104. Use of a RDIM system to analyse and optimize an interventional radiology procedure

• Autor: Colombo, P.E. ; De Mattia, C. ; Rottoli, F. ; Sutto, M. ; Rampoldi, A. ; Barbosa, F. ; Torresin, A.
• É parte de: Physica medica, 2018-12, Vol.56, p.126-126
• Descrição: To use NEXO[DOSE], a Radiation Dose Index Monitoring system, to collect and analyse dosimetric data to drive the optimization of the interventional radiology procedure for prostatic artery embolization (PAE). NEXO[DOSE] extracts geometric (primary and secondary angles, table height) and dosimetric (irradiation type, KAP, voltage, filter) parameters from the Radiation Dose Structured Report, and calculates a skin dose map. NEXO[DOSE] separately lists the dose contribution from the acquisition mode and the fluoroscopy. In our institution, the PAE interventional procedure involved high Kerma Area Product (KAP) compared to other angiographic protocols and was associated with high risk of skin lesions. A low dose protocol was introduced and phantom characterization, i.e. entrance dose and image quality (LCD), was assessed on 24 to 30 cm PMMA phantom to better represent the patient geometry, considering that the highest dose contributions came from events with oblique angles. After optimization, patient dose was monitored using KAP and peak skin dose. We retrospectively analysed the exposure values of 84 patients, using NEXO[DOSE]. The acquisition dose in PAE is 70% of the total procedure: the first step was the introduction of an acquisition protocol with low entrance detector dose. The frame rate was reduced from 3 to 2 fps, and additional X-ray filtration of 1 mmAl + 0.1 mmCu was added. The fluoroscopy frame rate was also reduced from 15 to 7.5 fps. Entrance dose at the phantom surface was reduced by 49%, while the LCD reduction was 30% for details dimensions from 0.5 to 6 mm. The physicians assessed the loss of image quality to be acceptable. After optimization PAE procedures showed a 60% KAP reduction and a 49% peak skin dose reduction. A RDIM software is a useful tool to highlight high dose procedures and to understand what parameters to modify, after a multidisciplinary team discussion.
  
• Editor: Elsevier Ltd
  
• Idioma: Inglês