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Utilization of Radimetrics to Calculate Peak Skin Dose for Fluoroscopically Guided Interventions: A Guide for Three Manufacturers

N Ball1*, Z Glass2 , R Neill1 , J Nye1 , (1) Emory University, Atlanta, GA, (2) Alliance Medical Physics, LLC., Alpharetta, GA

Presentations

(Saturday, 4/7/2018)  

Room: Foyer

Purpose: Peak skin dose (PSD) estimates are an important dose metric to assess if, when, and how to follow-up with patients who undergo fluoroscopic guided procedures. Radimetrics (Bayer Healthcare LLC, Whippany, NJ) is a commercially-available dose tracking tool that can help gather data for PSD estimations. In this study, we share our recent experiences converting reference point air kerma (K_(a,r)) values to PSD estimates using data available through Radimetrics.

Methods: Our healthcare system has three vendors that are configured to export radiation dose structured reports (RDSR), or dose sheets and DICOM images to Radimetrics. A custom excel tool was developed to estimate PSD values based on corrections made to K_(a,r) measurements, including inverse square correction, f-factor, backscatter, and table attenuation. The required data for such a calculation (field size, table height, beam filtration, angulation data) was extracted from Radimetrics in a vendor-specific fashion, and used as input variables within our in-house PSD estimation calculator.

Results: A majority of required input data is easily exported using the “Study Exporter� tool in Radimetrics; however, this export tool is missing key information required of robust PSD calculations. All data for GE, barring beam filtration, can be found in this export. Philips requires further data from the RDSR to determine table height and beam filtration. Siemens machines require additional information located within DICOM meta-data to determine table height, beam filtration, and angulation. Caution is warranted when using table height data from different sources, due to differences in table height field definitions.

Conclusion: Radimetrics can be a useful tool for piecewise PSD estimates; however there are limitations and vendor-specific intricacies. Easily locating the variables needed to adjust for acquisition setup and technique is often non-trivial, and therefore the development of vendor-specific implementation techniques is essential for PSD calculations.

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