@article {Qureshi713, author = {A.M. Qureshi and L.K. Davies and P.A. Patel and A. Rennie and F. Robertson}, title = {Determinants of Radiation Dose in Selective Ophthalmic Artery Chemosurgery for Retinoblastoma}, volume = {40}, number = {4}, pages = {713--717}, year = {2019}, doi = {10.3174/ajnr.A6000}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: Retinoblastoma is the most common pediatric ocular neoplasm. Multimodality treatment approaches are commonplace, and selective ophthalmic artery chemosurgery has emerged as a safe and effective treatment in selected patients. Minimizing radiation dose in this highly radiosensitive patient cohort is critical. We explore which procedural factors affect the radiation dose in a single-center cohort of children managed in the UK National Retinoblastoma Service.MATERIALS AND METHODS: A retrospective review was performed of 177 selective ophthalmic artery chemosurgery procedures in 48 patients with retinoblastoma (2013{\textendash}2017). Medical records, angiographic imaging, and radiation dosimetry data (including total fluoroscopic screening time, skin dose, and dose-area product) were reviewed.RESULTS: The mean fluoroscopic time was 13.5 {\textpm} 13 minutes, the mean dose-area product was 11.7 {\textpm} 9.7 Gy.cm2, and the mean total skin dose was 260.9 {\textpm} 211.6 mGy. One hundred sixty-three of 177 procedures (92.1\%) were technically successful. In 14 (7.9\%), the initial attempt was unsuccessful (successful in 13/14 re-attempts). Screening time and radiation dose were associated with drug-delivery microcatheter location and patient age; screening time was associated with treatment cycle.CONCLUSIONS: In selective ophthalmic artery chemosurgery, a microcatheter tip position in the proximal or ostial ophthalmic artery and patient age 2 years or younger were associated with reduced fluoroscopic screening time and radiation dose; treatment beyond the first cycle was associated with reduced fluoroscopic screening time.DAPdose-area productOAophthalmic arterySOACselective ophthalmic artery chemosurgery}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/40/4/713}, eprint = {https://www.ajnr.org/content/40/4/713.full.pdf}, journal = {American Journal of Neuroradiology} }