Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite

Sapoval, Marc; Pellerin, Olivier; Rehel, Jean-Luc; Houdoux, Nicolas; Rahmoune, Ghizlaine; Aubert, Bernard; Fitton, Isabelle

doi:10.1007/S00270-010-9795-0

Title: Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite

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Abstract

The purpose of this study was to assess the ability of low-dose/low-frame fluoroscopy/angiography with a flat-panel detector angiographic suite to reduce the dose delivered to patients during uterine fibroid embolization (UFE). A two-step prospective dosimetric study was conducted, with a flat-panel detector angiography suite (Siemens Axiom Artis) integrating automatic exposure control (AEC), during 20 consecutive UFEs. Patient dosimetry was performed using calibrated thermoluminescent dosimeters placed on the lower posterior pelvis skin. The first step (10 patients; group A) consisted in UFE (bilateral embolization, calibrated microspheres) performed using the following parameters: standard fluoroscopy (15 pulses/s) and angiography (3 frames/s). The second step (next consecutive 10 patients; group B) used low-dose/low-frame fluoroscopy (7.5 pulses/s for catheterization and 3 pulses/s for embolization) and angiography (1 frame/s). We also recorded the total dose-area product (DAP) delivered to the patient and the fluoroscopy time as reported by the manufacturer's dosimetry report. The mean peak skin dose decreased from 2.4 {+-} 1.3 to 0.4 {+-} 0.3 Gy (P = 0.001) for groups A and B, respectively. The DAP values decreased from 43,113 {+-} 27,207 {mu}Gy m{sup 2} for group A to 9,515 {+-} 4,520 {mu}Gy m{sup 2} for group B (P = 0.003). The dose tomore »« less

Authors:

Sapoval, Marc; Pellerin, Olivier ^[1]; Rehel, Jean-Luc ^[2]; Houdoux, Nicolas; Rahmoune, Ghizlaine ^[1]; Aubert, Bernard ^[2]; Fitton, Isabelle ^[1]

Georges Pompidou European Hospital, Department of Cardio Vascular Radiology (France)
Institute for Radiological Protection and Nuclear Safety (IRSN) (France)

Publication Date:: Fri Oct 15 00:00:00 EDT 2010

OSTI Identifier:: 21428925

Resource Type:: Journal Article

Journal Name:: Cardiovascular and Interventional Radiology

Additional Journal Information:: Journal Volume: 33; Journal Issue: 5; Other Information: DOI: 10.1007/s00270-010-9795-0; Copyright (c) 2010 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Journal ID: ISSN 0174-1551

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; DOSIMETRY; EMBOLI; FLUOROSCOPY; OPTIMIZATION; OVARIES; PATIENTS; PELVIS; RADIATION DOSES; SKIN; THERMOLUMINESCENT DOSEMETERS; UTERUS; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; BODY; CARDIOVASCULAR SYSTEM; DIAGNOSTIC TECHNIQUES; DOSEMETERS; DOSES; FEMALE GENITALS; GONADS; LUMINESCENT DOSEMETERS; MEASURING INSTRUMENTS; MEDICINE; NUCLEAR MEDICINE; ORGANS; RADIOLOGY

Citation Formats


                    Sapoval, Marc, Pellerin, Olivier, Rehel, Jean-Luc, Houdoux, Nicolas, Rahmoune, Ghizlaine, Aubert, Bernard, and Fitton, Isabelle. Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite.  United States: N. p., 2010. 
        Web.  doi:10.1007/S00270-010-9795-0.

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                    Sapoval, Marc, Pellerin, Olivier, Rehel, Jean-Luc, Houdoux, Nicolas, Rahmoune, Ghizlaine, Aubert, Bernard, & Fitton, Isabelle. Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite.  United States.  https://doi.org/10.1007/S00270-010-9795-0

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                    Sapoval, Marc, Pellerin, Olivier, Rehel, Jean-Luc, Houdoux, Nicolas, Rahmoune, Ghizlaine, Aubert, Bernard, and Fitton, Isabelle. 2010.  
        "Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite".  United States.  https://doi.org/10.1007/S00270-010-9795-0.

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@article{osti_21428925,

  title        = {Uterine Artery Embolization for Leiomyomata: Optimization of the Radiation Dose to the Patient Using a Flat-Panel Detector Angiographic Suite},

  author       = {Sapoval, Marc and Pellerin, Olivier and Rehel, Jean-Luc and Houdoux, Nicolas and Rahmoune, Ghizlaine and Aubert, Bernard and Fitton, Isabelle},

  abstractNote = {The purpose of this study was to assess the ability of low-dose/low-frame fluoroscopy/angiography with a flat-panel detector angiographic suite to reduce the dose delivered to patients during uterine fibroid embolization (UFE). A two-step prospective dosimetric study was conducted, with a flat-panel detector angiography suite (Siemens Axiom Artis) integrating automatic exposure control (AEC), during 20 consecutive UFEs. Patient dosimetry was performed using calibrated thermoluminescent dosimeters placed on the lower posterior pelvis skin. The first step (10 patients; group A) consisted in UFE (bilateral embolization, calibrated microspheres) performed using the following parameters: standard fluoroscopy (15 pulses/s) and angiography (3 frames/s). The second step (next consecutive 10 patients; group B) used low-dose/low-frame fluoroscopy (7.5 pulses/s for catheterization and 3 pulses/s for embolization) and angiography (1 frame/s). We also recorded the total dose-area product (DAP) delivered to the patient and the fluoroscopy time as reported by the manufacturer's dosimetry report. The mean peak skin dose decreased from 2.4 {+-} 1.3 to 0.4 {+-} 0.3 Gy (P = 0.001) for groups A and B, respectively. The DAP values decreased from 43,113 {+-} 27,207 {mu}Gy m{sup 2} for group A to 9,515 {+-} 4,520 {mu}Gy m{sup 2} for group B (P = 0.003). The dose to ovaries and uterus decreased from 378 {+-} 238 mGy (group A) to 83 {+-} 41 mGy (group B) and from 388 {+-} 246 mGy (group A) to 85 {+-} 39 mGy (group B), respectively. Effective doses decreased from 112 {+-} 71 mSv (group A) to 24 {+-} 12 mSv (group B) (P = 0.003). In conclusion, the use of low-dose/low-frame fluoroscopy/angiography, based on a good understanding of the AEC system and also on the technique during uterine fibroid embolization, allows a significant decrease in the dose exposure to the patient.},

  doi          = {10.1007/S00270-010-9795-0},

  url          = {https://www.osti.gov/biblio/21428925},
  journal      = {Cardiovascular and Interventional Radiology},

  issn         = {0174-1551},

  number       = 5,

  volume       = 33,

  place        = {United States},

  year         = {Fri Oct 15 00:00:00 EDT 2010},

  month        = {Fri Oct 15 00:00:00 EDT 2010}

}

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