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Skin dose and dose–area product values in patients undergoing intracoronary brachytherapy

¹ Medical Physics Service and ² Interventional Cardiology Service and ³ Radiothereapy Service, San Carlos University Hospital, 28040 Madrid, Spain and ⁴ Radiology Department, Medicine School, Complutense University, 28040 Madrid, Spain

View larger version (57K): [in a new window]   Figure 1. A typical information exploit from the Digital Imaging and Communications in Medicine (DICOM) record of an intervention, showing graphical details. The upper plot shows the angular leaning coordinates of the cine series recorded. (b) The digitized picture of the slow film shows the corresponding fields and other from intermediate fluoroscopy projections. The film image has been adapted in size to approximately match the dimensions of the DICOM header graph. Angular data for every projection are referred to the II entrance position, whereas radiation enters the patient in the reverse direction. Arrows in the image on the left indicate where both information details come from; image (a) from the short arrow and image (b) from the long arrow. The image on the right shows the real size and location of the slow film on the patient. In this example, the entire fields recorded by the film only reach the projections around +50° lateral, -30° and +32° in craniocaudal projection, with reference to the vertical. Beyond the fields located at +50° lateral, -20° and +25° craniocaudal (left side of the slow film, on the horizontal midline) one can see the right border of the about +80° lateral projection (the projection at near +95° lateral, +8° craniocaudal does not appear).

View larger version (104K): [in a new window]   Figure 2. Slow film from a procedure showing saturation (darkest region), as well as a fairly high radiation field concentration. The image corresponds to patient GCM260701 (Table 1) with dose–area product of 193 Gy cm2 and maximum skin dose of 3.5 Gy.

View larger version (48K): [in a new window]   Figure 3. (a) Slow film corresponding to patient MIIM011212 (Table 1) with dose–area product of 185 Gy cm2 and maximum skin dose of 4.6 Gy. (b) Isocontours of 30% and 99% (film saturation) corresponding to the analysis of the digitized slow film of patient MIIM011212 (Table 1).

View larger version (29K): [in a new window]   Figure 4. (a–c) Frequency plots of dose–area product, fluoroscopy time and number of frames from Table 2.