Measurement of Patient Lens Exposure during Cerebral Endovascular Treatment Using a Scintillation Optical Fiber Dosimeter

Purpose: It is difficult to predict lens radiation dose of the patients during neuroendovascular treatment due to various factors potentially affecting radiation dose such as a various working projection for individual procedures. The purpose of this study was to examine the association between the patient lens entrance dose (lens dose) during cerebral endovascular treatment and displayed dose on a system, as well as the influence of 3D imaging on lens exposure, and clarify factors influencing lens exposure. Methods: In patients who underwent cerebral endovascular treatment under general anesthesia between February and December 2017, the lens dose was measured using a real-time scintillation optical fiber dosimeter. The correlation between the lens dose and displayed dose on each system was analyzed. Furthermore, dose data were divided into fluoroscopy, DSA, and 3D imaging, and respective values as a percentage of the lens dose were calculated. Results: There was a strong correlation between the lens dose and Kerma Area Product (KAP) value. The lens dose was weakly correlated with the Air Kerma (AK) value and duration of fluoroscopy. 3D imaging for the visualization of a stent increased the value of 3D imaging as a percentage of the lens dose, and the lens dose increased with the frequency of imaging. In patients with a large field of irradiation after the establishment of a working angle, the lens dose increased. Conclusion: We evaluated the characteristics of the lens dose. In the future, the management of the lens dose should be examined.