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With X-ray radiation protection and dose management constantly gaininginterest in interventional radiology, novel procedures often undergoprospective dose studies using anthropomorphic phantoms to determine expecteddose values. Due to inherent uncertainties, these dose values might not allowfor patient-specific risk assessment. Therefore, first the aim of this study isto quantify the influence of these parameters on local X-ray dose to evaluatetheir relevance in the assessment of patient-specific organ doses. Second, thisknowledge further enables validating a simulation approach, which allowsemploying physiological material models and patient-specific geometries.Phantom dosimetry experiments using MOSFET dosimeters were conductedreproducing imaging scenarios in prostatic arterial embolization (PAE).Associated organ-equivalent dose of prostate, bladder, colon and skin wasdetermined. Dose deviation induced by possible small displacements of thepatient was reproduced by moving the X-ray source. Dose deviation induced bymaterial differences was investigated by analyzing two different commonly usedphantoms. We reconstructed the experiments using Monte Carlo (MC) simulations,a reference male geometry, and different material properties. Overall, MCsimulated organ dose values are in accordance with the measured ones for themajority of cases. Marginal displacements of X-ray source relative to thephantoms lead to deviations of 6% to 135% in organ dose values, while skin doseremains relatively constant. Regarding the impact of phantom materialcomposition, underestimation of internal organ dose values by 12% to 20% isprevalent in all simulated phantoms. Skin dose, however, can be estimated withlow deviation of 1% to 8% at least for two materials. Prospective referencedose studies might not extend to precise patient-specific dose assessment.

international journal of computer assisted radiology and surgery

Pitfalls in interventional X-ray organ dose assessment -- combined  experimental and computational phantom study: application to prostatic artery  embolization