TU‐D‐209‐04: How Useful Are Indirect Dose Metrics for Estimating Peak Skin Dose in Interventional Cardiology?

Abstract

Purpose:The purpose of this study was to determine if a relationship between indirect dose metrics and PSD could be established for fluoroscopically‐guided interventional cardiology procedures.Methods:PSD were measured directly using XR‐RV3 radiochromic film for 94 consecutive fluoroscopically guided interventional cardiology procedures performed at two sites. Procedures were both diagnostic and therapeutic in nature. Radiation dose structured reports (RDSR) were collected for each procedure and used to calculate indirect estimates of PSD which were compared to the measured PSD. Reference air kerma (Ka,r) was also compared to the measured PSD. Pearson's correlation coefficient was calculated for each metric and metrics were compared to measured PSD using a two‐tailed t‐test. Data were log transformed prior to statistical analysis.Results:Both Ka,r and the calculated PSD were closely correlated with measured PSD at each sites (Ka,r: 0.92 and 0.86, indirect PSD: 0.91 and 0.88). At one site, neither Ka,r nor indirect PSD was significantly different from the measured PSD (p = 0.22 and p=0.054, respectively), while at the second site both Ka,r and indirect PSD were significantly higher than measured PSD (p<0.0001 and p<0.0001, respectively). In almost all cases, both Ka,r and indirect PSD overestimated the true PSD.Conclusions:The use of a range of gantry angles and table positions, along with variation in procedural imaging requirements, limits the utility of indirect dose metrics for predicting PSD for interventional cardiology procedures.A. Kyle Jones and Alexander S. Pasciak are owners of Fluoroscopic Safety, LLC.