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    An Assessment of Common Approaches to Estimating Peak Skin Dose Rresulting from Fluoroscopically Guided Interventions

    Cover for An Assessment of Common Approaches to Estimating Peak Skin Dose Rresulting from Fluoroscopically Guided Interventions
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    View/Open: Smith_georgetown_0076M_13795.pdf (795kB) Bookview

    Creator
    Smith, Caleb Martin
    Advisor
    Smith, David A
    Abstract
    Fluoroscopy guided procedures are increasing in complexity, and with that, Peak Skin Doses (PSD) that produce cutaneous radiation injury are a growing concern. Direct measurement of PSD is possible, but the decision to do so must be made in advance. PSD estimates and correctly monitoring their possible deterministic skin injuries are important to patient care. Three methods of indirect PSD estimation are examined for nine cases at MedStar Georgetown University Hospital. The aim of the study is to determine the magnitude of variation between these three methods for estimating the PSD. Method 1 (Fluoroscopy Time and Maximum Entrance Skin Exposure) was used at MedStar Georgetown University Hospital up until 2016. Methods 2 and 3 incorporate procedure information (Reference Point Air Kerma, Source-to-Patent distance, and Backscatter Factor) from DICOM (Digital Imaging and Communications in Medicine) tags into PSD estimates. Method 1 PSD estimates are vastly different, by as much as 136%, than those from Methods 2 and 3. Method 2 and 3 PSD estimates differ very little, 7.3% or less. Governing bodies have discounted Method 1 as a reliable dose metric because of its poor correlation with PSD. The accuracy of Method 2 is suitable to determine PSD and which dose band a patient fits so their injuries can be accurately monitored. Method 3, the most time intensive approach, should only be used in the case of a sentinel event where a full investigation is warranted.
    Description
    M.S.
    Permanent Link
    http://hdl.handle.net/10822/1047804
    Date Published
    2017
    Subject
    Radiology; Diagnostic imaging; Nuclear physics; Medical imaging; Nuclear physics and radiation;
    Type
    thesis
    Publisher
    Georgetown University
    Extent
    36 leaves
    Collections
    • Graduate Theses and Dissertations - Health Physics
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    • Cover for Estimation of Peak Skin Dose and Its Relation to the Size-Specific Dose Estimate

      Estimation of Peak Skin Dose and Its Relation to the Size-Specific Dose Estimate 

      Abdullah, Abdullatif S (Georgetown University, 2022)
      The study tests the concept that the size-specific dose estimate (SSDE) and the Computed Tomography Dose Index volume (CTDIvol) have a significant association with the peak skin dose (PSD). To determine the relationship ...
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    Georgetown University Seal
    ©2009 - 2023 Georgetown University Library
    37th & O Streets NW
    Washington DC 20057-1174
    202.687.7385
    digitalscholarship@georgetown.edu
    Accessibility