SIR 2024
Embolization
Raj Ayyagari, MD (he/him/his)
Associate Professor of Radiology
Boston Medical Center
Disclosure information not submitted.
Kevin Grizzard, PhD
Assistant Professor
Yale University School of Medicine
Disclosure information not submitted.
Saumik Z. Rahman, MD
Resident Physician
Yale New Haven Hospital
Disclosure information not submitted.
Jessica Lee, MD
Assistant Professor of Clinical Radiology and Biomedical Imaging
Yale School of Medicine
Disclosure information not submitted.
Fabian M. Laage Gaupp, MD
Interventional Radiologist
Yale School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Adel Mustafa, PhD
Associate Professor
Yale University School of Medicine
Disclosure information not submitted.
To compare reference point cumulative air kerma (CAK) measurements to peak skin dose (PSD) calculations created with an institutionally developed algorithm, as a method for quantifying radiation dose associated with prostatic artery embolization (PAE) procedures.
Materials and Methods: Patient body mass index (BMI) and radiation dose data including CAK were retrospectively collected from 121 PAE procedures performed by a single experienced operator ( >10 years PAE experience) at a single center from August 2018 to November 2021. Institutionally written MATLAB code (Mathworks, Natick, MA) calculated PSD for each procedure by modeling each patient as an ellipsoid and used Radimetrics software-generated radiation dose report data (Bayer HealthCare, Whippany, NJ) to project each radiation field, exposure-by-exposure, onto that ellipsoid. Calculated PSD values were compared to measured CAK values using two-sample t-tests and PSD/CAK ratios, for all procedures with CAKs measured at 3 Gy or higher.
Results:
20/121 (16%) PAE procedures resulted in CAKs of 3Gy or higher. Calculated PSDs for these procedures were lower than the measured CAKs in all cases (2.58±0.75 Gy vs 4.01±0.99 Gy, P< 0.001) (Table). Mean calculated PSD was 64% of mean CAK. Individual procedural PSD/CAK ratios decreased with increasing dose distribution, as quantified by the summation of radiation exposures projected on each ellipsoid patient model.
Conclusion:
The institutionally derived algorithm for calculating PSD used in this study, utilizing widely available software platforms, demonstrated PAE procedure-related radiation exposure to be less than that approximated by standard CAK measurements. Such PSD calculations may more accurately represent patient radiation exposure during PAE procedures.