scholarly journals Radiation distribution in a hybrid operating room, utilizing different X-ray imaging systems: investigations to minimize occupational exposure

2021 ◽  
pp. neurintsurg-2021-018220
Author(s):  
Paulina Cewe ◽  
Robert Vorbau ◽  
Artur Omar ◽  
Adrian Elmi-Terander ◽  
Erik Edström
Keyword(s):  
Radiation Exposure ◽  
Operating Room ◽  
Imaging Systems ◽  
3D Image ◽  
Hybrid Operating Room ◽  
Occupational Radiation Exposure ◽  
X Ray ◽  
Image Guided ◽  
X Ray Imaging ◽  
Occupational Radiation

ObjectivesTo reduce occupational radiation exposure in a hybrid operating room (OR) used for three-dimensional (3D) image guided spine procedures. The effects of staff positioning, different X-ray imaging systems, and freestanding radiation protection shields (RPSs) were considered.MethodsAn anthropomorphic phantom was imaged with a robotic ceiling mounted hybrid OR C-arm cone beam CT (hCBCT), a mobile O-arm CBCT (oCBCT), and a mobile two-dimensional C-arm fluoroscopy system. The resulting scatter doses were measured at different positions in the hybrid OR using active personal dosimeters and an ionization chamber. Two types of RPSs were evaluated.ResultsUsing the hCBCT system instead of the oCBCT system reduced the occupational radiation dose on average by 22%. At 200 cm from the phantom, scatter doses from the hCBCT were 27% lower compared with the oCBCT. One rotational acquisition with hCBCT or oCBCT corresponded to 12 or 16 min of fluoroscopy with the C-arm, respectively. The scatter dose decreased by more than 90% behind an RPS. However, the protection was slightly less effective at 60 cm behind the RPS, due to tertiary scatter from the surroundings.ConclusionsFor 3D image guided spine procedures in the hybrid OR, occupational radiation exposure is lowered by using hCBCT rather than oCBCT. Radiation exposure can also be decreased by optimal staff positioning in the OR, considering distance to the source and positioning relative to the walls, ceiling, and RPS. In this setting and workflow, staff can use RPSs instead of heavy aprons during intraoperative CBCT imaging, to achieve effective whole body dose reduction with improved comfort.

scholarly journals Comparative occupational radiation exposure between fixed and mobile imaging systems

2016 ◽  
Vol 63 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Daniel E. Kendrick ◽  
Claire P. Miller ◽  
Pamela A. Moorehead ◽  
Ann H. Kim ◽  
Henry R. Baele ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Imaging Systems ◽  
Occupational Radiation Exposure ◽  
Mobile Imaging ◽  
Occupational Radiation

Impact of considering non-occupational radiation exposure on the association between occupational dose and solid cancer among French nuclear workers

2017 ◽  
Vol 75 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Lucie Fournier ◽  
Enora Cléro ◽  
Eric Samson ◽  
Sylvaine Caër-Lorho ◽  
Dominique Laurier ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Cancer Risk ◽  
Radiation Exposure ◽  
Cancer Mortality ◽  
Environmental Radiation ◽  
Occupational Radiation Exposure ◽  
X Ray ◽  
Work Related ◽  
The Mean ◽  
Occupational Radiation

ObjectivesThe French nuclear worker cohort allows for the assessment of cancer risk associated with occupational radiation exposure, but workers are also exposed to medical and environmental radiation which can be of the same order of magnitude. This study aims to examine the impact of non-occupational radiation exposures on the dose-risk analysis between occupational radiation exposure and cancer mortality.MethodsThe cohort included workers employed before 1995 for at least one year by CEA, AREVA NC or EDF and badge-monitored for external radiation exposure. Monitoring results were used to calculate occupational individual doses. Scenarios of work-related X-ray and environmental exposures were simulated. Poisson regression was used to quantify associations between occupational exposure and cancer mortality adjusting for non-occupational radiation exposure.ResultsThe mean cumulative dose of external occupational radiation was 18.4 mSv among 59 004 workers. Depending on the hypotheses made, the mean cumulative work-related X-ray dose varied between 3.1 and 9.2 mSv and the mean cumulative environmental dose was around 130 mSv. The unadjusted excess relative rate of cancer per Sievert (ERR/Sv) was 0.34 (90% CI −0.44 to 1.24). Adjusting for environmental radiation exposure did not substantially modify this risk coefficient, but it was attenuated by medical exposure (ERR/Sv point estimate between 0.15 and 0.23).ConclusionsOccupational radiation risk estimates were lower when adjusted for work-related X-ray exposures. Environmental exposures had a very slight impact on the occupational exposure risk estimates. In any scenario of non-occupational exposure considered, a positive but insignificant excess cancer risk associated with occupational exposure was observed.

Operating room radiation exposure in cone beam computed tomography–based, image-guided spinal surgery

2013 ◽  
Vol 19 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Eric W. Nottmeier ◽  
Stephen M. Pirris ◽  
Steven Edwards ◽  
Sherri Kimes ◽  
Cammi Bowman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Operating Room ◽  
Cone Beam Computed Tomography ◽  
Spinal Surgery ◽  
Image Guidance ◽  
Cone Beam ◽  
3D Image ◽  
Image Guided ◽  
Radiation Scatter

Object Surgeon and operating room (OR) staff radiation exposure during spinal surgery is a concern, especially with the increasing use of multiplanar fluoroscopy in minimally invasive spinal surgery procedures. Cone beam computed tomography (cbCT)–based, 3D image guidance does not involve the use of active fluoroscopy during instrumentation placement and therefore decreases radiation exposure for the surgeon and OR staff during spinal fusion procedures. However, the radiation scatter of a cbCT device can be similar to that of a standard 64-slice CT scanner and thus could expose the surgeon and OR staff to radiation during image acquisition. The purpose of the present study was to measure radiation exposure at several unshielded locations in the OR when using cbCT in conjunction with 3D image-guided spinal surgery in 25 spinal surgery cases. Methods Five unshielded badge dosimeters were placed at set locations in the OR during 25 spinal surgery cases in which cbCT-based, 3D image guidance was used. The cbCT device (O-ARM) was used in conjunction with the Stealth S7 image-guided platform. The radiology department analyzed the badge dosimeters after completion of the last case. Results Fifty high-definition O-ARM spins were performed in 25 patients for spinal registration and to check instrumentation placement. Image-guided placement of 124 screws from C-2 to the ileum was accomplished without complication. Badge dosimetry analysis revealed minimal radiation exposure for the badges 6 feet from the gantry in the area of the anesthesiology equipment, as well as for the badges located 10–13 feet from the gantry on each side of the room (mean 0.7–3.6 mrem/spin). The greatest radiation exposure occurred on the badge attached to the OR table within the gantry (mean 176.9 mrem/spin), as well as on the control panel adjacent to the gantry (mean 128.0 mrem/spin). Conclusions Radiation scatter from the O-ARM was minimal at various distances outside of and not adjacent to the gantry. Although the average radiation exposure at these locations was low, an earlier study, undertaken in a similar fashion, revealed no radiation exposure when the surgeon stood behind a lead shield. This simple precaution can eliminate the small amount of radiation exposure to OR staff in cases in which the O-ARM is used.

scholarly journals Occupational Radiation Exposure in Health Care Facilities

2013 ◽  
Vol 10 (3) ◽  
pp. 48-51 ◽  
Author(s):  
Chhavi Raj Bhatt ◽  
A Widmark ◽  
SL Shrestha ◽  
T Khanal ◽  
B Ween
Keyword(s):  
Health Care ◽  
Radiation Exposure ◽  
Background Radiation ◽  
Health Care Facilities ◽  
High Dose ◽  
Occupational Radiation Exposure ◽  
X Ray ◽  
Care Facilities ◽  
Personal Dosimetry ◽  
Occupational Radiation

Background  Radiation, which is used extensively to diagnose and treat human diseases, poses an occupational health risk for the concerned health workers. Personal dosimetry is an important tool to monitor occupational radiation exposures. Objective  This study was conducted to reveal and to describe the situation of occupational radiation exposure monitoring among staffs in different health care facilities in Nepal. Methods  A cross-sectional study was performed among the 35 Health Care Facilities. Information about types and number of X-ray procedures performed, types and number of personnel involved, workload and the availability of personal dosimetry service were collected. Results  Six Health Care Facilities had personal dosimetry service available for a total of 149 personnel. Of a total of nearly one million X-ray procedures performed in the 35 Health Care Facilities in 2007, 76 % was performed by non-monitored personnel. The majority of the facilities performing high dose procedures, like catheterisation, angiography and intestinal barium procedures did not offer personal dosimetry for the involved personnel. Conclusion  There are a limited number of personnel being monitored with personal dosimetry. There are no regulatory dose limits for occupationally exposed staff. Thus, there is an urgent need to establish a national radiation protection authority to regulate the use of radiation in Nepal. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 48-51 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8019

Adult Fingers Visualized on Neonatal Intensive Care Unit Chest Radiographs: What You Don't See

2013 ◽  
Vol 64 (3) ◽  
pp. 236-239 ◽  
Author(s):  
Jordan Russell ◽  
Brent E. Burbridge ◽  
Meghan D. Duncan ◽  
Jennifer Tynan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Radiation Exposure ◽  
Neonatal Intensive Care ◽  
Pediatric Intensive Care ◽  
Occupational Radiation Exposure ◽  
X Ray ◽  
Picture Archiving And Communication ◽  
Occupational Radiation

Purpose In a previous publication, it was revealed that a disturbingly high incidence of adult fingers were seen on pediatric intensive care unit radiographs, an example of inappropriate occupational exposure to diagnostic radiation. The present study examined adult fingers seen on neonatal intensive care unit (NICU) radiographs to assess the frequency of this occupational radiation exposure. During this study, we encountered an unexpected issue. The inappropriately exposed fingers appeared on the raw images but were sometimes cropped during technologist image processing before being sent to the picture archiving and communication system (PACS) for interpretation. Our audit describes the frequency of cropping adult fingers from images before display on PACS, with the intent of unmasking this source of occupational radiation exposure, of which quality assurance personnel may not be aware. Methods At the x-ray workstation, the raw NICU source x-ray images were analysed for the visibility of adult fingers and then were compared with the final processed images sent to PACS by the x-ray technologist. Results Of 230 radiographs audited, 30 (13%) contained fingers directly in the x-ray beam that remained visible on PACS, 22 (10%) contained fingers in the direct beam that were cropped before being sent to PACS for analysis, and 44 (19%) contained fingers in the coned area. Conclusions A significant number of adult fingers are being exposed to radiation during the acquisition of NICU radiographs. Cropping NICU radiographs before sending them to PACS can conceal a significant source of occupational radiation exposure.

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