Intra-arterial chemotherapy for retinoblastoma: the dosimetric impact

• Published in: Neuroradiology Vol. 61; no. 9; pp. 1083 - 1091
• Main Authors: Guasti, Andrea, Leonini, Sara, Bertelli, Eugenio, Baldi, Roberta, Gennari, Paola, Cioni, Samuele, Vallone, Ignazio Maria, Romano, Daniele Giuseppe, Casseri, Tommaso, Guerrini, Leonardo, La Rocca, Annunziata Elena, Scala, Paolo Gambini Della, De Francesco, Sonia, Hadjistilianou, Theodora, Bracco, Sandra
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2019; Springer Nature B.V
• Subjects: Adolescent; Angiography; Antineoplastic Agents - administration & dosage; Cancer; Chemotherapy; Child; Child, Preschool; Dosimetry; Exposure; Female; Females; Fluoroscopy; Humans; Imaging; Infant; Infusions, Intra-Arterial; Interventional Neuroradiology; Male; Males; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Organs; Phantoms, Imaging; Prospective Studies; Radiation; Radiation Dosage; Radiation measurement; Radiology; Radiometry; Retina; Retinal Neoplasms - diagnostic imaging; Retinal Neoplasms - drug therapy; Retinoblastoma; Retinoblastoma - diagnostic imaging; Retinoblastoma - drug therapy; Tumors; Radiation parameters; Absorbed dose; Dose exposition; Retinoblastoma; Intra-arterial chemotherapy
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-019-02260-7

Purpose Purposes are (1) to measure main radiation parameters and (2) to propose a method to estimate the absorbed doses of internal organs starting from DAP values. Measuring the exposition of internal organs by repeated irradiations on an anthropomorphic phantom with the same settings used in vivo, we could establish correlations between (1) DAP and the dose recorded by a dosimeter placed along the X-ray beam entrance pathway; (2) the dose recorded by the same dosimeter and the absorbed dose in internal organs. Methods Forty-four consecutive patients (16 males, 28 females) (mean age 35.4 months) treated at our institution with IAC (216 procedures: 196 via the ICA and 20 into branches of the ECA) were included in this prospective study. IAC was divided into 5 phases. Fluoroscopic time, DAP, and ESD were measured. Results The mean DAP was 595 ± 445 cGy cm 2 and the mean fluoroscopic time was 540 ± 403 s. ESD was on average 9.59 mGy (range 0.8–165 mGy). The absorbed dose was lower than 12.1 mGy in the left retina (the more exposed organ) in 75% of single treatments and lower than 25 mGy in 95% of treatments. In the cases of 3 and 6 sessions, the left retina of 75% of patients absorbed respectively less than 36.3 and 72.7 mGy, whereas the left retina of 95% of patients received less than 75.2 and 150.4 mGy. Other organs were less exposed. Conclusion This paper describes a method of absorbed dose estimation providing ranges used clinically in a single practice and the basis for further prospective studies.