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KMID : 1155820160110020078
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Neurointervention
2016 Volume.11 No. 2 p.78 ~ p.85
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Patient Radiation Exposure During Diagnostic and Therapeutic Procedures for Intracranial Aneurysms: A Multicenter Study
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Ihn Yon-Kwon
Kim Bum-Soo
Byun Jun-Soo
Suh Sang-Hyun
Won Yoo-Dong
Lee Deok-Hee
Kim Byung-Moon
Kim Young-Soo
Jeon Pyong
Ryu Chang-Woo
Suh Sang-Il
Choi Dae-Seob
Choi See-Sung
Choi Jin-Wook
Chang Hyuk-Won
Lee Jae-Wook
Kim Sang-Heum
Lee Young-Jun
Shin Shang-Hun
Lim Soo-Mee
Yoon Woong
Jeong Hae-Woong
Han Moon-Hee
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Abstract
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Purpose: To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL).
Materials and Methods: We studied a sample of 490 diagnostic and 371 therapeutic procedures for intracranial aneurysms, which were performed at 23 hospitals in Korea in 2015. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time and total angiographic image frames were obtained and analyzed.
Results: Total mean DAP, CAK, fluoroscopy time, and total angiographic image frames were 106.2 ± 66.4 Gy-cm2, 697.1 ± 473.7 mGy, 9.7 ± 6.5 minutes, 241.5 ± 116.6 frames for diagnostic procedures, 218.8 ± 164.3 Gy-cm2, 3365.7 ± 2205.8 mGy, 51.5 ± 31.1 minutes, 443.5 ± 270.7 frames for therapeutic procedures, respectively. For diagnostic procedure, the third quartiles for DRLs were 144.2 Gy-cm2 for DAP, 921.1 mGy for CAK, 12.2 minutes for fluoroscopy times and 286.5 for number of image frames, respectively. For therapeutic procedures, the third quartiles for DRLs were 271.0 Gy-cm2 for DAP, 4471.3 mGy for CAK, 64.7 minutes for fluoroscopy times and 567.3 for number of image frames, respectively. On average, rotational angiography was used 1.5 ± 0.7 times/session (range, 0-4; n=490) for diagnostic procedures and 1.6 ± 1.2 times/session (range, 0-4; n=368) for therapeutic procedures, respectively.
Conclusion: Radiation dose as measured by DAP, fluoroscopy time and image frames were lower in our patients compared to another study regarding cerebral angiography, and DAP was lower with fewer angiographic image frames for therapeutic procedures. Proposed DRLs can be used for quality assurance and patient safety in diagnostic and therapeutic procedures.
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KEYWORD
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Cerebral angiography, Cerebral embolization, Diagnostic reference levels, Radiation dose
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