Estimation and clinical verification of the effective and skin doses for pediatric and adult patients undergoing the cardiac interventional examination using five PMMA phantoms and TLD/ionization chamber technique

Abstract

BACKGROUND: Effective and skin doses gain much attention since the cardiac catheterization laboratory (CCL) is a place where both patients and medical staff are exposed to X-ray or fluoroscopy environment and gain a cumulative dose during the cardiac interventional procedure. OBJECTIVE: These doses for pediatric and adult patients undergone cardiac interventional examination using five PMMA phantoms and thermoluminescence dosimeter (TLD)/ionization chamber technique were estimated in this work with the further clinical verification. METHODS: Five PMMA phantoms (10, 30, 50, 70, and 90 kg) were customized to represent baby, child, adult female, adult male, and overweight adult (by Asian complexion standards), respectively, in accordance with the ICRU-48 report. Each phantom could be disassembled into 31 plates to insert TLD chips for measuring X-ray exposed dose or assisted with an auxiliary plate to insert high-sensitivity ionization chamber for surveying low-energy fluoroscopy dose. RESULTS: The data acquired from five phantoms were integrated into four semi-empirical formulas, in order to fit the binary quadratic form 'Dose = A BMI2+B DAP2+C BMI+ D DAP+E'. The latter linked the X-ray and fluoroscopy effective/skin doses, respectively, with a high coefficient of determination R2(from 0.888 to 0.986). CONCLUSIONS: The model refinement with DAP share adjustment is envisaged.