Neurointervention.  2016 Sep;11(2):78-85. 10.5469/neuroint.2016.11.2.78.

Patient Radiation Exposure During Diagnostic and Therapeutic Procedures for Intracranial Aneurysms: A Multicenter Study

• Ihn YK
• Kim BS
• Byun JS
• Suh SH
• Won YD
• Lee DH
• Kim BM
• Kim YS
• Jeon P
• Ryu CW
• Suh SI
• Choi DS
• Choi SS
• Choi JW
• Chang HW
• Lee JW
• Kim SH
• Lee YJ
• Shin SH
• Lim SM
• Yoon W
• Jeong HW
• Han MH

• KMID: 2350684
• DOI: http://doi.org/10.5469/neuroint.2016.11.2.78

Abstract

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.

Keyword

Cerebral angiography; Cerebral embolization; Diagnostic reference levels; Radiation dose

MeSH Terms

Angiography
Cerebral Angiography
Fluoroscopy
Humans
Intracranial Aneurysm*
Korea
Patient Safety
Radiation Exposure*

Figure

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  Fig. 1 Distribution of the DAP, cumulative air kerma, fluoroscopy time and number of frames for diagnostic procedures. Dashed lines represent third quartile.

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  Fig. 2 Distribution of the DAP, cumulative air kerma, fluoroscopy time and number of frames for aneurysm embolization. Dashed lines represent third quartile.

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  Fig. 3 Comparison of the mean values of the DAP, cumulative air kerma, fluoroscopy time and number of frames for diagnostic and therapeutic procedures for multi-centers. The alphabet of x-axis represents the various hospitals.

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