During fluoroscopically-guided interventional (FGI) procedures, dose to the patient as well as the scatter dose to staff can be high. However, a significant dose reduction can be possible by using a region-of-interest (ROI) attenuator that reduces the x-ray intensity in the peripheral x-ray field while providing full field of view imaging. In this work, we investigated the magnitude of scatter dose reduction to staff made possible by using an ROI attenuator composed of 0.7-mm Cu with a central circular hole that projected a 5.4-cm ROI onto a Kyoto anthropomorphic phantom in the head, chest, and abdomen regions. A 150-cc ionization chamber was placed on a stand at a height of 150-cm (eye level) from the floor and 25-cm and 50-cm lateral distance from the gantry isocenter in a direction perpendicular to the table centerline to measure scatter dose at different positions along the length of the table. Scatter dose per entrance air kerma (mGy/Gy) was measured with and without the ROI attenuator and the percent scatter reduction for the ROI attenuator was determined as a function of staff positions, beam energy and gantry angulation. For head imaging, the measured percent dose reduction was 50% to 65% and, for chest and abdomen imaging, the scatter dose reduction was 63% to 72% at 50-cm lateral distance when using this ROI attenuator with about 20% beam transmission at 80-kVp. Overall, a considerable reduction of scattered radiation in the interventional room can be realized using an ROI attenuator.
KEYWORDS: Head, Attenuators, Eye, Signal attenuation, Collimation, Neuroimaging, Visualization, Monte Carlo methods, Signal intensity, Image processing
Lens dose can be high during neuro-interventional procedures, increasing the risk of cataractogenesis. Although beam collimation can be effective in reducing lens dose, it also restricts the FOV. ROI imaging with a reduced-dose peripheral field permits full-field information with reduced lens dose. This work investigates the magnitude of lens-dose reduction possible with ROI imaging. EGSnrc Monte-Carlo calculations of lens dose were made for the Zubal head phantom as a function of gantry angulation and head shift from isocenter for both large and small FOV’s. The lens dose for ROI attenuators of varying transmission was simulated as the weighted sum of the lens dose from the small ROI FOV and that from the attenuated larger FOV. Image intensity and quantum mottle differences between ROI and periphery can be equalized by image processing. The lens dose varies considerably with beam angle, head shift, and field size. For both eyes, the lens-dose reduction with an ROI attenuator increases with LAO angulation, being highest for lateral projections and lowest for PA. For an attenuator with small ROI field (5 x 5 cm) and 20% transmission, the lens dose for lateral projections is reduced by about 75% compared to a full dose 10 x10 cm FOV, while the reduction ranges between 30 and 40% for PA projections. Use of ROI attenuators can substantially reduce the dose to the lens of the eye for all gantry angles and head shifts, while allowing peripheral information to be seen in a larger FOV.
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