Radiation dose to the interventionalist is directly affected by the operating position

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 149-153 ◽  
Author(s):  
Brant W Ullery ◽  
Bruce Landau ◽  
Grace J Wang ◽  
Ronald M Faifrman ◽  
Edward Y Woo
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Image Intensifier ◽  
Radiation Absorption ◽  
Radiation Doses

We aimed to determine the optimal positioning of the interventionalist with regard to radiation exposure during endovascular aneurysm repairs (EVAR). The radiation absorption of two vascular surgeons and one trainee was prospectively monitored during a series of 10 routine EVARs. Position of the two vascular surgeons varied: surgeon A stood adjacent to the trainee and one person down from the image intensifier (II), whereas surgeon B stood directly across from the trainee at the same level as the II. Surgeon A absorbed significantly less mean body (0.004 mSv versus 0.036 mSv; P = 0.001), eye (0.036 versus 0.222 mSv; P < 0.001) and extremity (0.034 versus 0.212 mSv; P < 0.001) radiation doses compared with surgeon B and also had significantly lower doses of absorbed body (0.004 versus 0.04 mSv; P = 0.047), eye (0.036 versus 0.25 mSv; P = 0.043) and extremity (0.034 versus 0.248 mSv; P = 0.05) radiation relative to the trainee. In conclusion, there is considerable variation in radiation absorption due to the position of the interventionalist relative to the II and other operators. Although positioning of the operator next to the trainee may make it more difficult to assist and teach technical maneuvers, it greatly minimizes radiation exposure to the interventionalist.

The radiation doses and radiation protection on the endoscopic retrograde cholangiopancreatography procedures

2021 ◽  
pp. 20210399
Author(s):  
Mamoru Takenaka ◽  
Makoto Hosono ◽  
Shiro Hayashi ◽  
Tsutomu Nishida ◽  
Masatoshi Kudo
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Radiation Doses ◽  
Average Dose ◽  
Endoscopic Retrograde ◽  
X Ray ◽  
Endoscopic Procedures ◽  
Dose Area Product ◽  
Therapeutic Ercp

Although many interventions involving radiation exposure have been replaced to endoscopic procedure in the gastrointestinal and hepatobiliary fields, there remains no alternative for enteroscopy and endoscopic retrograde cholangiopancreatography (ERCP), which requires the use of radiation. In this review, we discuss the radiation doses and protective measures of endoscopic procedures, especially for ERCP. For the patient radiation dose, the average dose area product for diagnostic ERCP was 14–26 Gy.cm², while it increased to as high as 67–89 Gy.cm² for therapeutic ERCP. The corresponding entrance skin doses for diagnostic and therapeutic ERCP were 90 and 250 mGy, respectively. The mean effective doses were 3– 6 mSv for diagnostic ERCP and 12–20 mSv for therapeutic ERCP. For the occupational radiation dose, the typical doses were 94 μGy and 75 μGy for the eye and neck, respectively. However, with an over-couch-type X-ray unit, the eye and neck doses reached as high as 550 and 450 μGy, with maximal doses of up to 2.8 and 2.4 mGy/procedure, respectively. A protective lead shield was effective for an over couch X-ray tube unit. It lowered scattered radiation by up to 89.1% in a phantom study. In actual measurements, the radiation exposure of the endoscopist closest to the unit was reduced to approximately 12%. In conclusion, there is a clear need for raising awareness among medical personnel involved endoscopic procedures to minimise radiation risks to both the patients and staff.

scholarly journals Evaluation of radiation exposure from fluoroscopic examination in small animal veterinary staff using thermoluminescent dosimeters

2019 ◽  
Vol 64 (No. 6) ◽  
pp. 266-270
Author(s):  
J An ◽  
S Lim ◽  
S Lee ◽  
H Kim ◽  
K Min ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Small Animal ◽  
Radiation Doses ◽  
Thermoluminescent Dosimeters ◽  
Fluoroscopic Examination ◽  
Protection Devices ◽  
Exposure Levels ◽  
A Prospective Study ◽  
Occupational Radiation

The purpose of this study was to evaluate the occupational radiation exposure levels of veterinary staff during fluoroscopic examination using thermoluminescent dosimeters (TLDs). A prospective study was conducted to measure radiation doses in three positioned persons (two restrainers and one observer) using TLDs. The TLDs were placed on the inside and outside of the lead-equivalent protective devices of the panorama mask, thyroid shield, apron and arm shield. The TLDs were placed at five anatomic sites (eye, thyroid, breast, gonad and hand). Radiation exposure was measured in 65 fluoroscopic examinations at 80 kVp and 100 mAs. The doses (mSv) (outside/inside the shield) measured in restrainers A and B and observer C were 3.09/0.59, 3.80/0.65 and 0.63/0.44 in the eye; 2.20/0.73, 1.88/1.10 and 0.79/0.45 in the thyroid; 3.42/0.44, 3.94/2.35 and 0.61/0.34 in the breast; 1.84/0.45, 1.69/0.23 and 0.46/0.36 in the gonad; and 5.56/3.16, 8.29/2.99 and 0.79/0.34 in the hand, respectively. Out of all the lead protection devices, the radiation dose of the hand was the highest in all three participants, with the thyroid radiation dose value being the same as the hand in the observer C. Radiation doses received by the eyes of all three participants were also not negligible. Veterinary workers exposed to radiation through not only radiography but also fluoroscopy should wear protective gear, especially for the eyes.

scholarly journals Radiation Reduction and Protection for Radiosensitive Organs (Lens, Thyroid, and Genital Organs) of Patients Receiving Percutaneous Coronary Intervention—Real-World Measurement of Radiation Dose in a Single Center

2021 ◽  
Vol 8 (8) ◽  
pp. 99
Author(s):  
Wen-Hwa Wang ◽  
Kai-Che Wei ◽  
Wei-Chun Huang ◽  
Yuan-Yin Yen ◽  
Guang-Yuan Mar
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Dose ◽  
Radiation Exposure ◽  
Radiation Protection ◽  
Coronary Intervention ◽  
Frame Rate ◽  
Protective Equipment ◽  
Radiation Doses ◽  
Percutaneous Coronary ◽  
Radiosensitive Organs

Backgrounds: Reducing radiation exposure is the basic principle for performing percutaneous coronary intervention (PCI). Many studies have confirmed the effect of radiation protection for medical staff, but studies about the effectiveness of protection for patients and real measurement of radiation dose in patients’ specific organs are lacking. Aim: To measure the radiation doses absorbed by patients’ radiosensitive organs during PCI and the effectiveness of radiation protection. Methods: A total of 120 patients were included and allocated into three groups as the ratio of 1:1:2. A total of 30 patients received PCI at 15 frames rate per second (fps), 30 patients at 7.5 fps, and 60 patients wore radiation protective hat and glasses during PCI at 7.5 fps. The radiation doses were measured at right eyebrow (lens), neck (thyroid), back (skin), and inguinal area (genital organs) by using thermoluminescent dosimeters (TLDs). Results: Dose-area product (DAP) reduced by 58.8% (from 534,454 ± 344,660 to 220,352 ± 164,101 mGy·cm2, p < 0.001) after reducing the frame rate, without affecting successful rate of PCI. Radiation doses measured on skin, lens, genital organs, and thyroid decreased by 73.3%, 40.0%, 40.0%, and 35.3%, respectively (from 192.58 ± 349.45 to 51.10 ± 59.21; 5.29 ± 4.27 to 3.16 ± 2.73; 0.25 ± 0.15 to 0.15 ± 0.15; and 17.42 ± 12.11 to 11.27 ± 8.52 μSv, p < 0.05). By providing radiation protective equipment, radiation doses at lens and thyroid decreased further by 71.8% and 65.9% (from 3.16 ± 2.73 to 0.89 ± 0.79; 11.27 ± 8.52 to 3.84 ± 3.49 μSv, p < 0.05). Conclusions: By lowering the frame rate and providing protective equipment, radiation exposure in radiosensitive organs can be effectively reduced in patients.

Radiation exposure in patients (pts) with newly diagnosed breast cancer (BC) within first year (yr) from diagnostic procedures (DP).

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 123-123
Author(s):  
Lubna Chaudhary ◽  
Sarah Knapp ◽  
Samuel Hester ◽  
Sijin Wen ◽  
Jie Xiao ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Background Radiation ◽  
Ductal Carcinoma ◽  
Lobular Carcinoma ◽  
Diagnostic Procedures ◽  
Radiation Doses ◽  
X Rays ◽  
Computed Tomographic ◽  
Increased Risk

123 Background: Radiation exposure is associated with an increased risk of secondary cancers. Few studies have examined radiation exposure from DP in BC. Methods: We retrospectively analyzed the cumulative radiation doses (millisievert [mSv]) of routine DP done in 305 pts during the 1st yr following BC diagnosis between Jan 2008-Oct 2010. Data regarding the frequency of DP including mammograms, sentinel lymph node biopsies, X-rays, computed tomographic (CT) and/or positron emission tomographic (PET) scans, MUGA scans and bone scans were collected. Mean radiation doses of DP were obtained from Departments of Nuclear Medicine and Radiation at our institution. Kruskal-Wallis test and post-hoc pairwise comparisons were used to assess the influence of various factors including age, histology, ER/PR (Estrogen/Progesterone) status and stage on the amount of radiation exposure. Results: Mean radiation exposure relative to various factors is shown in the Table. Pts < 40yrs had a significantly higher radiation dose as compared to pts > 60yrs (35.9mSv vs. 19.2mSv; p = 0.009). Pts with DCIS (ductal carcinoma in situ) had a significantly less radiation exposure as compared to IDC (infiltrating ductal carcinoma) and ILC (invasive lobular carcinoma) (8.5mSv vs. 26.7mSv and 22.4mSv respectively; p< 0.0001). Stage ≥ IIB disease was associated with a significantly higher radiation exposure (p< 0.0001). Stage ≥ IIIA was the only factor associated with a higher radiation dose from PET/CTs (p< 0.0001). Conclusions: Radiation exposure from DP is significant in the 1st yr of BC diagnosis, especially for younger and advanced stage pts. Risk is small but relevant, especially in younger pts. [Table: see text]

The Employment of 197Hg EDTA in Kidney Scanning

1965 ◽  
Vol 05 (01) ◽  
pp. 56-67
Author(s):  
I. Pál ◽  
J. Földes ◽  
I. Krasznai
Keyword(s):  
Radiation Dose ◽  
Renal Cortex ◽  
Radiation Doses ◽  
Intravenous Pyelography ◽  
Edta Complex

SummaryThe authors investigated the use of 197Hg EDTA complex for kidney scanning. They describe the physical, biological and toxicological properties of the compound; its distribution within the organism, its excretion with urine and faeces and its uptake by the kidneys. The authors have established that the renal cortex selectively secretes the material which makes it suitable for kidney scanning. Some scintigrams of both normal and pathologic kidneys are presented.Finally a detailed discussion of the dosimetry is included. The radiation doses due to 197Hg EDTA are compared with those due to 203Hg-neohydrin and to intravenous pyelography. This comparison shows clearly that the use of 197Hg EDTA considerably decreases the radiation dose to the patient.

EVALUATION OF OCCUPATIONAL RADIATION EXPOSURE IN A RADIO-DIAGNOSTIC FACILITY IN KATSINA- NIGERIA

2020 ◽  
Vol 4 (2) ◽  
pp. 722-729
Author(s):  
Usman Sani ◽  
Bashir Gide Muhammad ◽  
Dimas Skam Joseph ◽  
D. Z. Joseph
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Short Exposure ◽  
Skin Dose ◽  
Continuous Training ◽  
Short Exposure Time ◽  
Occupational Dose ◽  
Dose Limits ◽  
Radiation Workers ◽  
Occupational Radiation

Poor implementation of quality assurance programs in the radiation industry has been a major setback in our locality. Several studies revealed that occupational workers are exposed to many potential hazards of ionizing radiation during radio-diagnostic procedures, yet radiation workers are often not monitored. This study aims to evaluate the occupational exposure of the radiation workers in Federal Medical Centre Katsina, and to compare the exposure with recommended occupational radiation dose limits. The quarterly readings of 20 thermo-luminescent dosimeters (TLDs') used by the radiation workers from January to December, 2019 were collected from the facility's radiation monitoring archive, and subsequently assessed and analyzed. The results indicate that the average annual equivalent dose per occupational worker range from 0.74 to 1.20 mSv and 1.28 to 2.21 mSv for skin surface and deep skin dose, measured at 10 mm and 0.07 mm tissue depth respectively. The occupational dose was within the recommended national and international limits of 5 mSv per annum or an average of 20 mSv in 5 years. Therefore, there was no significant radiation exposure to all the occupational workers in the study area. Though, the occupational radiation dose is within recommended limit, this does not eliminate stochastic effect of radiation. The study recommended that the occupational workers should adhere and strictly comply with the principles of radiation protection which includes distance, short exposure time, shielding and proper monitoring of dose limits. Furthermore, continuous training of the radiation workers is advised.

Radiation Minimisation and Outcome Maximisation in Cardiac Computed Tomograpy

2010 ◽  
Vol 6 (1) ◽  
pp. 15
Author(s):  
James P Earls ◽  
Jonathon A Leipsic ◽  
◽  
Keyword(s):  
Radiation Dose ◽  
Dose Reduction ◽  
New Technologies ◽  
Cardiac Computed Tomography ◽  
Substantial Reduction ◽  
Radiation Doses ◽  
Tube Current ◽  
Prospective Triggering ◽  
Effective Radiation ◽  
Selection Of

Recent reports have raised general awareness that cardiac computed tomography (CT) has the potential for relatively high effective radiation doses. While the actual amount of risk this poses to the patient is controversial, the increasing concern has led to a great deal of research on new CT techniques capable of imaging the heart at substantially lower radiation doses than was available only a few years ago. Methods of dose reduction include optimised selection of user-defined parameters, such as tube current and voltage, as well as use of new technologies, such as prospective triggering and iterative reconstruction. These techniques have each been shown to lead to substantial reduction in radiation dose without loss of diagnostic accuracy. This article will review the most frequently used and widely available methods for radiation dose reduction in cardiac CT and give practical advice on their use and limitations.

scholarly journals Radiation Dose Reduction in CT Torsion Measurement of the Lower Limb: Introduction of a New Ultra-Low Dose Protocol

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1209
Author(s):  
Gabriel Keller ◽  
Simon Götz ◽  
Mareen Sarah Kraus ◽  
Leonard Grünwald ◽  
Fabian Springer ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Lower Limb ◽  
Low Dose ◽  
Body Volume ◽  
Reconstruction Algorithms ◽  
Pelvic Radiograph ◽  
Lower Radiation Dose ◽  
Median Total Dose ◽  
Image Reconstruction Algorithms

This study analyzed the radiation exposure of a new ultra-low dose (ULD) protocol compared to a high-quality (HQ) protocol for CT-torsion measurement of the lower limb. The analyzed patients (n = 60) were examined in the period March to October 2019. In total, 30 consecutive patients were examined with the HQ and 30 consecutive patients with the new ULD protocol comprising automatic tube voltage selection, automatic exposure control, and iterative image reconstruction algorithms. Radiation dose parameters as well as the contrast-to-noise ratio (CNR) and diagnostic confidence (DC; rated by two radiologists) were analyzed and potential predictor variables, such as body mass index and body volume, were assessed. The new ULD protocol resulted in significantly lower radiation dose parameters, with a reduction of the median total dose equivalent to 0.17 mSv in the ULD protocol compared to 4.37 mSv in the HQ protocol (p < 0.001). Both groups showed no significant differences in regard to other parameters (p = 0.344–0.923). CNR was 12.2% lower using the new ULD protocol (p = 0.033). DC was rated best by both readers in every HQ CT and in every ULD CT. The new ULD protocol for CT-torsion measurement of the lower limb resulted in a 96% decrease of radiation exposure down to the level of a single pelvic radiograph while maintaining good image quality.

Evaluation of Velopharyngeal Closure Function With 4-Dimensional Computed Tomography and Assessment of Radiation Exposure in Pediatric Patients: A Cross-Sectional Study

2021 ◽  
pp. 105566562110017
Author(s):  
Yoshikazu Kobayashi ◽  
Masanao Kobayashi ◽  
Daisuke Kanamori ◽  
Naoko Fujii ◽  
Yumi Kataoka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Exposure ◽  
Exposure Dose ◽  
Velopharyngeal Insufficiency ◽  
Radiation Doses ◽  
Secondary Surgery ◽  
Cross Sectional ◽  
Computed Tomography Images ◽  
Velopharyngeal Closure ◽  
Closure Function

Objective: Some patients with cleft palate (CP) need secondary surgery to improve functionality. Although 4-dimensional assessment of velopharyngeal closure function (VPF) in patients with CP using computed tomography (CT) has been existed, the knowledge about quantitative evaluation and radiation exposure dose is limited. We performed a qualitative and quantitative assessment of VPF using CT and estimated the exposure doses. Design: Cross-sectional. Setting: Computed tomography images from 5 preoperative patients with submucous CP (SMCP) and 10 postoperative patients with a history of CP (8 boys and 7 girls, aged 4-7 years) were evaluated. Patients: Five patients had undergone primary surgery for SMCP; 10 received secondary surgery for hypernasality. Main Outcome Measures: The presence of velopharyngeal insufficiency (VPI), patterns of velopharyngeal closure (VPC), and cross-sectional area (CSA) of VPI was evaluated via CT findings. Organ-absorbed radiation doses were estimated in 5 of 15 patients. The differences between cleft type and VPI, VPC patterns, and CSA of VPI were evaluated. Results: All patients had VPI. The VPC patterns (SMCP/CP) were evaluated as coronal (1/4), sagittal (0/1), circular (1/2), and circular with Passavant’s ridge (2/2); 2 patients (1/1) were unevaluable because of poor VPF. The CSA of VPI was statistically larger in the SMCP group ( P = .0027). The organ-absorbed radiation doses were relatively lower than those previously reported. Conclusions: Four-dimensional CT can provide the detailed findings of VPF that are not possible with conventional CT, and the exposure dose was considered medically acceptable.

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