A Mathematical Approach Evaluation of Dose Area Product (DAP) Using to Patients Undergoing Intravenous Urography Examinations in Addis Ababa, Ethiopia

OBJECTIVEIntraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study.METHODSPatients were retrospectively included if a thoracolumbar 3D scan was performed intraoperatively between 2016 and 2019 using a 3D C-arm with a large 30 × 30–cm flat-panel detector (3D scan volume 4096 cm3) or a 3D C-arm with a smaller 20 × 20–cm flat-panel detector (3D scan volume 2097 cm3), and the dose area product was available for the 3D scan. Additionally, the fluoroscopy time and the number of fluoroscopic images per 3D scan, as well as the BMI of the patients, were recorded.RESULTSThe authors compared 62 intraoperative thoracolumbar 3D scans using the 3D C-arm with a large flat-panel detector and 12 3D scans using the 3D C-arm with a small flat-panel detector. Overall, the 3D C-arm with a large flat-panel detector required more fluoroscopic images per scan (mean 389.0 ± 8.4 vs 117.0 ± 4.6, p < 0.0001), leading to a significantly higher dose area product (mean 1028.6 ± 767.9 vs 457.1 ± 118.9 cGy × cm2, p = 0.0044).CONCLUSIONSThe novel, noninvasive patient tracker mask facilitates intraoperative 3D navigation while eliminating the need for an additional skin incision with detachment of the autochthonous muscles. However, the use of this patient tracker mask requires a larger intraoperative 3D image data set for accurate registration, resulting in a 2.25 times higher radiation exposure to the patient. The use of the patient tracker mask should thus be based on an individual decision, especially taking into considering the radiation exposure and extent of instrumentation.

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Accuracy of a dose-area product compared to an absorbed dose to water at a point in a 2 cm diameter field

Medical Physics ◽

10.1118/1.4953207 ◽

2016 ◽

Vol 43 (7) ◽

pp. 4085-4092 ◽

Cited By ~ 4

Author(s):

S. Dufreneix ◽

A. Ostrowsky ◽

B. Rapp ◽

J. Daures ◽

J. M. Bordy

Keyword(s):

Absorbed Dose ◽

Dose Area Product ◽

Absorbed Dose To Water ◽

Area Product

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PF7 Monitoring the radiation dose delivered by the fluoroscopic units with DAP (dose area product) values in locking intra-medullary nailing operations

Injury ◽

10.1016/s0020-1383(13)70140-2 ◽

2013 ◽

Vol 44 ◽

pp. S39

Author(s):

T. Ege ◽

K. Koca ◽

Y. Yurttas ◽

M. Kürklü ◽

H. Özkan ◽

...

Keyword(s):

Radiation Dose ◽

Dose Area Product ◽

Medullary Nailing ◽

Area Product

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Establishment of dosimetric references in terms of dose-area product for small sizes MV X-ray beams

Physica Medica ◽

10.1016/j.ejmp.2015.10.082 ◽

2015 ◽

Vol 31 ◽

pp. e52-e53 ◽

Cited By ~ 1

Author(s):

M. Le Roy ◽

S. Dufreneix ◽

J. Daures ◽

F. Delaunay ◽

J. Gouriou ◽

...

Keyword(s):

X Ray ◽

Dose Area Product ◽

Area Product

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

QJM ◽

10.1093/qjmed/hcab090.003 ◽

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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Clinical apparatus for the reduction of dose area product for patients undergoing x-ray catheterization

Medical Physics ◽

10.1118/1.4903898 ◽

2015 ◽

Vol 42 (1) ◽

pp. 521-530 ◽

Cited By ~ 3

Author(s):

Normand Robert ◽

Kristina N. Watt ◽

Sophie Rochette ◽

Lionel Desponds ◽

Régis Vaillant ◽

...

Keyword(s):

X Ray ◽

Dose Area Product ◽

Area Product

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Assessing the institutional learning curve for pararenal aortic repair using the fenestrated Anaconda endograft

Vascular ◽

10.1177/1708538118799132 ◽

2018 ◽

Vol 27 (1) ◽

pp. 46-50 ◽

Cited By ~ 1

Author(s):

Fadi Taher ◽

Juergen Falkensammer ◽

Joseph Nguyen ◽

Miriam Uhlmann ◽

Edda Skrinjar ◽

...

Keyword(s):

Learning Curve ◽

Endovascular Aneurysm Repair ◽

Mortality Rates ◽

Lower Percentage ◽

Technical Success ◽

Dose Area Product ◽

Aortic Repair ◽

Area Product ◽

Aneurysm Repair ◽

Over Time

Objective Custom-made fenestrated aortic endografts allow exclusion of pararenal aortic aneurysms while maintaining blood flow to aortic branches. Meticulous device planning and precise deployment of the main body are essential to allow successful cannulation of the fenestrations. This study investigates whether a learning curve can be observed with more reliable cannulation and connection of fenestrations over time at a single department of vascular and endovascular surgery with multiple surgeons trained to use the device. Methods A retrospective analysis of data from all patients undergoing primary fenestrated endovascular aneurysm repair during the study period was performed. Outcome measures included case volume and average number of fenestrations over time, average fluoroscopy dose area product per calendar year and primary unconnected fenestration and 30-day mortality rates. Results Between 1 January 2013 and 31 December 2016, 89 patients with no history of endovascular aneurysm repair underwent fenestrated endovascular aneurysm repair at our institution. The number of fenestrations per case increased over time, averaging 2.6 in 2013 and 3.3 in 2016. Primary unconnected fenestration and 30-day mortality rates were 5.6%. Primary-assisted technical success was 93.3%, secondary-assisted technical success was 94.4%. Fluoroscopy dose area product declined over the study period. Thirty-day mortality and primary unconnected fenestration rates did not significantly change over the study period. Conclusion Albeit the reduction in lethal complications and primary technical success rates were not statistically significant, a lower percentage of unconnected fenestrations and 30-day mortality per calendar year were observed over time. At the same time, an increasing complexity of performed cases, as reflected by an increasing number of fenestrations per case, was observed. Complications associated with this complex endovascular procedure are potentially lethal and remain an unfortunate reality and may not be entirely dependent on overcoming a learning curve. A higher volume of cases performed over the study period and a reduction in fluoroscopy use can be considered a representation of the institutional development and learning curve for the Anaconda fenestrated endograft at a department with prior complex endovascular aortic repair experience, but due to limitations of the current retrospective observation, deserve further consideration in future trials, ideally designed in a prospective fashion.

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Valores típicos do "produto dose-área" (DAP) obtidos durante o estudo videofluoroscópico da deglutição

Radiologia Brasileira ◽

10.1590/s0100-39842003000100006 ◽

2003 ◽

Vol 36 (1) ◽

pp. 17-20 ◽

Cited By ~ 6

Author(s):

Milton Melciades Barbosa Costa ◽

Lucia Viviana Canevaro ◽

Ana Cecília Pedrosa de Azevedo ◽

Marcelo Diniz Santa Marinha

Keyword(s):

Dose Area Product ◽

Area Product

Analisamos o produto dose-área ("dose area product" - DAP) de 12 pacientes submetidos a videofluoroscopia da deglutição. O objetivo foi estimar a exposição à radiação produzida neste tipo de estudo. Utilizamos medidor de DAP (PTW-Diamentor), que registra, de modo cumulativo, as doses de radiação que atingem o examinado durante todo o procedimento. Obtivemos nossos dados em duas salas dotadas com equipamentos da mesma marca e modelo. O protocolo, rigorosamente o mesmo, foi efetuado por um único e experiente profissional. Os valores do DAP para o estudo da deglutição em três fases (oral, faríngea e esofágica) foram: sala 1 (sete pacientes) - 4.101 cGy.cm² de DAP médio com 577 cGy.cm²/min.; sala 2 (cinco pacientes) - 804 cGy.cm² de DAP médio com 119 cGy.cm²/min. Estes resultados díspares foram obtidos de indivíduos com média de 1,57 m de altura e 56 kg de peso, em protocolo que se cumpriu em cerca de sete minutos. Concluímos que as doses, cinco vezes mais baixas, obtidas na sala 2, retratam mais adequadamente a exposição determinada pela videofluoroscopia da deglutição. Acreditamos que as doses mais altas, da sala 1, embora dentro dos padrões internacionais para exames do tubo digestivo, devam-se ao desconhecimento do desempenho, nem sempre perfeito, dos equipamentos radiológicos. Esta conclusão encontra apoio no fato de, em nosso meio, não ser usual que os serviços de radiodiagnóstico tenham implementado um rotineiro "programa de garantia de qualidade" e aponta para a importância do DAP na qualificação dos métodos e equipamentos radiológicos.

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