The Need for Real-time Skin Dose Tracking

The number of patients' requiring vital interventional procedures has risen sharply in the last decade and will continue to increase with an aging world population. In conjunction with the University at Buffalo, Toshiba has developed an innovative dose tracking system that provides interventionalists with real-time data on the delivery of radiation during interventional procedures in the form of a detailed, easy-to-read color coded human map. The intuitive graphic aid highlights, with changing colors, if and when a targeted area of radiation distribution should be changed to 'spread the skin dose'. This enables doctors to instantaneously monitor and minimize patient radiation exposure and therefore significantly reduce the risk of any radiation based skin injury, such as erythema, epilation, desquamation and even skin necrosis.

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Automatic Real-time Dose Tracking System (DTS)

Toshiba has developed a dose tracking system (DTS) that provides a real-time display of the cumulative skin dose distribution as well as dose rate:

  • Exposure and imaging-system-geometry parameters are obtained from the digital bus on a Toshiba Infinix-i C-arm unit.
  • The fluoroscopic system is simulated and the radiation dose to each point on the patient's skin is calculated.
  • The calculated dose is displayed on a 3D patient graphic in real-time.
  • The skin dose calculation of the DTS includes:
  • Tracking of beam movement for each projection to obtain a spatial distribution
  • Inverse Square calculation to each point on the patient's skin using the source-to-skin distance
  • Backscatter to the skin from the patient in addition to the primary beam exposure
  • Table and patient attenuation of the primary beam as a function of transmission angle
  • Real-time Skin dose rather than air kerma values.

Feedback provided by the Dose Tracking System during a fluoroscopic procedure can help the interventionalist to manage the dose given to the patient to avoid serious skin effects and to make an informed decision on the risk versus benefit trade-offs of radiation use.