A novel personalized dosimetry method for endovascular aneurysm repair (EVAR) procedures
- 6 March 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Radiology
- Vol. 31 (9), 6547-6554
- https://doi.org/10.1007/s00330-021-07789-x
Abstract
To estimate radiation doses for the primarily irradiated organs/tissues of patients subjected to standard endovascular aneurysm repair (EVAR) procedures using a novel personalized dosimetry method. Dosimetric and anthropometric data were collected prospectively for eight patients who underwent standard EVAR procedures. Patient-specific Monte Carlo simulations were performed to estimate organ/tissue doses from each of the fluoroscopic and digital subtraction angiography acquisitions involved in EVAR. Individual-specific cumulative absorbed doses were estimated for the skin, spinal bone marrow, heart, kidneys, liver, colon, bladder, pancreas, stomach, and spleen and compared to corresponding values estimated through a commercially available dosimetric software package that employs standardized phantoms. The highest organ/tissue radiation doses from EVAR were found for the skin, spinal bone marrow, kidneys, and spleen as 192.4 mGy, 96.7 mGy, 72.9 mGy, and 33.6 mGy respectively, while the doses to the heart, liver, colon, bladder, pancreas, and stomach were 6.3 mGy, 14.4 mGy, 18.4 mGy, 14.8 mGy, 21.6 mGy, and 11.2 mGy respectively. Corresponding dose values using standardized phantoms were found to differ up to 151%. Considerable radiation doses may be received by primarily exposed organs/tissues during standard EVAR. The specific size/anatomy of the patient and the variation in exposure parameters/beam angulation between different projections commonly involved in EVAR procedures should be taken into account if reliable organ dose data are to be derived. • A novel patient-specific dosimetry method was utilized to estimate radiation doses to the primarily irradiated organs/tissues of patients subjected to standard endovascular aneurysm repair procedures. • The use of standardized mathematical anthropomorphic phantoms to derive organ dose from fluoroscopically guided procedures may result in considerable inaccuracies due to differences in the assumed organ position/volume/shape compared to patients.Keywords
This publication has 30 references indexed in Scilit:
- Occupational Radiation Exposure During Endovascular Aortic ProceduresEuropean Journal of Vascular and Endovascular Surgery, 2013
- Measurement and Optimization of Patient Radiation Doses in Endovascular Aneurysm RepairEuropean Journal of Vascular and Endovascular Surgery, 2012
- Dosimetry concepts for scanner quality assurance and tissue dose assessment in micro-CTMedical Physics, 2012
- The radiation burden from increasingly complex endovascular aortic aneurysm repairInsights into Imaging, 2011
- The impact of radiation dose exposure during endovascular aneurysm repair on patient safetyJournal of Vascular Surgery, 2010
- DOSE-AREA PRODUCT TO PATIENTS DURING STENT-GRAFT TREATMENT OF THORACIC AND ABDOMINAL AORTIC ANEURYSMSHealth Physics, 2009
- Radiation burden of patients undergoing endovascular abdominal aortic aneurysm repairJournal of Vascular Surgery, 2009
- Concepts for dose determination in flat-detector CTPhysics in Medicine & Biology, 2008
- Validation of a Monte Carlo tool for patient-specific dose simulations in multi-slice computed tomographyEuropean Radiology, 2007
- Radiation exposure in stent-grafting of abdominal aortic aneurysmsThe British Journal of Radiology, 2005