Graduate Thesis Or Dissertation
 

Radiation dose and risk in interventional neuroradiology

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https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/qf85ng49r

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  • BACKGROUND/PURPOSE: Exposure from medical radiation sources are on the rise in the United States. Often the highest potential source of radiation dose to patients and radiology staff occur during interventional radiology procedures performed using fluoroscopy and digital subtraction angiography (DSA) to provide image guidance in minimally invasive surgical procedures. Several methods have been proposed for monitoring these radiation doses. The radiology staff are legally required by the Nuclear Regulatory Commission (NRC), or Agreement States, to wear radiation dosimetry badges on the outside of their lead aprons, but at this time the only patient dose requirements are equipment based monitors with audible alarms. Interventional patient radiation dose monitoring has not been standardized for all institutions performing these procedures, so it is the responsibility of the institution and thus the Interventionalist performing the procedure to be aware of the patient radiation dose and potential risks associated with that dose during the procedure. MATERIALS/METHOD: An investigation of Interventional Neuroradiology (INR) patient cases performed during a one month period beginning in February 2010 at the Medical University of South Carolina (MUSC) were studied to characterize the typical radiation geometries, and general patient demographic (ie. sex and age) for these procedures. Using that knowledge effective dose and thyroid dose conversion factors were derived for use in calculating patient radiation doses post procedure. A relationship between the thyroid organ dose and consequent risk of thyroid cancer incidence was established using the BEIR VII data. RESULTS: Sample calculations were completed on a small cohort of these INR patients undergoing both treatment and diagnostic procedures with fluoroscopy times averaging 49 minutes. Using the conversion factors established from the typical INR radiation geometries effective doses ranged from 0.23 mSv to 1.49 mSv and thyroid organ doses ranged from 0.35 mGy to 4.56 mGy. The corresponding risk of thyroid cancer incidence was greatest for adult females age 25 by a factor of ~ 5 to that of their male counterparts. The difference in age from 25 to 65 years decreases the thyroid cancer incidence risk by a factor of ~ 83 in females and ~ 58 in males. CONCLUSION: The ability to quantify the radiation dose imparted to the patient during an INR procedure and the associated cancer incidence risk is essential to establishing effective radiation safety guidelines and monitoring methods within an institution.
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