Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases

2019 ◽  
Vol 49 (5) ◽  
pp. 600-608
Author(s):  
Matthew S. Lazarus ◽  
Benjamin H. Taragin ◽  
William Malouf ◽  
Terry L. Levin ◽  
Eduardo Nororis ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Fluoroscopy Time ◽  
High Exposure ◽  
Dose Area Product ◽  
Dose Monitoring ◽  
Radiation Dose Monitoring ◽  
Area Product

Using 7.5 frames per second reduces radiation exposure in lower extremity peripheral vascular interventions

Vascular ◽  
2014 ◽  
Vol 23 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nuri I Akkus ◽  
George S Mina ◽  
Abdulrahman Abdulbaki ◽  
Fereidoon Shafiei ◽  
Neeraj Tandon
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Success Rate ◽  
Frame Rate ◽  
Fluoroscopy Time ◽  
Peripheral Vascular ◽  
Dose Area Product ◽  
Group A ◽  
Group B ◽  
Area Product

Background Peripheral vascular interventions can be associated with significant radiation exposure to the patient and the operator. Objective In this study, we sought to compare the radiation dose between peripheral vascular interventions using fluoroscopy frame rate of 7.5 frames per second (fps) and those performed at the standard 15 fps and procedural outcomes. Methods We retrospectively collected data from consecutive 87 peripheral vascular interventions performed during 2011 and 2012 from two medical centers. The patients were divided into two groups based on fluoroscopy frame rate; 7.5 fps (group A, n = 44) and 15 fps (group B, n = 43). We compared the demographic, clinical, procedural characteristics/outcomes, and radiation dose between the two groups. Radiation dose was measured as dose area product in micro Gray per meter square. Results Median dose area product was significantly lower in group A (3358, interquartile range (IQR) 2052–7394) when compared to group B (8812, IQR 4944–17,370), p < 0.001 with no change in median fluoroscopy time in minutes (18.7, IQR 11.1–31.5 vs. 15.7, IQR 10.1–24.1), p = 0.156 or success rate (93.2% vs. 95.3%), p > 0.999. Conclusion Using fluoroscopy at the rate of 7.5 fps during peripheral vascular interventions is associated with lower radiation dose compared to the standard 15 fps with comparable success rate without associated increase in the fluoroscopy time or the amount of the contrast used. Therefore, using fluoroscopy at the rate of 7.5 fps should be considered in peripheral vascular interventions.

scholarly journals What factors affect fluoroscopy use during Bernese periacetabular osteotomy for acetabular dysplasia?

2019 ◽  
Vol 6 (3) ◽  
pp. 259-264
Author(s):  
James D Wylie ◽  
Michael P McClincy ◽  
Evan K Stieler ◽  
Michael B Millis ◽  
Young-Jo Kim ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Acetabular Dysplasia ◽  
Periacetabular Osteotomy ◽  
Male Gender ◽  
Fluoroscopy Time ◽  
Linear Modeling ◽  
Factors Affecting ◽  
Dose Area Product ◽  
Area Product ◽  
Open Arthrotomy

Abstract Periacetabular osteotomy (PAO) is the treatment of choice for acetabular dysplasia in the skeletally mature. Little is known about factors affecting fluoroscopy use in PAO. Therefore, we strived to determine patient and surgery factors are associated with the amount of fluoroscopy time and radiation dose during PAO. We performed a retrospective review of 378 patients who underwent PAO between January 2012 and August 2017. The mean age was 21.7 years and 326 (86%) were females. A total of 85 patients underwent concomitant arthroscopy and 60 underwent open arthrotomy. We recorded fluoroscopy time in minutes and radiation dose area product (DAP) in mGy·m2. Multivariate general linear modeling identified independent predictors of fluoroscopy time and radiation dose. Mean fluoroscopy time was 1.21 minutes and mean fluoroscopy DAP was 0.71 mGy·m2. Multivariate predictors of increased fluoroscopy time were male gender (P = 0.001), surgeon (P < 0.001) and whether an arthroscopy was performed (P < 0.001). Multivariate predictors of increased fluoroscopy DAP were increased body mass index (BMI) (P = 0.001), surgeon (P < 0.001) and whether an arthroscopy was performed (P < 0.001). Patients undergoing hip arthroscopy concomitant to PAO are at higher risk of longer fluoroscopy time and higher radiation dose. Other factors affecting fluoroscopy time included male gender and surgeon, while radiation dose was further affected by surgeon and BMI. Our findings can facilitate discussion about the risk of radiation exposure during PAO.

scholarly journals Radiation Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula

2022 ◽  
Author(s):  
Yigit Ozpeynirci ◽  
Christoph Trumm ◽  
Robert Stahl ◽  
David Fischer ◽  
Thomas Liebig ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Low Dose ◽  
Fluoroscopy Time ◽  
Reference Level ◽  
Spinal Angiography ◽  
Spinal Dural Arteriovenous Fistula ◽  
Dose Area Product ◽  
Arteriovenous Fistulas ◽  
Diagnostic Angiography ◽  
Area Product

Abstract Purpose Spinal dural arteriovenous fistulas (SDAVFs) represent the most common indication for a spinal angiography. The diagnostic reference level (DRL) for this specific endovascular procedure is still to be determined. This single-center study provides detailed dosimetrics of diagnostic spinal angiography performed in patients with SDAVFs. Methods Retrospective analysis of all diagnostic spinal angiographies between December 2011 and January 2021. Only patients with an SDAVF who had baseline magnetic resonance angiography (MRA), diagnostic digital subtraction angiography (DSA), treatment and follow-up at this institution were included. Dose area product (DAP, Gy cm2) and fluoroscopy time were compared between preoperative and postoperative angiographies, according to SDAVF locations (common versus uncommon), MRA results at baseline (positive versus negative) and DSA protocols (low-dose, mixed-dose, normal-dose). The 75th percentile of the DAP distribution was used to define the local DRL. Results A total of 62 spinal angiographies were performed in 25 patients with SDAVF. Preoperative angiographies (30/62, 48%) yielded a significantly higher DAP and longer fluoroscopy time when compared to postoperative angiographies (32/62, 53%) (p < 0.01). The local DRL was 329.41 Gy cm2 for a nonspecific (n = 62), 395.59 Gy cm2 for a preoperative and 138.6 Gy cm2 for a postoperative spinal angiography. Preoperative angiography of uncommonly located SDAVFs yielded a significantly longer fluoroscopy time (p = 0.02). The MRA-based fistula detection had no significant impact on dosimetrics (p > 0.05). A low-dose protocol yielded a 61% reduction of DAP. Conclusion The results of the present study suggest novel DRLs for spinal angiography in patients with SDAVF. Dedicated low-dose protocols enable radiation dose optimization in these procedures.

Radiation dose reduction during neurointerventional procedures by modification of default settings on biplane angiography equipment

2015 ◽  
Vol 8 (8) ◽  
pp. 819-823 ◽  
Author(s):  
Elyne N Kahn ◽  
Joseph J Gemmete ◽  
Neeraj Chaudhary ◽  
Byron Gregory Thompson ◽  
Kevin Chen ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Frame Rate ◽  
Fluoroscopy Time ◽  
P Value ◽  
Dose Cohort ◽  
Dose Area Product ◽  
Reduced Dose ◽  
Cine Frame ◽  
Area Product ◽  
Neurointerventional Procedures

BackgroundNeurointerventional procedures represent a significant source of ionizing radiation. We sought to assess the effect during neurointerventional procedures of varying default rates of radiation dose in fluoroscopy (F) and image acquisition (IA) modes, and frame rates during cine acquisition (CINE) on total X-ray dose, acquisition exposures, fluoroscopy time, and complications.MethodsWe retrospectively reviewed procedures performed with two radiation dose and CINE settings: a factory setting dose cohort (30 patients, F 45 nGy/pulse, IA 3.6 μGy/pulse, factory CINE frame rate) and a reduced dose cohort (30 patients, F 32 nGy/pulse, IA 1.2 μGy/pulse, with a decreased CINE frame rate). Total radiation dose, dose area product, number of acquisition exposures, fluoroscopy time, and complications were compared between the groups. Means comparisons (t tests) were employed to evaluate differences in the outcome variables between the two groups. p Value <0.05 was considered significant.ResultsThe reduced dose cohort had a significant reduction in mean radiation dose (factory, 3650 mGy; reduced, 1650 mGy; p=0.005) and dose area product (factory, 34 700 μGy×m2; reduced, 15 000 μGy×m2; p=0.02). There were no significant differences between cohorts in acquisition exposure (p=0.73), fluoroscopy time (p=0.45), or complications.ConclusionsSignificant reductions in radiation dose delivered by neurointerventional procedures can be achieved through simple modifications of default radiation dose in F and IA and frame rate during CINE without an increase in procedural complexity (fluoroscopy time) or rate of complications.

PF7 Monitoring the radiation dose delivered by the fluoroscopic units with DAP (dose area product) values in locking intra-medullary nailing operations

Injury ◽  
2013 ◽  
Vol 44 ◽  
pp. S39
Author(s):  
T. Ege ◽  
K. Koca ◽  
Y. Yurttas ◽  
M. Kürklü ◽  
H. Özkan ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Dose Area Product ◽  
Medullary Nailing ◽  
Area Product

scholarly journals Development of Diagnostic Reference Levels Using a Real-Time Radiation Dose Monitoring System at a Cardiovascular Center in Korea

2015 ◽  
Vol 28 (6) ◽  
pp. 684-694 ◽  
Author(s):  
Jungsu Kim ◽  
Deoknam Seo ◽  
Inseok Choi ◽  
Sora Nam ◽  
Yongsu Yoon ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Real Time ◽  
Monitoring System ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Monitoring ◽  
Radiation Dose Monitoring ◽  
Cardiovascular Center

AN ASSESSMENT OF RADIATION EXPOSURE DOSES IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION BASED ON ANGIOGRAPHIC RECORDS

2018 ◽  
Vol 183 (4) ◽  
pp. 475-482 ◽  
Author(s):  
M Maghbool ◽  
M A Hosseini
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Dose ◽  
Primary Percutaneous Coronary Intervention ◽  
Standard Dose ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Dose Area Product ◽  
Percutaneous Coronary ◽  
Using Data ◽  
Area Product

Abstract The stochastic and non-stochastic (deterministic) effects of radiation dose in patients undergoing primary percutaneous coronary intervention (PPCI) have been investigated using data recorded by an angiographic monitoring system. A total of 132 patients with acute myocardial infarction referred to the angiography department of Vali-Asr hospital, Fasa, Iran, during the second half of 2016 were recruited. Quantities like dose–area product (DAP), total air kerma (Ka,r) and fluoroscopy time (FT) were calculated and converted into effective dose (ED) and peak skin dose (PSD). The values for Ka,r, DAP and FT equaled 80 399.20 ± 63 312 mGy cm2, 1392.80 ± 1155.373 mGy and 524.11 ± 423.057 s, respectively, which were within the ranges reported in previous studies. After considering standard dose thresholds for Ka,r and PSD, it was revealed that only a small portion of patients had reached these thresholds and exceeded them (<3%). Moreover, ED < 20 mSv for the majority of patients was fairly consistent with results from a recent research in eight Belgian hospitals. It was shown that angiographic records are reliable for assessing radiation dose in patients.

IMPACT OF PELVIC AND RAD-BOARD LEAD SHIELDS ON OPERATOR AND PATIENT RADIATION DOSE IN TRANS-RADIAL CORONARY PROCEDURES

2019 ◽  
Vol 187 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Aida Khaleghi Fard ◽  
Amir Hossein Mohammad Alian ◽  
Leili Pourafkari ◽  
Morteza Ghojazadeh ◽  
Ali Tarighatnia ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Dose Area Product ◽  
Radial Approach ◽  
Cardiac Procedures ◽  
Coronary Procedure ◽  
Patient Doses ◽  
In Trans ◽  
Area Product ◽  
The Cost ◽  
Patient Radiation Dose

Abstract Background Trans-radial approach for cardiac catheterisation procedures has long been associated with high operator and patient radiation dose. The aim of the present study was to determine the effect of pelvic and radial shields on decreasing coronary procedure radiation doses. Methods A total of 418 patients randomly underwent diagnostic and therapeutic cardiac procedures with and without the pelvic and rad-board lead shields during the procedures. The operator and patient doses were then determined by means of a personal dosimeter and dose area product (DAP), respectively. Results The shields decreased the operator radiation dose by 40% in coronary angiography (CA) and by 45% during angioplasty (PCI). These results were achieved at the cost of increased patient radiation dose. Conclusion Pelvic lead shields combined with rad-board shields are highly effective in reducing operator radiation dose in trans-radial approach, but it is only achieved at the cost of increased patient DAP.

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