Neurointervention.  2016 Sep;11(2):78-85. 10.5469/neuroint.2016.11.2.78.

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

Affiliations
  • 1Department of Radiology, St.Vincent's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Korea.
  • 2Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. bumrad@catholic.ac.kr
  • 3Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
  • 4Department of Radiology, Gangnam Severance Hospital, Yonsei University, Seoul, Korea.
  • 5Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Korea.
  • 6Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 7Department of Radiology, Severance Hospital Stroke Center, Yonsei Unviersity College of Medicine, Seoul, Korea.
  • 8Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University, Yangsan, Korea.
  • 9Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 10Department of Radiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
  • 11Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
  • 12Department of Radiology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
  • 13Department of Radiology, Wonkwang University Hospital, Iksan, Korea.
  • 14Department of Radiology, Ajou University School of Medicine, Gyeonggi-do, Korea.
  • 15Department of Radiology, Keimyung University College of Medicine, Dongsan Medical Center, Daegu, Korea.
  • 16Department of Radiology, National Health Insurance Service Ilsan Hospital, Gyeonggi-do, Korea.
  • 17Department of Radiology, CHA Bundang Medical Center, CHA University, Gyeonggi-do, Korea.
  • 18Department of Radiology, Hanyang University College of Medicine, Seoul, Korea.
  • 19Department of Radiology, Ulsan University Hospital, University of Ulsan, College of Medicine, Ulsan, Korea.
  • 20Department of Radiology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
  • 21Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.
  • 22Department of Radiology, Busan Paik Hospital, Inje University, Busan, Korea.
  • 23Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To assess patient radiation doses during cerebral angiography and embolization of intracranial aneurysms across multi-centers and propose a diagnostic reference level (DRL).
MATERIALS AND METHODS
We 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.
RESULTS
Total 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.
CONCLUSION
Radiation 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.

Keyword

Cerebral angiography; Cerebral embolization; Diagnostic reference levels; Radiation dose

MeSH Terms

Angiography
Cerebral Angiography
Fluoroscopy
Humans
Intracranial Aneurysm*
Korea
Patient Safety
Radiation Exposure*
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