O151 Fluoroscopy time is a poor predictor of radiation dose during biventricular device implantation; proposed diagnostic reference levels from a large U.K. case series

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e41
Author(s):  
Gwilym M. Morris ◽  
Zena Salih ◽  
Gareth J. Wynn ◽  
Fozia Ahmed ◽  
Benjamin D. Brown ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Case Series ◽  
Fluoroscopy Time ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Device Implantation ◽  
Poor Predictor

Diagnostic Reference Levels for Common Orthopedic Hand and Wrist Procedures Using Intraoperative mini C-arm Fluoroscopy

Hand ◽  
2021 ◽  
pp. 155894472199425
Author(s):  
Kiran R. Madhvani ◽  
Matthew J. R. Clark ◽  
Alex A. J. Kocheta
Keyword(s):  
Radiation Dose ◽  
Fracture Fixation ◽  
Wrist Fracture ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Audit Data ◽  
Small Joint ◽  
Open Fixation ◽  
Phalangeal Fracture

Background: Diagnostic reference levels are radiation dose levels in medical radiodiagnostic practices for typical examinations for groups of standard-sized individuals for broadly defined types of equipment. This study aimed to contribute to national diagnostic reference levels for common hand and wrist procedures using mini C-arm fluoroscopy. Small joint and digital fracture procedure diagnostic reference levels have not been reported in significant numbers previously with procedure-level stratification. Methods: Data were collected from fluoroscopy logbooks and were cross-referenced against the audit log kept on fluoroscopy machines. A total of 603 procedures were included. Results: The median radiation dose for wrist fracture open fixation was 2.73 cGycm2, Kirschner wiring (K-wiring) procedures was 2.36 cGycm2, small joint arthrodesis was 1.20 cGycm2, small joint injections was 0.58 cGycm2, and phalangeal fracture fixation was 1.05 cGycm2. Conclusions: Wrist fracture fixation used higher radiation doses than phalangeal fracture fixation, arthrodeses, and injections. Injections used significantly less radiation than the other procedures. There are significant differences in total radiation doses when comparing these procedures in hand and wrist surgery. National and international recommendations are that institutional audit data should be collected regularly and should be stratified by procedure type. This study helps to define standards for this activity by adding to the data available for wrist fracture diagnostic reference levels and defining standards for digital and injection procedures.

Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

2021 ◽  
Vol 17 (3) ◽  
pp. 216-221
Author(s):  
Fawad Yasin ◽  
Anum Rasheed ◽  
Muhammad Nauman Malik ◽  
Farheen Raza ◽  
Ramish Riaz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
European Commission ◽  
Large Scale ◽  
Radiology Department ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Length Product ◽  
Ct Dose

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length

scholarly journals Use of the Magellan Robotic System for Conventional Transarterial Chemoembolization (cTACE): A 6-Patient Case Series Showing Safety and Technical Success

2019 ◽  
Vol 03 (02) ◽  
pp. 142-146 ◽  
Author(s):  
Warren Clements ◽  
Madeleine Scicchitano ◽  
Jim Koukounaras ◽  
Tim Joseph ◽  
Gerard S. Goh
Keyword(s):  
Radiation Dose ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
First Generation ◽  
Case Series ◽  
Fluoroscopy Time ◽  
Technical Success ◽  
Catheter Tip ◽  
Further Development ◽  
Generation Technology

AbstractRobotic endovascular technology is an emerging concept, and is being developed to allow more precise navigation of anatomy in challenging endovascular cases. The Magellan Endovascular System allows either direct or remote steerability of a 2-point articulating robotic platform with the ability to place a conventional microcatheter through the catheter tip. Such flexibility may help to reach an otherwise difficult anatomic location, especially in variant anatomy. To date, this platform has been shown to be technically successful in a small number of different settings. This case series shows another potential platform for such technology and explores the technical use and overall safety in conventional transarterial chemoembolization (cTACE). The study retrospectively assessed 6 patients undergoing selective cTACE. Treatments were performed in a single center by two experienced interventional radiologists. Fluoroscopy time, radiation dose, anatomic target, and adverse events were logged. In spite of a longer than expected average fluoroscopy time, which can be expected for a first-generation technology, the average radiation dose was comparable to literature and technical success was able to be shown in all 6 patients with no adverse events. This technology has wide scope for future use and once overcoming a learning curve, may allow us to avoid repeat procedure attempts thus reducing fluoroscopy time and leading to earlier successful treatment. Providing a platform of interest and usability in the interventional radiology world may also lead to further development of smaller, cheaper, and more widely-accessible devices.

Identifying Institutional Diagnostic Reference Levels for CT with Radiation Dose Index Monitoring Software

Radiology ◽  
2015 ◽  
Vol 276 (2) ◽  
pp. 507-517 ◽  
Author(s):  
Kate MacGregor ◽  
Iris Li ◽  
Timothy Dowdell ◽  
Bruce G. Gray
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Monitoring Software ◽  
Dose Index

CT radiation dose in children: a survey to establish age-based diagnostic reference levels in MITERA hospital (a private Mediterranean hospital)

2014 ◽  
Vol 30 ◽  
pp. e43
Author(s):  
Tagkalakis Panayiotis ◽  
Zabelis Ioannis ◽  
Trimis Panayiotis ◽  
Tsatsaronis Konstantinos ◽  
Papaioannou Georgia ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Ct Radiation

scholarly journals Multicentric survey of patient doses in fluoroscopy guided diagnostic and interventional cardiac procedures: comparison with Diagnostic Reference Levels and follow-up levels for patients at risk for radiation induced skin effects

2020 ◽  
Vol 26 (1) ◽  
pp. 44-52
Author(s):  
Anna Zagorska ◽  
Desislava Ivanova ◽  
Dessislava Kostova-Lefterova ◽  
Filip Simeonov ◽  
Valeri Gelev ◽  
...  
Keyword(s):  
At Risk ◽  
Coronary Intervention ◽  
Fluoroscopy Time ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Cardiac Procedures ◽  
Patients At Risk ◽  
Radiation Induced ◽  
Patient Doses

Introduction. Interventional cardiac procedures are often associated with high patient exposure and therefore require special care in protecting patients from radiation-induced effects. Materials and methods. A retrospective study of typical patients’doses was performed in nine hospitals, with a total number of fourteen angiography systems. The typical values for kerma-area product (KAP), cumulative dose (CD) and fluoroscopy time (FT) for two of the most commonly performed procedures - percutaneous coronary intervention (PCI) and coronary arteriography (CA), were calculated and compared with the Bulgarian National Diagnostic Reference Levels (NDRL). Data analysis, regarding the risk of radiation-induced skin effects due to interventional cardiac procedures, was performed. Aim. 1) to present and analyze the typical KAP values for PCI and CA procedures in cardiology departments with high workload and to compare them with the NDRL; 2) to compare the patient doses with the follow-up levels published in Ordinance 2, to identify patients at risk for radiation-induced effects. Results. The results show that typical values for PCI and CA procedures for some of the angiography systems are higher than the NDRL. In all investigated departments there are patients with at least one exceeded follow-up level for PCI. Conclusions. The results show a potential for optimization in the departments with both high or very low typical dose or FT values. No radiation-induced effect was observed in the followed-up group of patients. The introduction of procedure with "Instruction to the patient after an interventional cardiac procedure(s) with greater complexity and a long fluoroscopy time" for patient follow-up and its regular implementation into the routine clinical practice will help for timely diagnosis and treatment of radiation-induced skin effects after cardiac procedures under fluoroscopy control.

PROPOSAL FOR LOCAL DIAGNOSTIC REFERENCE LEVELS IN GENERAL RADIOGRAPHY IN JAPAN

2019 ◽  
Author(s):  
Yasuki Asada ◽  
Koji Ono ◽  
Yuya Kondo ◽  
Kazuma Sugita ◽  
Takuma Ichikawa ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Dose Distributions ◽  
X Ray ◽  
Non Invasive ◽  
Air Kerma ◽  
Aichi Prefecture

Abstract The present study aimed to propose local diagnostic reference levels (DRLs) formulated by calculating entrance surface doses for general radiography at 20 facilities of Aichi prefecture in Japan, by comparing these values with DRLs established in Japan in 2015 (DRLs 2015) and assessing radiation dose differences among facilities. X-ray outputs (half-value layer and air kerma) of each facility were measured with a non-invasive type of detector. The results were employed to formulate local DRLs based on the 75th percentiles of dose distributions. These local DRLs were lower than the DRLs 2015 for all examinations. If proposed local DRLs from other 46 prefectures can be collected, this paper can be used to benefit the next effort to draft better DRL for Japan.

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