Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Estimation of patient skin dose in fluoroscopy: summary of a joint report by AAPM TG357 and EFOMP
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
State University of New York, 875 Ellicott St, NY, Buffalo, United States.
University of Florida, 1275 Center Drive, FL, Gainesville, United States.
Orange Factor Imaging Physicists, 4035 E Captain Dreyfus Ave, AZ, Phoenix, United States.
Show others and affiliations
2021 (English)In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 48, no 7, p. e671-e696Article in journal (Refereed) Published
Abstract [en]

Background: Physicians use fixed C-arm fluoroscopy equipment with many interventional radiological and cardiological procedures. The associated effective dose to a patient is generally considered low risk, as the benefit-risk ratio is almost certainly highly favorable. However, X-ray-induced skin injuries may occur due to high absorbed patient skin doses from complex fluoroscopically guided interventions (FGI). Suitable action levels for patient-specific follow-up could improve the clinical practice. There is a need for a refined metric regarding follow-up of X-ray-induced patient injuries and the knowledge gap regarding skin dose-related patient information from fluoroscopy devices must be filled. The most useful metric to indicate a risk of erythema, epilation or greater skin injury that also includes actionable information is the peak skin dose, that is, the largest dose to a region of skin.

Materials and Methods: The report is based on a comprehensive review of best practices and methods to estimate peak skin dose found in the scientific literature and situates the importance of the Digital Imaging and Communication in Medicine (DICOM) standard detailing pertinent information contained in the Radiation Dose Structured Report (RDSR) and DICOM image headers for FGI devices. Furthermore, the expertise of the task group members and consultants have been used to bridge and discuss different methods and associated available DICOM information for peak skin dose estimation.

Results: The report contributes an extensive summary and discussion of the current state of the art in estimating peak skin dose with FGI procedures with regard to methodology and DICOM information. Improvements in skin dose estimation efforts with more refined DICOM information are suggested and discussed.

Conclusions: The endeavor of skin dose estimation is greatly aided by the continuing efforts of the scientific medical physics community, the numerous technology enhancements, the dose-controlling features provided by the FGI device manufacturers, and the emergence and greater availability of the DICOM RDSR. Refined and new dosimetry systems continue to evolve and form the infrastructure for further improvements in accuracy. Dose-related content and information systems capable of handling big data are emerging for patient dose monitoring and quality assurance tools for large-scale multihospital enterprises.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021. Vol. 48, no 7, p. e671-e696
Keywords [en]
fluoroscopically guided interventions, peak skin dose, x-ray fluoroscopy
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-183708DOI: 10.1002/mp.14910ISI: 000652210100001PubMedID: 33930183Scopus ID: 2-s2.0-85106011476OAI: oai:DiVA.org:umu-183708DiVA, id: diva2:1558444
Available from: 2021-05-31 Created: 2021-05-31 Last updated: 2023-03-24Bibliographically approved

Open Access in DiVA

fulltext(1624 kB)289 downloads
File information
File name FULLTEXT02.pdfFile size 1624 kBChecksum SHA-512
faf56ebea112e26231600c2a0c8e8c064aa29f49bd665c6b8f838fbba6185ee42808aaa566843a22036713c08dbc5ebe42cdde8e2389a005c09847b3fdaab0df
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Andersson, JonasGranberg, ChristofferHellström, Max

Search in DiVA

By author/editor
Andersson, JonasGranberg, ChristofferHellström, Max
By organisation
Radiation Physics
In the same journal
Medical physics (Lancaster)
Radiology, Nuclear Medicine and Medical Imaging

Search outside of DiVA

GoogleGoogle Scholar
Total: 470 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 525 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf