluoroscopy time (FT) of 240 cases (120 cases/DSA unit) were retrospectively reviewed and collected. To assess skin dose, 28 nanoDot optically stimulated luminescence dosimeters (OSLDs) were placed on the phantom’s back and the TACE procedure was performed with 2 DSA units.Results: The median DAP, RAK, NI, and FT of unit A were 200.49 Gy·cm2, 379.84 mGy, 115 images, and 9.04 minutes, while for unit B were 109.74 Gy·cm2, 276.55 mGy, 121 images, and 10.19 minutes, respectively. Significant differences were observed in DAP, RAK, and FT. The RAK of all patients was less than 2 Gy. The phantom skin dose obtained from unit B was significantly lower than that of unit A in all positions. The peak skin doses of the phantom studies from both units were 973.15 and 658.66 mGy, respectively.Conclusion: The median DAP of the unit A DSA was higher than the national diagnostic reference levels (DRLs). The TACE procedure from both units is safe from skin reaction. To benefit patients, the planning of a dose optimization process of unit A DSA and management of TACE cases using the existing DSA machine must be considered.