Monitoring Radiation Doses during Diagnostic and Therapeutic Neurointerventional Procedures: Multicenter Study for Establishment of Reference Levels

被引：6

作者：

Ihn, Yon-Kwon ^{[1
]}

Kim, Bum-soo ^{[2
]}

Jeong, Hae Woong ^{[3
]}

Suh, Sang Hyun ^{[4
]}

Won, Yoo Dong ^{[5
]}

Lee, Young-Jun ^{[6
]}

Kim, Dong Joon ^{[7
]}

Jeon, Pyong ^{[8
]}

Ryu, Chang-Woo ^{[9
]}

Suh, Sang-il ^{[10
]}

Choi, Dae Seob ^{[11
]}

Choi, See Sung ^{[12
]}

Kim, Sang Heum ^{[13
]}

Byun, Jun Soo ^{[14
]}

Rho, Jieun ^{[15
]}

Song, Yunsun ^{[16
]}

Jeong, Woo Sang ^{[17
]}

Hong, Noah ^{[18
]}

Baik, Sung Hyun ^{[19
]}

Park, Jeong Jin ^{[20
]}

Lim, Soo Mee ^{[21
]}

Kim, Jung-Jae ^{[22
]}

Yoon, Woong ^{[23
]}

机构：

[1] Catholic Univ Korea, St Vincents Hosp, Dept Radiol, 93 Jungbu Daero, Suwon 16247, South Korea

[2] Catholic Univ Korea, Seoul St Marys Hosp, Dept Radiol, Seoul, South Korea

[3] Inje Univ, Busan Paik Hosp, Dept Radiol, Busan, South Korea

[4] Yonsei Univ, Gangnam Severance Hosp, Dept Radiol, Seoul, South Korea

[5] Catholic Univ Korea, Coll Med, Uijeongbu St Marys Hosp, Dept Radiol, Uijongbu, South Korea

[6] Hanyang Univ, Coll Med, Dept Radiol, Seoul, South Korea

[7] Yonsei Unviers, Coll Med, Severance Hosp, Dept Radiol, Seoul, South Korea

[8] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiol, Seoul, South Korea

[9] Kyung Hee Univ Hosp Gangdong, Dept Radiol, Seoul, South Korea

[10] Korea Univ, Coll Med, Guro Hosp, Dept Radiol, Seoul, South Korea

[11] Gyeongsang Natl Univ, Sch Med, Gyeongsang Natl Univ Hosp, Dept Radiol, Jinju, South Korea

[12] Wonkwang Univ Hosp, Dept Radiol, Iksan, South Korea

[13] CHA Univ, CHA Bundang Med Ctr, Dept Radiol, Seongnam, South Korea

[14] Chung Ang Univ Hosp, Dept Radiol, Seoul, South Korea

[15] Pusan Natl Univ, Yangsan Hosp, Dept Radiol, Yangsan, South Korea

[16] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea

[17] Ajou Univ, Sch Med, Med Ctr, Dept Radiol, Suwon, South Korea

[18] Seoul Natl Univ Hosp, Dept Neurosurg, Seoul, South Korea

[19] Seoul Natl Univ, Bundang Hosp, Dept Radiol, Seongnam, South Korea

[20] Konkuk Univ, Med Ctr, Dept Neurol, Seoul, South Korea

[21] Ewha Womans Univ, Seoul Hosp, Dept Radiol, Seoul, South Korea

[22] Ewha Womans Univ, Seoul Hosp, Dept Neurosurg, Seoul, South Korea

[23] Chonnam Natl Univ Hosp, Dept Radiol, Gwangju, South Korea

来源：

NEUROINTERVENTION | 2021年 / 16卷 / 03期

关键词：

Cerebral angiography; Diagnostic reference levels; Radiation monitoring; Intracranial aneurysm; Thrombectomy; Intracranial arteriovenous malformation; INTERVENTIONAL RADIOLOGY; PATIENT; FLUOROSCOPY; EXPERIENCE; EXPOSURE;

D O I：

10.5469/neuroint.2021.00437

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose: To assess patient radiation doses during diagnostic and therapeutic neurointerventional procedures from multiple centers and propose dose reference level (RL). Materials and Methods: Consecutive neurointerventional procedures, performed in 22 hospitals from December 2020 to June 2021, were retrospectively studied. We collected data from a sample of 429 diagnostic and 731 therapeutic procedures. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time (FT), and total number of image frames (NI) were obtained. RL were calculated as the 3rd quartiles of the distribution. Results: Analysis of 1160 procedures from 22 hospitals confirmed the large variability in patient dose for similar procedures. RLs in terms of DAP, CAK, FT, and NI were 101.6 Gy center dot cm(2), 711.3 mGy, 13.3 minutes, and 637 frames for cerebral angiography, 199.9 Gy center dot cm(2), 3,458.7 mGy, 57.3 minutes, and 1,000 frames for aneurysm coiling, 225.1 Gy center dot cm(2), 1,590 mGy, 44.7 minutes, and 800 frames for stroke thrombolysis, 412.3 Gy center dot cm(2), 4,447.8 mGy, 99.3 minutes, and 1,621.3 frames for arteriovenous malformation (AVM) embolization, respectively. For all procedures, the results were comparable to most of those already published. Statistical analysis showed male and presence of procedural complications were significant factors in aneurysmal coiling. Male, number of passages, and procedural combined technique were significant factors in stroke thrombolysis. In AVM embolization, a significantly higher radiation dose was found in the definitive endovascular cure group. Conclusion: Various RLs introduced in this study promote the optimization of patient doses in diagnostic and therapeutic interventional neuroradiology procedures. Proposed 3rd quartile DAP (Gy center dot cm(2)) values were 101.6 for diagnostic cerebral angiography, 199.9 for aneurysm coiling, 225.1 for stroke thrombolysis, and 412.3 for AVM embolization. Continual evolution of practices and technologies requires regular updates of RLs.

引用

页码：240 / 251

页数：12

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