Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose

Objective: To compare the use of a dose mapping software to Gafchromic film measurement for a simplified peak skin dose (PSD) estimation in interventional cardiology procedure.

Methods: The study was conducted on a total of 40 cardiac procedures (20 complex coronary angioplasty of chronic total occlusion (CTO) and 20 coronary angiography and coronary angioplasty (CA-PTCA)) conducted between January 2014 to December 2015. PSD measurement (PSD_Film) was obtained by placing XR-RV3 Gafchromic under the patient's back for each procedure. PSD (PSD_em.dose) was computed with the software em.dose©. The calculation was performed on the dose metrics collected from the private dose report of each procedure. Two calculation methods (method A: fluoroscopic kerma equally spread on cine acquisition and B: fluoroscopic kerma is added to one air Kerma cine acquisition that contributes to the PSD) were used to calculate the fluoroscopic dose contribution as fluoroscopic data were not recorded in our interventional room. Statistical analyses were carried out to compare PSD_Film and PSD_em.dose.

Results: The PSD_Film median (1st quartile; 3rd quartile) was 0.251(0.190;0.336)Gy for CA-PTCA and 1.453(0.767;2.011)Gy for CTO. For method-A, the PSD_em.dose was 0.248(0.182;0.369)Gy for CA-PTCA and 1.601(0.892;2.178)Gy for CTO, and 0.267(0.223;0.446)Gy and 1.75 (0.912;2.584)Gy for method-B, respectively. For the two methods, the correlation between PSD_Film and PSD_em.dose was strong. For all cardiology procedures investigated, the mean deviation between PSD_Film and PSD_em.dose was 3.4±21.1% for method-A and 17.3%±23.9% for method-B.

Conclusion: The dose mapping software is convenient to calculate peak skin dose in interventional cardiology.