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Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization.

Abstract

OBJECTIVE

To present values for the dose parameters predictive of alopecia as an adverse effect induced by neuroembolization using a biplane fluoroscopy.

METHODS

This study included a total of 151 patients (52 men, mean age of 55.1 ± 12.2 years) treated for intracranial neuroembolization between 2014 to 2018 with the following criteria: 1) obtainable dose report with digital subtraction angiographic image records, 2) no history of radiation exposure 6 months prior to the first procedure, and 3) and clinical follow-up performed through 12 months following the procedure. Patients were divided into 2 groups according to their presentation of alopecia during the follow-up period.

RESULTS

Eighteen (11.9%) patients developed alopecia 10 to 30 days after the procedure (average: 18.5 ± 5.3 days). Sixteen (88.9%) patients in the alopecia group were affected by projection of the A-plane fluoroscopy. Area under the receiver operating characteristic analysis curves of 0.865 (P = 0.000) and 0.831 (P = 0.000) were used to compute the optimal A-plane dose area product (255.4 Gy-cm2; sensitivity: 0.875; specificity: 0.805; Youden J = 0.682) and cumulative dose (4437.5 mGy; sensitivity, 0.750; specificity, 0.805; Youden J = 0.556) cutoff values, respectively, capable of distinguishing patients with alopecia (n = 16) from subtotal patients (n = 149).

CONCLUSIONS

The dose area product and the cumulative dose may be useful, intuitive factors for predicting the adverse effects of the neurointerventional radiation. Further multicenter research should be performed to confirm the efficacy and utility of the reference values of dose area product and cumulative dose for preventing excessive irradiation during neurointerventional procedures.

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  • Authors+Show Affiliations

    ,

    Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

    ,

    Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

    ,

    Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.

    Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea. Electronic address: skymedi@gachon.ac.kr.

    Source

    World neurosurgery : 2019 Jun 14 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31203064

    Citation

    Choi, Dae Han, et al. "Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization." World Neurosurgery, 2019.
    Choi DH, Yoo CJ, Park CW, et al. Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization. World Neurosurg. 2019.
    Choi, D. H., Yoo, C. J., Park, C. W., & Kim, M. J. (2019). Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization. World Neurosurgery, doi:10.1016/j.wneu.2019.06.039.
    Choi DH, et al. Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization. World Neurosurg. 2019 Jun 14; PubMed PMID: 31203064.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neurointerventional Radiation: Relationship Between the Dose Parameters and Temporary Alopecia After Intracranial Coil Embolization. AU - Choi,Dae Han, AU - Yoo,Chan Jong, AU - Park,Cheol Wan, AU - Kim,Myeong Jin, Y1 - 2019/06/14/ PY - 2019/04/26/received PY - 2019/06/01/revised PY - 2019/06/03/accepted PY - 2019/6/17/pubmed PY - 2019/6/17/medline PY - 2019/6/17/entrez KW - Alopecia KW - Dose KW - Embolization KW - Fluoroscopy KW - Radiation JF - World neurosurgery JO - World Neurosurg N2 - OBJECTIVE: To present values for the dose parameters predictive of alopecia as an adverse effect induced by neuroembolization using a biplane fluoroscopy. METHODS: This study included a total of 151 patients (52 men, mean age of 55.1 ± 12.2 years) treated for intracranial neuroembolization between 2014 to 2018 with the following criteria: 1) obtainable dose report with digital subtraction angiographic image records, 2) no history of radiation exposure 6 months prior to the first procedure, and 3) and clinical follow-up performed through 12 months following the procedure. Patients were divided into 2 groups according to their presentation of alopecia during the follow-up period. RESULTS: Eighteen (11.9%) patients developed alopecia 10 to 30 days after the procedure (average: 18.5 ± 5.3 days). Sixteen (88.9%) patients in the alopecia group were affected by projection of the A-plane fluoroscopy. Area under the receiver operating characteristic analysis curves of 0.865 (P = 0.000) and 0.831 (P = 0.000) were used to compute the optimal A-plane dose area product (255.4 Gy-cm2; sensitivity: 0.875; specificity: 0.805; Youden J = 0.682) and cumulative dose (4437.5 mGy; sensitivity, 0.750; specificity, 0.805; Youden J = 0.556) cutoff values, respectively, capable of distinguishing patients with alopecia (n = 16) from subtotal patients (n = 149). CONCLUSIONS: The dose area product and the cumulative dose may be useful, intuitive factors for predicting the adverse effects of the neurointerventional radiation. Further multicenter research should be performed to confirm the efficacy and utility of the reference values of dose area product and cumulative dose for preventing excessive irradiation during neurointerventional procedures. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/31203064/Practical_Dose_Parameter_Values_for_the_Prediction_of_the_Adverse_Effect_of_Neuro-interventional_Radiation:_Relationships_between_the_Dose_Parameters_and_Temporary_Alopecia_after_Intracranial_Coil_Embolization L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(19)31580-3 DB - PRIME DP - Unbound Medicine ER -