Hi,needing some general info about radiation doses for cerebral angiogram. particularly digital subtraction. can't find anything online, not a single thing which seems weird. How bad is the total dose compared with just a standard CT scan? thank you so much and best wishes for recovery!!!
This is a pretty good website to get an idea of how much radiation you have been exposed to.
http://www.ans.org/pi/resources/dosechart/
I hope that this helps
~ Carol
Thank you both so much xoxo
So does that mean that the "digital subtraction" feature does not add any additional radiation to the test? I could have sworn that someone told me that there is more radiation with a digital subtraction angiogram versus a convential angiogram. I thought this was because they use radiation to take the "before" picture and then more radiation to take the "after" picture. Whereas conventional just takes the one picture. Hope I'm making sense ;)
Eva...try searching: DSA angio then add definition / radiation levels / (other words) ...
Recently, learned of website of Health Physics Society...may want to review as it notes angio at 55 mSv
DICOM...(Digital Imaging and Communication of Medicine) under nema (National Electrical Manufacturer's Association.. it is used to track all of our rad procedures...back to basic x-rays...
Other sources: Merck Manual and the BAF webinar...I think what
These have same/similar and different mSv #s... none explain how to multiply their numbers to which procedure portions...at least not clearly / specifically for the public (patients) to understand
Arteriography (angiograms):
Diagnostic: typically 4 angios...two for each hemisphere...sometimes additions and sometimes the procedure is done w/o a wait time...tho it is addition of angios...and the "final" results angio..
Each angio has 1-9 Series;
Each Series can film up to 120 images...
Thus, which mSv number should be used w/which portion...
TIME:...may run from 3-5 hours...which # do we multiply that to?
The numbers of film images do not relate to the hours of visualization on the screens in the angiosuites...I cannot imagine our arteries/other are being displayed on the screen w/o radiation...a light switch volume not likely to be able to do it...
As I type...it draws memory flash to DICOM data..."GR" for high dose and "SC" for low dose ...
perhaps the SC low does is during the screen visualization...and GR high dose for the filming decision...DICOM on my angio CD/DVDs note only "GR"...which suggests the diff in GR and SC..
My first Q to our "ask the doc"...was September 2011; attempted again 02/19/13... The BAF webinar was May 2013...and, what we are missing is how to compare the mSv #...as I noted above...
There is more related to all of this...and, I do not know how to minimize (slim down) what I just typed...
I can only share my ideas, interpretations and questions...I have no expertise...I hope it may give you all questions to ask your doctors when making your selections...thus, getting more data to share with us...
Thanks much, Eva...for bringing this forward again...prayers you will get answers to your questions...
Pat
Thank you for your replies.
Pat: I tried to follow the information you provided but I'm not fluent in the scientific language. Does this mean that there's 55 mSv in a single angiogram? If so, oh....my...god. That's horrifying!!! My surgeon at one point told me that the angiogram would be less radiation than a CT. I don't know if he had planned on a DSA all along or not. They initially planned on doing an angiogram and then embolizing my AVM and coiling my aneurysm. None of that happened. It was just a plain old angiogram. Does this mean that people receiving coiling treatment receive even more radiation than the diagnostic angio? I'm so confused and a little mad if my doctor misled me.
xoxo: My research keeps showing that digital subtraction does involve more radiation because a picture is being taken before and after the contrast dye is injected. I can't find anything that really makes any sense. It keeps saying that DSA is the "Gold standard" but I can't tell if it's what most aneurysm sufferers received for testing. It's a little scary how few details are out there.
Xoxo...thanks...
Rolf M Sievert..1896 - 1966...he did a grand start...perhaps it continues...He worked on doses...
What I have asked, and searched for, are how to multiply the doses over which part of an angio...per x-ray function...angio, series, or images... times which mSv...or rem...#
Is one "derived unit"...per angio, series, or images?
I found another site: www.xrayrisk.com which others may find of interest...
However, it does not qualify what to measure to compare...to mSv....or equivalent..
The "Calculator" portion lists:
Plain /film (x-rays);
CT Scans; Fluoroscopy; Nuclear medicine; to
Interventional Procedures: ... NO ref to Cerebral Procedures...
Coronary angio (diagnostic) ... No note on cerebral diagnostic...
Coronary angio (stent, ablation) ... Nothing on cerebral devices..
Pulmonary angiogram
Abdominal angiogram
Head and Neck angiogram ... not the brain... or angios...
TIPS; Pelvic Vein Embolization; ERCP; Endomyocardial Biopsy ...
Members may want to view this site...they have a calculator to put in their data... AND, well, if w know how to multiply how many items per...
The one most startling is the Health Physcis society...w/ non-cardiac embolization...w/ no ref to cerebral...and, yet what else in our brain/body would be embolized besides our hearts?
Just questioning...again, since Health Physics does not track w/Merck or our webinar...nand, it has no cerebral data listed...just non-cardiac...
Eva...I am not fluent in any of the scientific language either...and, which drove my first questions in September 2011...to the experts...
Angios have been known as the gold standard for a long time...the Merck Manual and the webinar done for us use same/similar ranges... and, which are so diff than the Health Physics Society... However, "cerebral" is not displayed...as is coronary, pulmonary, etc.. tho it lists noncardiac ...thus, what could be more noncardiac than our brain?
I have no expertise whatever...non-degreed /non-licensed...and, why I have asked multiple times for info from the experts...and, for various reasons...
Pat
Xo...you were so blessed because you had no leaks/ruptures...w/clear, alert level to read/comprehend...
I understand your confusion, Pat. It's unsatisfying to me that this information is not easily accessible. My surgeon did say to me that the radiation would be less than CT. If DSA is the gold standard test, then I'd imagine he meant that DSA's were less radiation than CT. His info sounds very different from other sources. My surgeon is a vascular specialist. He's not an interventional radiologist. I don;t know if he does things differently. I don't see why any test would need to be more than 20 mSv... ever. So I hope that study is wrong or an exception. I had the misfortune of needing a CT after my AVM surgery so I ended up with my big DSA, follow up quick angio and CT all within 72 hours. Plus my inital CT two weeks prior. I cry every day about getting cancer later in life. I have a very young child.
god bless
Eva,
My sensitivity/concerns vary greatly...not cancer as a top... the causes of cancers, vary tremendously...and, I have lost family/friends...over varying ages...
You note your doc said your next will be less than CT...Ask him if your DICOM will note "GR" (high dose) or "SC" (low dose)...and, then if he has the mSv conversion for GR and SC...
As for the Health Physics Society, you may want to peruse their website...for their background/purpose...maybe you have already...re: the 55 mSv noncardiac...
I'd so appreciate your explaining to me how you calculated 20 mSv...my math/ accounting was so easy...including the med billing/accounting from REV Codes to CPTs...and, my mind blanks on mSv to procedure...
Some day I will give example of med code/billing...even tracking the f/ups...
Thanks much for that...prayers you do not worry about cancers...We need to cherish each day...put in the same order as you do when you drive...we pay attention...and do not over worry...
Blessings to you...
Thanks Pat. It's nice to have people to talk to about this stuff. It seems so foreign to have a lot of radiation exposure and experts don't even seem to know for sure how much is too much. I'm a worrier to begin with... so you can imagine me now :)
I was not referring to a specific test when I said 20 mSv. I was just musing that it's nonsense for any imaging test to require more than that. I'm lost in a sea of contradicting information on the web.
Thank you for your encouragement. I hate worrying like this. I lost my mom when I was in high school. I thought that would be the only tragic thing in my young life.... oops. I get chills up my spine when I think of history repeating itself with my boy. It's so surreal. I hope all is well for you.
Eva...yes. I can only imagine...two of my high school friends lost their mothers when we were sophomores...the impact was horrendous...
The next thing I can/will add...on worrying...that is prayer...and, that you try/do yoga deep breathing when you feel yourself getting uptight from your thinking...We can talk much more again...
I have done some more research and none to share now...I lost a lot of my brain and I have to read/outline/study to begin to grasp the data...
Hugs and prayers...
Pat