Experimental evaluation of a radiation dose management system-integrated 3D skin dose map by comparison with XR-RV3 Gafchromic® films

Objective: To assess the interactive Skin Dose Map (R) tool (SDMTool) integrated to the radiation dose management system (RDMS) DoseWatch (R) with Gafchromic (R) films for implementation in routine practice. Methods: A retrospective dose estimation software SDMTool was used to calculate Peak Skin Dose (PSD) and display the patient skin dose distribution. PSD was calculated with a triangle mesh of 0.055 cm(2) resolution on ICRP 110 male anthropomorphic phantom and with a square ROI of 1 cm(2) on flat phantom. The tool uses Radiation Dose Structured Reports (RDSR) data to model exposure events and calculate the PSD per event. The PSD and the skin dose distribution estimated with SDMTool were evaluated in comparison with Gafchromic (R) films positioned under the PMMA phantom (20 cm) for 13 configurations. Measurements were performed on a Philips system. Statistical analysis were carried out to compare PSDFilm and PSDSDM. Results: Average differences between PSDFilm and PSDSDM were 6% +/- 6% (range from -3% to 22%) for flat phantom and 5% +/- 7% (range from -3% to 25%) for ICRP phantom. Concordance was good between the measured PSDFilm and the estimated PSDSDM with Lin's coefficient estimation and 95% Confidence Interval of 0.979 [0.875; 0.984] for flat phantom and 0.977 [0.877; 0.985] for ICRP phantom. Dose map representations are concordant for 11 of the 13 tests on PMMA phantom. Disparities arose from the limitations of the RSDR format: table displacement during fluoroscopy events and the use of wedge filter. Conclusion: The results found in this experimental evaluation show that the SDMTool is a suitable alternative to Gafchromic (R) film to calculate PSD.