Vendor‐independent skin dose mapping application for interventional radiology and cardiology

PURPOSE: The purpose of this paper is to present and validate an originally developed application SkinCare used for skin dose mapping in interventional procedures, which are associated with relatively high radiation doses to the patient’s skin and possible skin reactions. METHODS: SkinCare is an application tool for generating skin dose maps following interventional radiology and cardiology procedures using the realistic 3D patient models. Skin dose is calculated using data from Digital Imaging and Communications in Medicine (DICOM) Radiation Dose Structured Reports (RDSRs). SkinCare validation was performed by using the data from the Siemens Artis Zee Biplane fluoroscopy system and conducting “Acceptance and quality control protocols for skin dose calculating software solutions in interventional cardiology” developed and tested in the frame of the VERIDIC project. XR‐RV3 Gafchromic films were used as dosimeters to compare peak skin doses (PSDs) and dose maps obtained through measurements and calculations. DICOM RDSRs from four fluoroscopy systems of different vendors (Canon, GE, Philips, and Siemens) were used for the development of the SkinCare and for the comparison of skin dose maps generated using SkinCare to skin dose maps generated by different commercial software tools (Dose Tracking System (DTS) from Canon, RadimetricsTM from Bayer and RDM from MEDSQUARE). The same RDSRs generated during a cardiology clinical procedure (percutaneous coronary intervention—PCI) were used for comparison. RESULTS: Validation performed using VERIDIC's protocols for skin dose calculation software showed that PSD calculated by SkinCare is within 17% and 16% accuracy compared to measurements using XR‐RV3 Gafchromic films for fundamental irradiation setups and simplified clinical procedures, respectively. Good visual agreement between dose maps generated by SkinCare and DTS, Radimetrics(TM) and RDM was obtained. CONCLUSIONS: SkinCare is proved to be very convenient solution that can be used for monitoring delivered dose following interventional procedures.