Author Affiliations: Interventional Neuroradiology, Departments of Radiology, Neurosurgery, and Neurology (Dr Gobin) and Office of Health Physics (Dr Rosenstein), Weill Cornell Medical College, Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center (Drs Gobin, Marr, and Abramson), and Department of Ophthalmology, Mount Sinai School of Medicine (Dr Brodie), New York, New York.
Since our successful introduction of superselective intra-arterial chemotherapy (IAC) for retinoblastoma,1,2 we have been careful to use techniques that limit radiation exposure to the young children who receive treatment. The IAC can be performed with short fluoroscopy time and little or no digital subtraction angiography, so it can be done with significantly lower radiation doses than other procedures in interventional neuroradiology. A recent article by Vijayakrishnan et al,3 however, reported strikingly high doses of radiation during IAC for retinoblastoma. These doses are not only higher than those we have recorded but are even higher than the doses previously reported for performing complex interventional neuroradiology procedures (such as embolization of aneurysms and arteriovenous malformations), which require long fluoroscopy time and multiple digital subtraction angiograms.4,5 For example, in the report by Theodorakou and Horrocks4 on 30 patients undergoing interventional neuroradiology procedures, the right eye (on the side of the lateral fluoroscopy tube) received a mean dose of 60 mGy (to convert to rad, multiply by 0.10), almost 3 times less than in the article by Vijayakrishnan and colleagues.
Gobin YP, Rosenstein LM, Marr BP, Brodie SE, Abramson DH. Radiation Exposure During Intra-arterial Chemotherapy for Retinoblastoma. Arch Ophthalmol. 2012;130(3):403–405. doi:10.1001/archopthalmol.2011.2717