INTERVENTIONAL RADIOLOGICAL PROCEDURES MOST PRONE TO CAUSE HIGH PATIENT PEAK SKIN DOSES BASED ON REVIEW OF 7607 PROCEDURES.

Abstract

Peak skin doses to patients undergoing interventional radiological procedures in a 3-year period were assessed to identify the most critical procedures and evaluate probability for occurrence of radiation-induced tissue injuries. Data of 7607 patients were reviewed, identifying those with cumulative air kerma at a reference point (Ka,r) exceeding 3 Gy. Observed tissue injuries in patients with exceeded levels were gathered by a questionnaire. Ka,r exceeded 3 Gy in 145 patients, all during vascular procedures; most frequently in preparations for liver radioembolization (SIRT), transjugular intrahepatic portosystemic shunt (TIPS), endovascular abdominal aortic repair (EVAR), adrenal venous sampling (AVS), endovascular thoracic aortic repair (TEVAR) and embolizations in abdominal/pelvic area (30, 21.4, 13.4, 12.6, 9.6 and 3.5% of patients, respectively). A total of 10 patients, extrapolating to ~0.6% of all patients, reported tissue injuries. During interventional radiological procedures threshold for radiation-induces tissue injuries can be exceeded in a significant number of patients (1.9%). Tissue injuries were reported approximately three times less frequently than anticipated; their severity was poorly related to those expected.