The potential for radiation-induced skin damage in interventional neuroradiological procedures: a review of 522 cases using automated dosimetry.

The Food and Drug Administration (FDA) has recommended the monitoring of radiation skin dose to patients during procedures having the potential for radiation damage. Radiologists need information about typical radiation doses during interventional procedures. The skin doses to patients during 522 interventional neuroradiological procedures have been monitored using an automated dosimetry system. Estimated entrance skin doses (ESD) were binned into 0.5 Gy increments and compared to FDA recommended thresholds for inclusion in the patient record. Percentages of procedures exceeding the above mentioned thresholds are presented. In addition, the percentage of dose in each view and the percentage of dose in fluoroscopic and digital angiographic modes are shown. Six percent of embolization procedures and one percent of cerebral angiograms are estimated to have potential for main erythema (ESD>6 Gy). All types of procedures have potential for temporary erythema and exceed the threshold for inclusion in the patient record (ESD> 1 Gy) at the 95% percentile. The types of procedures with most potential for skin damage also have significant percentages of dose in the digital angiographic mode. Thus, monitoring fluoroscopic time alone underestimates the potential for skin injury. On the other hand, combining the doses in the posterior-anterior and lateral views, tends to overestimate the potential for radiation injury.