Neurointervention (Sep 2016)

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

  • Yon Kwon Ihn,
  • Bum-Soo Kim,
  • Jun Soo Byun,
  • Sang Hyun Suh,
  • Yoo Dong Won,
  • Deok Hee Lee,
  • Byung Moon Kim,
  • Young Soo Kim,
  • Pyong Jeon,
  • Chang-Woo Ryu,
  • Sang-il Suh,
  • Dae Seob Choi,
  • See Sung Choi,
  • Jin Wook Choi,
  • Hyuk Won Chang,
  • Jae-Wook Lee,
  • Sang Heum Kim,
  • Young Jun Lee,
  • Shang Hun Shin,
  • Soo Mee Lim,
  • Woong Yoon,
  • Hae Woong Jeong,
  • Moon Hee Han

DOI
https://doi.org/10.5469/neuroint.2016.11.2.78
Journal volume & issue
Vol. 11, no. 2
pp. 78 – 85

Abstract

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PurposeTo assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL).Materials and MethodsWe 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.ResultsTotal 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.ConclusionRadiation 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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