| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 1882353 | Physica Medica | 2014 | 7 Pages |
•This paper reports on the possible risks of patient skin injuries for specific fluoroscopically-guided interventional procedures in Belgian hospitals.•Specific trigger levels are determined for steering the follow-up of patients at risk.•The obtained results are compared against international recommendations.•In general, our results comply reasonably well with the values proposed in the NCRP 168 report.•For some specific procedures considerable lower trigger values are obtained, compared to the NCRP recommendations.
The accumulated dose to the skin of the patient during fluoroscopically-guided procedures can exceed the thresholds for tissue reactions. In practice, interventionalists have no direct information about the local procedure-related skin doses in their patient, causing suboptimal or delayed treatment. In current study, the accumulated Kerma-Area-Product (KAP) values were registered, as well as the reference air kerma (Ka,r) values, if available, for almost 200 cases undergoing seven different procedures. A sheet filled with 50 thermoluminescent dosemeters was wrapped around each patient to measure the peak skin dose. In a significant part of the Transjugular Intrahepatic Portosystemic Shunt (TIPSS) procedures, chemo-embolizations of the liver and cerebral embolizations, the threshold values for deterministic skin damage (2 Gy) were attained. Trigger values in terms of KAP, corresponding to a peak skin dose of 2 Gy, were determined. In general, our results comply reasonably well with the values proposed in the NCRP 168 report, with a KAP value of 425 Gy cm² and a Ka,r value of 3 Gy, corresponding to a peak skin dose of 3 Gy. Only for the TIPSS procedure a considerably lower value of 2 Gy was obtained at the published Ka,r and for the RF ablations we obtained a considerably lower value of 250 Gy cm² in terms of KAP.
