Abstract
PurposeThe purpose of this paper is to present and validate an originally developed application SkinCare used for skin dose mapping in interventional procedures, which are associated with relatively high radiation doses to the patient’s skin and possible skin reactions.MethodsSkinCare is an application tool for generating skin dose maps following interventional radiology and cardiology procedures using the realistic 3D patient models. Skin dose is calculated using data from Digital Imaging and Communications in Medicine (DICOM) Radiation Dose Structured Reports (RDSRs). SkinCare validation was performed by using the data from the Siemens Artis Zee Biplane fluoroscopy system and conducting “Acceptance and quality control protocols for skin dose calculating software solutions in interventional cardiology” developed and tested in the frame of the VERIDIC project. XR‐RV3 Gafchromic films were used as dosimeters to compare peak skin doses (PSDs) and dose maps obtained through measurements and calculations. DICOM RDSRs from four fluoroscopy systems of different vendors (Canon, GE, Philips, and Siemens) were used for the development of the SkinCare and for the comparison of skin dose maps generated using SkinCare to skin dose maps generated by different commercial software tools (Dose Tracking System (DTS) from Canon, RadimetricsTM from Bayer and RDM from MEDSQUARE). The same RDSRs generated during a cardiology clinical procedure (percutaneous coronary intervention—PCI) were used for comparison.ResultsValidation performed using VERIDIC's protocols for skin dose calculation software showed that PSD calculated by SkinCare is within 17% and 16% accuracy compared to measurements using XR‐RV3 Gafchromic films for fundamental irradiation setups and simplified clinical procedures, respectively. Good visual agreement between dose maps generated by SkinCare and DTS, RadimetricsTM and RDM was obtained.ConclusionsSkinCare is proved to be very convenient solution that can be used for monitoring delivered dose following interventional procedures.
Highlights
Interventional procedures in radiology and cardiology are associated with relatively high radiation doses to the patient’s skin which may lead to skin reactions.[1]
Last two columns of templates correspond to calibration factor (CF) and table attenuation factor (TAF) values for fluoroscopy and image acquisition, this mode enables very accurate skin dose assessment
The tests have shown that peak skin doses (PSDs) calculated by SkinCare is within 17% accuracy compared with measurements using XR-RV3 Gafchromic films
Summary
Interventional procedures in radiology and cardiology are associated with relatively high radiation doses to the patient’s skin which may lead to skin reactions.[1]. Most equipment vendors have developed online solutions for skin dose calculations. CareMonitor by Siemens and DoseWise by Philips are solutions which basically provide the accumulated peak air kerma in the current projection.[3] On the other hand, Dose Map from GE is an advanced two-dimensional (2D) solution,[4,5,6] while Dose Tracking System (DTS) from Canon (Toshiba) represents a state of the art three-dimensional (3D) solution for skin dose mapping.[7,8,9] The most important drawback of previously mentioned solutions is that they are vendor specific and cannot be used in fluoroscopy systems from other manufacturers
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