TY - JOUR T1 - Patient Radiation Dose Management in the Follow-Up of Potential Skin Injuries in Neuroradiology JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 277 LP - 282 DO - 10.3174/ajnr.A3211 VL - 34 IS - 2 AU - E. Vano AU - J.M. Fernandez AU - R.M. Sanchez AU - D. Martinez AU - L. Lopez Ibor AU - A. Gil AU - C. Serna-Candel Y1 - 2013/02/01 UR - http://www.ajnr.org/content/34/2/277.abstract N2 - BACKGROUND AND PURPOSE: Radiation exposure from neurointerventional procedures can be substantial, with risk of radiation injuries. We present the results of a follow-up program applied to potential skin injuries in interventional neuroradiology based on North American and European guidelines. MATERIALS AND METHODS: The following guidelines approved in 2009 by SIR and CIRSE have been used over the last 2 years to identify patients with potential skin injuries requiring clinical follow-up: peak skin dose >3 Gy, air kerma at the patient entrance reference point >5 Gy, kerma area product >500 Gy ยท cm2, or fluoroscopy time >60 minutes. RESULTS: A total of 708 procedures (325 in 2009 and 383 in 2010) were included in the study. After analyzing each dose report, 19 patients (5.9%) were included in a follow-up program for potential skin injuries in 2009, while in 2010, after introducing several optimizing actions and refining the selection criteria, only 4 patients (1.0%) needed follow-up. Over the last 2 years, only 3 patients required referral to a dermatology service. CONCLUSIONS: The application of the guidelines to patient radiation dose management helped standardize the selection criteria for including patients in the clinical follow-up program of potential skin radiation injuries. The peak skin dose resulted in the most relevant parameter. The refinement of selection criteria and the introduction of a low-dose protocol in the x-ray system, combined with a training program focused on radiation protection, reduced the number of patients requiring clinical follow-up. CIRSECardiovascular and Interventional Radiology Society of EuropeDAPdose-area productDOLIRdose on-line for interventional radiologyICRPInternational Commission on Radiologic ProtectionSIRSociety of Interventional Radiology ER -