Measuring Patient Exposure in Interventional Radiology
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1 Measuring Patient Exposure in Interventional Radiology GAFCHROMIC XR-R, a Wide-Area Dosimetry Film to Assess Peak Skin Dose (PSD) Xiang Yu, Ph.D. Director, Advanced Materials International Specialty Products
2 Our Credentials ISP develops and manufactures GAFCHROMIC radiochromic films Instantaneous color change when exposed to ionizing radiation Not light sensitive No development, no chemicals Radiochromic film is used to image and measure radiation fields Principal uses are in radiology and radiotherapy
3 You don t know what you need to know unless you know what you need to know Louis K. Wagner, Professor of Radiology and Chief Physicist, University of Texas Medical School at Houston
4 PATIENT EXPOSURE DURING FLUOROSCOPY Since 1994 FDA has issued several advisories and notices on the avoidance of skin injuries during fluoroscopically guided surgery and recommendations to keep estimates of skin exposure in a patient file Archer and Wagner at Baylor College of Medicine and many others have written extensively on the dangers involved and the minimization of risks ICRP has issued procedures for avoiding injuries during interventional radiology CRCPD (2001) issued a resolution regarding the prevention of unnecessary exposure to patients during fluoroscopy
5 Keys to Reducing Patient Exposure Education Training Measurement Analysis Improvement
6 Responsible Radiation Management Monitor and document patients peak skin dose, in particular for: Heavy patients Pediatric Long Procedures Repeat Procedures Strategize & refine fluoroscopy management Safe planning of future procedures Improves fluoroscopic technique Reduces patient exposure
7 Dose Monitoring Methods Measurement Method TLD/OSL Advantages Disadvantages Inadequate when beam is re-oriented, not real time Diode/Ion chamber Real time values Inadequate when beam is re-oriented DAP/KAP Real time values Difficult to assess and locate peak skin dose Fluoroscopy time Easy to measure Poorly correlated to peak skin dose Radiochromic film Directly locates and measures peak skin dose Not ideal for real time
8 Positioning of GAFCHROMIC XR-R FILM
9 Positioning of the GAFCHROMIC XR-R *Provided by Les Hopitaux Universitaires de Strasbourg, used with permission
10 Dose Monitoring with Gafchromic XR-R L L & R are patient s orientation Immediate visualization of patient exposure magnitude and location Detailed dose distribution R
11 Ways to Measure Dose Skin dose is determined by measuring the darkening of the film using either: Densitometer (preferably a reflection densitometer) Comparator strip Flatbed scanner specifically designed software FilmQA-XR
12 IAEA Sponsored Studies # of patients % > 2Gy Coronary Non- Coronary Repeat 40% 40% Gafchromic Film Easiest Simple Visual Reference Feedback during procedure Consistent and Reliable Results DAP/KAP Difficult to correlate to peak skin dose Importance of Dose Monitoring
13 Comparison of Gafchromic XR-R Measurement vs. Diodes *Data provide by Les Hopitaux Universitaires de Strasbourg, used with permission
14 Patient Peak Skin Dose History *Data provide by Les Hopitaux Universitaires de Strasbourg, used with permission
15 FilmQA TM XR Specifically Designed for Optimized Use of Gafchromic XR series of Films Easy Use Simple Work Flow Film Batch Specific Calibration Single Click Film Analysis Point Dose Dose Mapping
16 FilmQA TM XR - Calibration
17 FilmQA TM XR Point Dose
18 FilmQA TM XR Dose Mapping
19 FilmQA TM XR Dose Mapping
20 For more System Information.. Please visit
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