Radiation Dose Assessment from Computed Tomography and Endovascular Treatment of Acute Ischemic Stroke Patients
DOI:
https://doi.org/10.14456/jdms.2023.30Keywords:
Acute ischemic stroke, Effective dose, Endovascular treatment, CancerAbstract
Background: Several treatments are available for acute ischemic stroke. Endovascular treatment is a commonly used method at the Neurological Institute of Thailand. Therefore, this group of patients undergoes radiation exposure from Computed Tomography or CT and Digital Subtraction Angiography or DSA procedures. Objectives: This study aimed to determine the radiation dose received by patients undergoing CT in combination with endovascular treatment and to assess the risk to patients. Method: The effective dose was calculated using conversion factors of 61 acute ischemic stroke patients treated with endovascular treatment between October 1, 2019, and October 1, 2020. The data were retrospectively collected from CT and DSA machines. Results: The study included patients diagnosed with acute ischemic stroke and treated with endovascular treatment, which were 28 females (45.9%)and 33 males (54.1%) aged between 40 - 89 years old, with a mean age of 64 years old. In terms of CT, the mean volumetric computed tomography index was 40.71±13.88 mGy and the mean dose-length product was 1938±638 mGycm. As for endovascular treatment, the mean air KERMA was 242 ± 229 mGy with the mean dose area product of 6192.3±4322.3 µGycm2, and the mean fluoroscopy time was 22±16 minutes. The mean effective dose from computed tomography was 4.45±1.92 mSv (range 1.65-10.67 mSv), and 2.48±1.73 mSv was from endovascular treatment. The total effective dose for patients had a mean of 6.94±2.69 mSv. Conclusion: Acute ischemic stroke patients exposed to radiation from CT and endovascular treatment are at a very low additional risk of death from cancer. The risk is 1 in 10,000 compared to the mean effective dose of 6.94 mSv. In addition, the risk is 1 in 1,000 compared to the maximum effective dose of 13.73 mSv.
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