scholarly journals Repeated Pelvic Radiographs in Infants, After Harness Treatment for Developmental Dysplasia of the Hip, Carry Very Low Radiation Risk

2021 ◽  
Author(s):  
Elizabeth Vogel ◽  
Thomas Leaver ◽  
Fiona Wall ◽  
Ben Johnson ◽  
Michael Uglow ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Radiation Risk ◽  
Low Risk ◽  
Lifetime Risk ◽  
Body Region ◽  
Pavlik Harness ◽  
Pelvic Radiographs ◽  
Risk Of Malignancy ◽  
The Mean

Abstract Objective There are no data on the effect of X-Ray irradiation to the vulnerable pelvic organs of babies during DDH follow-up. This study aims to calculate, for the first time, the radiation exposure to infants during follow-up for DDH harness treatment, and thus quantify the lifetime risk of malignancy. Methods Patients who had completed 5 years’ follow-up following successful Pavlik harness treatment were identified from the hospital DDH database. The radiation dose was extracted from the Computerised Radiology Information System database for every radiograph of every patient. The effective dose (ED) was calculated using conversion coefficients for age, sex and body region irradiated. Cumulative ED was compared to Health Protection Agency standards to calculate lifetime risk of malignancy from the radiographs. Results All radiographs of 40 infants, successfully treated in Pavlik harness for DDH, were assessed. The mean number of AP pelvis radiographs was 7.00 (range: 6–9, mode: 7). The mean cumulative ED was 0.25 mSv (Range: 0.11–0.46, SD: 0.07). This is far lower than the annual ‘safe’ limit for healthcare workers of 20 mSv and is categorised as “Very Low Risk”. Conclusion Clinicians involved in the treatment DDH can be re-assured that the cumulative radiation exposure from pelvic radiographs following Pavlik harness treatment is “Very Low Risk”. Whilst being mindful of any radiation exposure in children, this study provides a scientific answer that help addresses parental concerns.

scholarly journals Radiation dose from common radiological investigations and cumulative exposure in children with cystic fibrosis: an observational study from a single UK centre

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e017548 ◽  
Author(s):  
Rebecca Ward ◽  
William D Carroll ◽  
Paula Cunningham ◽  
Sheng-Ang Ho ◽  
Mary Jones ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Cumulative Exposure ◽  
X Rays ◽  
Modern Equipment ◽  
Increased Risk ◽  
Risk Of Malignancy ◽  
The Mean ◽  
Cumulative Radiation Exposure

ObjectivesCumulative radiation exposure is associated with increased risk of malignancy. This is important in cystic fibrosis (CF) as frequent imaging is required to monitor disease progression and diagnose complications. Previous estimates of cumulative radiation are outdated as the imaging was performed on older equipment likely to deliver higher radiation. Our objectives were to determine the radiation dose delivered to children during common radiological investigations using modern equipment and to identify the number of such investigations performed in a cohort of children with CF to calculate their cumulative radiation exposure.Design, setting and participantsData including age at investigation and radiation exposure measured as estimated effective dose (EED) were collected on 2827 radiological studies performed on children at one UK paediatric centre. These were combined with the details of all radiological investigations performed on 65 children with CF attending the same centre to enable calculation of each child’s cumulative radiation exposure.ResultsThe mean EED for the common radiological investigations varied according to age. The range was 0.01–0.02 mSv for chest X-rays, 0.03–0.11 mSv for abdominal X-rays, 0.57–1.69 mSv for CT chest, 2.9–3.9 mSv for abdominal and pelvic CT, 0.20–0.21 mSv for sinus CT and 0.15–0.52 mSv for fluoroscopy-guided procedures. The mean EED was three to five times higher for helical compared with axial chest CT scans. The mean annual cumulative EED for our cohort of children with CF was 0.15 mSv/year with an estimated cumulative paediatric lifetime EED (0–18 years) of 3.5 mSv.ConclusionsThis study provides up-to-date estimations of the radiation exposure when using common radiological investigations. These doses and the estimates of cumulative radiation exposure in children with CF are lower than previously reported. This reflects the reduced EED associated with modern equipment and the use of age-specific scanning protocols.

scholarly journals Diagnostic Radiation Exposure in Patients with Inflammatory Bowel Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Catherine Langevin ◽  
Lysanne Normandeau ◽  
Mickael Bouin
Keyword(s):  
Inflammatory Bowel Disease ◽  
Radiation Exposure ◽  
Bowel Disease ◽  
Indeterminate Colitis ◽  
Number Of Patients ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Effects Of Radiation ◽  
And Control

Background. Because of the chronic and relapsing nature of inflammatory bowel disease (IBD), which often requires characterization with CT scan, IBD patients might be exposed to a large amount of radiation. As a cumulative effective dose (CED) ≥ 100 mSv is considered significant for stochastic risks of cancer, it is important to monitor and control the radiation exposure of the IBD patients. In the present work, we aimed to quantify the mean CED in IBD patients to assess any harmful effects of radiation. Methods. This study includes 200 IBD patients, identified retrospectively, from the outpatient clinics of the Centre Hospitalier de l’Université de Montréal between January 1, 2010, and February 15, 2017, from the gastroenterologists’ patients lists. The number and type of each radiology test performed were listed for each patient during the study period and the CED was calculated using our institution’s dose index when available and standardized tables. Results. Among the 200 IBD patients, 157 patients had Crohn’s disease (CD), 41 had ulcerative colitis (UC), and 2 had indeterminate colitis. The mean CED for IBD patients was 23.1 ± 45.2 mSv during a mean follow-up duration of 4.3 years. CED was higher among patients with CD than with UC (27.5 ± 49.5 versus 6.8 ± 14.8 mSv; p<0.01). Six patients were exposed to a high CED (>100 mSv) and all had CD. Conclusion. While potentially harmful levels of radiation exposure are of concern in only a small number of patients, strategies to limit such exposure are encouraged when clinically appropriate.

scholarly journals Minimal fluoroscopic approaches and factors associated with radiation dose when high-definition mapping is used for supraventricular tachycardia ablation: insight from the CHARISMA registry

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
C La Greca ◽  
FM Cauti ◽  
A Piro ◽  
N Di Belardino ◽  
M Anselmino ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Supraventricular Tachycardia ◽  
Right Atrial ◽  
High Dose ◽  
Inverse Association ◽  
High Definition ◽  
Factors Associated ◽  
Mapping System ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background Limited data exist on factors associated with radiation exposure during ablation procedures when a high definition mapping technology is used. Purpose To report factors associated with radiation exposure and data on feasibility and safety of a minimal fluoroscopic approach using the Rhythmia mapping system in supraventricular tachycardia (SVT) ablation procedures. Methods Consecutive patients indicated for arrhythmia ablation were enrolled in the CHARISMA study at 12 centers. We included in this analysis consecutive right-side procedures performed through a minimal fluoroscopy approach with the Rhythmia mapping system were analyzed. A 3D geometry of chambers of interest was reconstructed on the basis of the electroanatomic information taken from the mapping system. Fluoroscopy was used only if deemed necessary. The effective dose (ED) was calculated using accepted formula. For our purpose high dose exposure was defined as an ED greater than the median value of ED of the population exposed to radiation. Results This analysis included 325 patients (mean age = 56 ± 17 years, 57% male) undergoing SVT procedures (152 AVNRT, 116 AFL, 41 AP and 16 AT). During the study, 27481 seconds of fluoroscopy was used (84.6 ± 224 seconds per procedure), resulting in a mean equivalent ED of 1.1 ± 3.7 mSv per patient. The mean reconstructed RA volume was 99 ± 54 ml in a mean mapping time of 12.2 ± 7 min. The mean number of radiofrequency ablations (RFC) to terminate each arrhythmia was 9.4 ± 9 (mean RFC delivery time equal to 6.7 ± 6 min). 192 procedures (59.1%) were completed without any use of fluoroscopy; during the remaining 133 procedures (39.9%), 206.6 ± 313.4 seconds of fluoroscopy was used (median ED = 1.2 mSv). In a minority of the cases (n = 25, 7.7%) the fluoroscopy time was higher than 5 minutes (median ED = 6.5 mSv), whereas radiologic exposure time greater than 1 minute occurred in ninety cases (27.7%, median ED = 2.1 mSv). On multivariate logistic analysis adjusted for baseline confounders the RFC application time (OR = 1.0014, 95%CI: 1.0007 to 1.0022; p = 0.0001) was independently associated to an ED greater than 1.2 mSv, whereas female gender had an inverse association (0.54, 0.29 to 0.98; p = 0.0435). Acute success was reached in 97.8% of the cases. During a mean of 290.7 ± 169.6 days follow-up, no major adverse events related to the procedure were reported. Overall, the recurrence rate of the primary arrhythmia during follow-up was 2.5%. Conclusions In our experience, arrhythmias ablation through minimal fluoroscopy approach with the use of a novel ablation technology is safe, feasible, and effective in common right atrial arrhythmias. High-dose exposure occurred in a very limited number of cases, without any reduction of the safety and acute and long-term effectiveness profile.

scholarly journals Can we expand the borders in active surveillance for low-risk prostate cancer?

2018 ◽  
Vol 12 (1) ◽  
pp. 54-59
Author(s):  
Ekrem Islamoglu ◽  
Erdem Kisa ◽  
Cem Yucel ◽  
Orcun Celik ◽  
Ozgur Cakmak ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Low Risk ◽  
Significant Difference ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
The Mean

Purpose: We assessed the outcomes of men with low-risk prostate cancer enrolled in active surveillance. Methods: From January 2008, patients in our clinic who were classified as having low-risk prostate cancer according to the D’Amico classification were included in the protocol. Follow-up consisted of regular prostate-specific antigen tests, digital rectal examinations and biopsies. Outcomes were compared between men who progressed and those who did not, and survival analysis was obtained. Results: The mean follow-up period was 46 months. A total of six patients received curative treatment during follow-up as a result of meeting progression criteria. The mean follow-up time from the beginning of active surveillance until curative therapy was 27.1 months. Four of our 64 patients lost their lives due to diseases other than prostate cancer, none of the patients were lost due to prostate cancer. When patients who showed progression and those who did not were compared in terms of positive core numbers and the core tumour percentage we found no significant difference between the two groups ( P>0.05) Conclusion: Active surveillance seems to be a safe and feasible practice in men with low-risk prostate cancer. Gleason score, clinical stage and initial prostate-specific antigen seem to be the most definite criteria for the selection of patients, while it is thought that the number of positive cores is a matter that can be dealt with more flexibility. Level of evidence: Not applicable for this multicentre audit.

Nasopharyngeal Radium Irradiation: Fundamental Considerations

1996 ◽  
Vol 115 (5) ◽  
pp. 399-402
Author(s):  
Henry D. Royal
Keyword(s):  
Radiation Exposure ◽  
Lifetime Risk ◽  
Quantitative Risk Assessment ◽  
Risks And Benefits ◽  
Asymptomatic Patients ◽  
Medical Benefits ◽  
Carcinogenic Effects ◽  
Γ Rays ◽  
Effects Of Radiation

This article discusses the potential carcinogenic effects of radiation exposure from nasopharyngeal radium irradiation exposure and issues to consider when deciding whether to recommend screening for asymptomatic patients who have been treated by nasopharyngeal radium irradiation. The radiation exposure from the radium is primarily the result of γ-rays, which are very penetrating. β-Particles would affect only the tissues located within 1 cm of the eustachian tube orifice. On the basis of a quantitative risk assessment, the lifetime risk of brain cancer developing was estimated to be approximately 3 per 1000 persons, and the lifetime risk of a fatal cancer 5.6 per 1000 persons. When the medical benefits of screening asymptomatic patients are assessed, several factors, including the medical risks and benefits and cost-effectiveness of follow-up, should be considered.

scholarly journals Assessment of breast cancer risk among Iraqi women in 2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hashim Talib Hashim ◽  
Mustafa Ahmed Ramadhan ◽  
Kabas Monther Theban ◽  
John Bchara ◽  
Ahed El-Abed-El-Rassoul ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Low Risk ◽  
Lifetime Risk ◽  
Gail Model ◽  
Breast Cancer Risk Assessment ◽  
Iraqi Women ◽  
The Mean

Abstract Background Breast cancer is one of the most common cancers among women worldwide and the leading cause of death among Iraqi women. Breast cancer cases in Iraq were found to have increased from 26.6/100,000 in 2000 to 31.5/100,000 in 2009. The present study aims to assess the established risk factors of breast cancer among Iraqi women and to highlight strategies that can aid in reducing the incidence. Methods 1093 Iraqi females were enrolled in this cross-sectional study by purposive sampling methods. Data collection occurred from July 2019 to September 2019. 1500 women participated in the study, and 407 women were ultimately excluded. The questionnaire was conducted as a self-administrated form in an online survey. Ethical approval was obtained from the College of Medicine in the University of Baghdad. The Gail Model risk was calculated for each woman by the Breast Cancer Risk Assessment Tool (BCRAT), an interactive model developed by Mitchell Gail that was designed to estimate a woman’s absolute risk of developing breast cancer in the upcoming five years of her life and in her lifetime. Results The ages of the participants ranged from 35 to 84 years old. The mean 5–year risk of breast cancer was found to be 1.3, with 75.3% of women at low risk and 24.7% of women at high risk. The mean lifetime risk of breast cancer was found to be 13.4, with 64.7% of women at low risk, 30.3% at moderate risk, and 5.0% at high risk. The results show that geographically Baghdad presented the highest 5-year risk, followed by Dhi Qar, Maysan, and Nineveh. However, the highest lifetime risk was found in Najaf, followed by Dhi Qar, Baghdad, and Nineveh, successively. Conclusion Breast cancer is a wide-spreading problem in the world and particularly in Iraq, with Gail Model estimations of high risk in several governorates. Prevention programs need to be implemented and awareness campaigns organized in order to highlight the importance of early detection and treatment.

scholarly journals Occupational Radiation Exposure to Workers Used18F-FDG

2019 ◽  
Vol 29 (4) ◽  
pp. 100
Author(s):  
Ahmed Ali Wabdan
Keyword(s):  
Radiation Exposure ◽  
Radiation Risk ◽  
Whole Body ◽  
Thermoluminescent Dosimeters ◽  
Medical Physicist ◽  
Positron Emission ◽  
Pet Ct ◽  
Medical Physicists ◽  
The Mean ◽  
18F Fdg

The increasing interest of medical institutes in the development of imaging services to include the hybrid system [Positron Emission Tomography combined with Computed Tomography(PET/CT)], this system is acquiring explosive growth due to its ability to accurately detect and stage many types of cancer and follow the progress of treatments. An increasing demand for use of (18F-FDG PET) in oncology has been the main reason for its growth. The physical characteristics of positron emissions result in higher radiation risk for staff and growing use of PET/CT for diagnostic purposes increase radiation exposure. The objective of this study was to estimate the radiation exposure to the medical physicists, technicians and nurses working in three Egyptian nuclear medicine institutes under our investigations, based on the whole body collective dose measured by thermoluminescent dosimeters (TLDs) and the effective dose per study received by medical staff were measured by electronic pocked dosimeters and the finger doses by ring dosimeter during a period of six months. The (mean± SD) dose measured per PET/CT procedure were (2.45±0.137, 3.22±0.218 and 1.69±0.11) μSv for the medical physicist, technician and nurse respectively. The (mean± SD) dose measured per MBq of 18F-FDG were (7.35±0.43, 9.73±0.66 and 5.13±0.33) nSv/MBq for the medical physicist, technician and nurse respectively. The (mean± SD) finger dose measured per 18F-FDGPET/CT scans were (179.9±24.94, 8.82±2.912 and 24.15±4.164) μSv for the medical physicist, technician and nurse respectively.

scholarly journals Radiation Exposure Associated with Endovascular Aortic Repair and the Lifetime Risk of Malignancy

2019 ◽  
Vol 58 (6) ◽  
pp. e551
Author(s):  
Azeem Alam ◽  
Richard Harbron ◽  
Mohamed Abdelhalim ◽  
Ashish Patel ◽  
Elizabeth Ainsbury ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Endovascular Aortic Repair ◽  
Lifetime Risk ◽  
Aortic Repair ◽  
Risk Of Malignancy

Patient-initiated follow-up for low-risk endometrial cancer: a cost-analysis evaluation

2020 ◽  
Vol 30 (7) ◽  
pp. 1000-1004
Author(s):  
Iqra Luqman ◽  
Rochelle Wickham-Joseph ◽  
Nicola Cooper ◽  
Louise Boulter ◽  
Nafisa Patel ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Low Risk ◽  
Financial Benefit ◽  
Time Saving ◽  
Primary Surgery ◽  
Time Distance ◽  
The Mean ◽  
Telephone Calls ◽  
Potential Impact

ObjectiveRisk stratification has resulted in patient-initiated follow-up being introduced for low-risk endometrial cancer in place of routine hospital follow-up. The financial benefit to the patient and the healthcare economy of patient-initiated follow-up, as compared with hospital follow-up, has yet to be explored. In this study, we explored the potential impact for both the healthcare economy and patients of patient-initiated follow-up.MethodsWomen diagnosed with low-risk endometrial cancer enrolled on a patient-initiated follow-up scheme between November 2014 and September 2018 were included. Data on the number of telephone calls to the nurse specialists and clinic appointments attended were collected prospectively. The number of clinic appointments that would have taken place if the patient had continued on hospital follow-up, rather than starting on patient-initiated follow-up, was calculated and costs determined using standard National Health Service (NHS) reference costs. The time/distance traveled by patients from their home address to the hospital clinic was calculated and used to determine patient-related costs.ResultsA total of 187 patients with a median of 37 (range 2–62) months follow-up after primary surgery were enrolled on the scheme. In total, the cohort were scheduled to attend 1673 appointments with hospital follow-up, whereas they only attended 69 clinic appointments and made 107 telephone contacts with patient-initiated follow-up. There was a 93.5% reduction in costs from a projected £194 068.00 for hospital follow-up to £12 676.33 for patient-initiated follow-up. The mean patient-related costs were reduced by 95.6% with patient-initiated follow-up. The total mileage traveled by patients for hospital follow-up was 30 891.4 miles, which was associated with a mean traveling time per patient of 7.41 hours and clinic/waiting time of 7.5 hours compared with 1165.8 miles and 0.46 hours and 0.5 hours, respectively, for patient-initiated follow-up.ConclusionThe introduction of a patient self-management follow-up scheme for low-risk endometrial cancer was associated with financial/time saving to both the patient and the healthcare economy as compared with hospital follow-up.

scholarly journals P003: Do all clavicle fractures in children need to be managed by orthopaedic surgeons?

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S79-S79
Author(s):  
J.S. Adamich ◽  
M. Camp ◽  
A. Howard
Keyword(s):  
Radiation Exposure ◽  
Healthcare System ◽  
Care Pathway ◽  
Clinical Care ◽  
Initial Assessment ◽  
Radiology Department ◽  
Fractures In Children ◽  
Clavicle Fractures ◽  
The Mean

Introduction: Although many uncomplicated pediatric fractures do not require routine long-term follow-up with an orthopedic surgeon, practitioners with limited experience dealing with pediatrics fractures will often defer to a strategy of frequent clinical and radiographic follow-up. Development of an evidence-based clinical care pathway can help unnecessary radiation exposure to this patient population and reduce costs to patient families and the healthcare system. Methods: A retrospective analysis including patients who presented to the Hospital for Sick Children (SickKids) for management of clavicle fractures was performed. Results: Three hundred and forty patients (227 males, 113 females) with an average age of 8.1 (range 0.1-17.8) were included in the study. The mean number of clinic visits including initial consultation in the emergency department was 2.1 (±1.3). The mean number of radiology department appointments was 1.8 (±1.3) where patients received a mean number of 4.2 (±3.0) radiographs. Complications were minimal; 2 refractures in our series and no known cases of non-union. All patients achieved clinical and radiographic union and returned to sport after fracture healing. Conclusion: Our series suggests that the decision to treat operatively is made at the initial assessment. If no surgical indications were present at the initial assessment by the primary-care physician, then routine clinical or radiographic follow up is unnecessary. Our paediatric clavicle fracture pathway will reduce patient radiation exposure and reduce costs incurred by the healthcare system and patients’ families without jeopardizing patient outcomes.

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