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Radiation Protection Dosimetry Advance Access originally published online on September 25, 2008
Radiation Protection Dosimetry 2008 132(1):18-24; doi:10.1093/rpd/ncn247
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© The Author 2008. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Correlation of patient maximum skin doses in cardiac procedures with various dose indicators

J. Domienik1,*, S. Papierz1, J. Jankowski1,3, J. Z. Peruga2, A. Werduch3 and W. Religa4

1 Nofer Institute of Occupational Medicine in Lodz, Radiation Protection Department, Sw Teresy 8 St, 91-348 Lodz, Poland
2 Medical University of Lodz, II Chair and Department of Cardiology, Kniaziewicza 1/5 St, 91-347 Lodz, Poland
3 Institute of Physics, University of Lodz, Department of Nuclear Physics and Radiation Safety, Pomorska 149/153 St, 90-236 Lodz, Poland
4 Ministry of Internal Affairs Hospital, Polnocna 42 St, 91-425 Lodz, Poland

* Corresponding author: jdom{at}imp.lodz.pl

Received April 29, 2008, amended August 6, 2008, accepted September 1, 2008

In most countries of European Union, legislation requires the determination of the total skin dose received by patients during interventional procedures in order to prevent deterministic damages. Various dose indicators like dose–area product (DAP), cumulative dose (CD) and entrance dose at the patient plane (EFD) are used for patient dosimetry purposes in clinical practice. This study aimed at relating those dose indicators with doses ascribed to the most irradiated areas of the patient skin usually expressed in terms of local maximal skin dose (MSD). The study was performed in two different facilities for two most common cardiac procedures coronary angiography (CA) and percutaneous coronary interventions (PCI). For CA procedures, the registered values of fluoroscopy time, total DAP and MSD were in the range (0.7–27.3) min, (16–317) Gy cm2 and (43–1507) mGy, respectively, and for interventions, accordingly (2.1–43.6) min, (17–425) Gy cm2, (71–1555) mGy. Moreover, for CA procedures, CD and EFD were in the ranges (295–4689) mGy and (121–1768) mGy and for PCI (267–6524) mGy and (68–2279) mGy, respectively. No general and satisfactory correlation was found for safe estimation of MSD. However, results show that the best dose indicator which might serve for rough, preliminary estimation is DAP value. In the study, the appropriate trigger levels were proposed for both facilities.


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