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 Radiation protection effect of mobile shield barrier for the medical personnel during endoscopic retrograde cholangiopancreatography: a quasi-experimental prospective study

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e027729 ◽  
Author(s):  
Kwang Hyun Chung ◽  
Young Sook Park ◽  
Sang Bong Ahn ◽  
Byoung Kwan Son
Keyword(s):  
Radiation Dose ◽  
Prospective Study ◽  
Radiation Protection ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Personnel ◽  
Secondary Outcome ◽  
Radiation Doses ◽  
Endoscopic Retrograde ◽  
Quasi Experimental ◽  
The Mean

ObjectiveTo investigate the effectiveness of radiation protection offered by a newly designed mobile shield barrier for medical personnel during endoscopic retrograde cholangiopancreatography (ERCP).DesignQuasi-experimental prospective study.SettingERCP procedures conducted between October 2016 and June 2017 at a single secondary referral hospital that performs approximately 250 therapeutic ERCP procedures annually.InterventionsThe mobile shield barrier was a custom-made 2 mm Pb shielding plate (width: 120 cm, height: 190 cm) with a 0.5 mm Pb window (width: 115 cm, height: 60 cm) on its upper part was used. Four wheels were attached to the bottom to allow easy moving.Primary and secondary outcome measuresThe radiation doses were measured during ERCP using personal thermoluminescence dosimetry (TLD) badges on both sides of the mobile shield barrier (patient’s side: TLD1 and medical staff’s side: TLD2). The radiation doses were also measured on the outer surface of the thyroid shield of the endoscopist (TLD3), and on the chest area inside the protective apron of the endoscopist (TLD4) and the main assistant (TLD5). The TLD was changed and reported once every 3 months. The radiation dose measured by TLD badges were compared.ResultsDuring the study period, a total of 128 ERCP procedures were performed. The mean fluoroscopy time per procedure was 244.9±257.0 s and the mean number of digital radiographs per procedure was 3.7±1.0. TLD1 (outside the barrier) had a mean radiation dose of 26.85±3.47 mSv and all the other TLDs (inside the barrier) had less than 1 mSv (p<0.001). In the post hoc analysis, the difference between TLD1 and others showed a statistical significance; however, there were no significant differences between the TLDs inside the barrier.ConclusionOur mobile shield barrier was useful to reduce the radiation exposure of medical personnel during ERCP.

scholarly journals A Comparison of Radiation Exposure During Endoscopic Retrograde Cholangiopancreatography (ERCP) by Different Fluoroscope Techniques

2020 ◽  
Author(s):  
Saleh A. Alghsoon ◽  
Khaled S. Shaban ◽  
Altaf H. Khan ◽  
Fares M. Almeshal ◽  
Sulaimon O. Balogun ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Gastrointestinal Endoscopy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Endoscopic Retrograde ◽  
Dose Area Product ◽  
The Mean ◽  
Level I ◽  
American Society

ABSTRACT Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is a relatively new endoscopic procedure combined with fluoroscopy that is performed for multiple diagnostic and therapeutic indications. It carries a known risk of radiation exposure to patients and staff. We aimed to examine radiation administration techniques and to measure the radiation dose delivered by these techniques. Methods This was a retrospective analysis of 437 ERCP procedures performed at a tertiary care hospital between April 2015 and April 2017. Results A total of 437 ERCP procedural charts were reviewed: fluoroscopy administration was endoscopist controlled (EC, n = 187, 42.79%) or technician controlled (TC, n = 250, 57.21%). The mean (and SD) fluoroscopy time (FT) was 2.107 ± 2.0 minutes. The mean (and SD) dose–area product (DAP) was 15,227.371 ± 16,784.738 Gy·cm2. The degree of ERCP difficulty was evaluated as recommended by the American Society for Gastrointestinal Endoscopy, and graded 1–4. Level I TC procedures had a mean FT and DAP of 1.600 minutes and 12,644.72 Gy·cm2, respectively. The FT and DAP values for level I EC procedures were 1.514 minutes and 12,966.71 Gy·cm2, respectively, as compared with level IV TC procedures (mean FT, 2.539 minutes; mean DAP, 19,469.94 Gy·cm2) and level IV EC procedures (mean FT, 4.890 minutes; mean DAP, 37,921.00 Gy·cm2). Conclusion DAP and FT are increased significantly in EC ERCP in American Society for Gastrointestinal Endoscopy 4 procedures. Comparison of the different degrees of difficulty indicated that there is a linear correlation between the degree of difficulty and both FT and DAP.

scholarly journals Occupational Radiation Exposure during Endoscopic Retrograde Cholangiopancreatography and Usefulness of Radiation Protective Curtains

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tomoyuki Minami ◽  
Tamito Sasaki ◽  
Masahiro Serikawa ◽  
Michihiro Kamigaki ◽  
Masanobu Yukutake ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Medical Personnel ◽  
Radiation Doses ◽  
Endoscopic Retrograde ◽  
Occupational Radiation Exposure ◽  
Staff Members ◽  
The Mean ◽  
High Doses ◽  
Occupational Radiation

Objective. To evaluate the effectiveness of radiation protective curtains in reducing the occupational radiation exposure of medical personnel.Methods. We studied medical staff members who had assisted in 80 consecutive therapeutic endoscopic retrograde cholangiopancreatography (ERCP) procedures. Use of radiation protective curtains mounted to the X-ray tube was determined randomly for each procedure, and radiation doses were measured with electronic pocket dosimeters placed outside the protective apron.Results. When protective curtains were not used, the mean radiation doses to endoscopists, first assistants, second assistants, and nurses were 340.9, 27.5, 45.3, and 33.1 µSv, respectively; doses decreased to 42.6, 4.2, 13.1, and 10.6 µSv, respectively, when protective curtains were used (P<0.01). When the patient had to be restrained during ERCP (n=8), the radiation dose to second assistants without protective curtains increased by a factor of 9.95 (P<0.01) relative to cases in which restraint was not required.Conclusions. During ERCP, not only endoscopists, but also assistants and nurses were exposed to high doses of radiation. Radiation exposure to staff members during ERCP was reduced with the use of protective curtains.

Estimation of Radiation Doses in X-Ray Visualization of Biological Objects

2014 ◽  
Vol 880 ◽  
pp. 53-56 ◽  
Author(s):  
Sergei Stuchebrov ◽  
Andrey Batranin ◽  
Dan Verigin ◽  
Yelena Lukyanenko ◽  
Maria Siniagina ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Biological Object ◽  
Gas Discharge ◽  
Radiation Doses ◽  
Semiconductor Detectors ◽  
Interior Structure ◽  
Dose Calculations ◽  
Object Control ◽  
X Ray ◽  
Biological Objects

Two setups for X-ray visualization of objects interior structure were designed and assembled in TPU. These radiographic systems are based on linear gas-discharge and GaAs semiconductor detectors. During investigation of biological object control of radiation doses has a high priority. In this report radiation dose calculations in X-ray visualization are presented. These calculation also includes dose calculations of sinograms which are used for reconstruction of tomography slices.

Estimation of Radiation Exposure in the Pediatric Cath Lab in Ain Shams University; Cross-Sectional Observational Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Abdelrazik ◽  
Youssef Amin ◽  
Alaa Roushdy ◽  
Maiy El Sayed
Keyword(s):  
Radiation Exposure ◽  
Radiation Dosage ◽  
University Hospital ◽  
Heart Catheterization ◽  
Radiation Doses ◽  
Device Closure ◽  
Cross Sectional ◽  
Dose Area Product ◽  
Area Product ◽  
Hospital Pediatric

Abstract Aim and objectives The aim of the study is to assess the average radiation doses recorded per procedure in Ain Shams University Hospital pediatric cath lab to set benchmarks of radiation exposure in our institute. Patients and Methods The study included 198 patients who presented to Ain Shams cardiac pediatric cath lab who undergone interventional (BPV, BAV, ASD device closure, VSD device closure, PDA coil/device closure, Coarctation Stent/balloon) and diagnostic (Hemodynamics study, Diagnostic cath) heart catheterization. Radiation doses were measured without any interference with the operator’s preferences. Results Radiation dosages were measured in total AirKerma, Dose area product (DAP), and fluoroscopy time to set the benchmarks for radiation exposure in our institute per procedure. VSD device closure showed the highest radiation exposure followed by Coarctation stenting. Lowest radiation dosage was in PDA coil closure followed by ASD device closure then BPV. Conclusion Benchmarks for radiation exposure per procedure in pediatric cath lab in our institute were set and compared to each other.

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