scholarly journals A dose audit of fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital: Analysis of preliminary results

2009 ◽  
Vol 13 (2) ◽  
pp. 24
Author(s):  
T Nyathi ◽  
M L Pule ◽  
P Segone ◽  
D G Van der Merwe ◽  
S P Rapoho
Keyword(s):  
South Africa ◽  
Dose Optimization ◽  
Skin Dose ◽  
Radiation Doses ◽  
Voiding Cystourethrogram ◽  
Academic Hospital ◽  
Reference Levels ◽  
Large Variability ◽  
Dose Area Product ◽  
Area Product

Purpose: To retrospectively analyze the radiation doses delivered to patients undergoing fluoroscopy examinations in terms of the skin dose and the dose-area product (DAP). Materials and Methods: The subjects of this study were patients who underwent fluoroscopy examinations at Charlotte Maxeke Johannesburg Academic Hospital, South Africa during the period August 2007 to March 2008. The skin dose and dose-area product values were obtained from a built-in DAP-meter installed on a digital Philips Medical Systems MultiDiagnost Eleva fluoroscopy unit. The following cases were analyzed namely barium swallow, barium meal, barium enema, hexabrix swallow, gastrografin meal, voiding cystourethrogram, fistulogram, myelogram, nephrostomy and loopogram. Results: An analysis of three hundred and thirty one examinations is presented. From the recorded data the following quantities were deduced: the mean- and range of the skin doses and DAPs, mean screening time and mean fluoroscopy duration. An analysis of the screening time for the various examinations showed a weak correlation (r = 0.59) between skin dose and screening time, while a poor correlation (r = 0.42) was deduced between DAP reading and screening time. Conclusion: There is a wide spread in the radiation doses registered for any one given type of examination. The large variability in the radiation dose delivered proves that fluoroscopic examinations stand to gain from dose optimization. The usefulness and potential use of DAP meters with regards to dose optimization in radiology is shown. In line with efforts to optimize dose from diagnostic radiography examinations the authors recommend the establishment of diagnostic reference levels (DRLs) in South Africa for the most frequent examinations in general radiography, fluoroscopy, mammography and computed tomography. Keywords: patient dose, genetic risk, dose optimization, dose reference levels

RADIATION DOSE TO PATIENTS IN CORONARY INTERVENTIONAL PROCEDURES: A SURVEY

2018 ◽  
Vol 184 (1) ◽  
pp. 1-4 ◽  
Author(s):  
A Brindhaban
Keyword(s):  
Interventional Procedures ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Radiation Doses ◽  
Dose Area Product ◽  
Maximum Value ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Area Product ◽  
Peak Skin Dose

Abstract The objective of this study was to evaluate dose–area product (DAP) and peak skin dose (PSD) for coronary angiography (CA) and percutaneous coronary intervention (PCI). The DAP and PSD of 300 randomly selected patients who were referred to CA and/or PCI, over a period of 3 months were recorded and analyzed. The mean DAP of 32 Gy cm2 and mean PSD of 412 mGy for CA were lower than 118 Gy cm2 and 857 mGy, respectively, for PCI. The DAP range of 2–84 Gy cm2 for CA and 12–378 mGy for PCI were also established. The maximum value of PSD for PCI procedures reached above the 2 Gy threshold for erythema. However, these values are similar to those available in literature. Periodic surveys may be required to monitor and/or reduce radiation doses in coronary interventional procedures.

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.

AN ASSESSMENT OF RADIATION EXPOSURE DOSES IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION BASED ON ANGIOGRAPHIC RECORDS

2018 ◽  
Vol 183 (4) ◽  
pp. 475-482 ◽  
Author(s):  
M Maghbool ◽  
M A Hosseini
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Radiation Dose ◽  
Primary Percutaneous Coronary Intervention ◽  
Standard Dose ◽  
Coronary Intervention ◽  
Skin Dose ◽  
Dose Area Product ◽  
Percutaneous Coronary ◽  
Using Data ◽  
Area Product

Abstract The stochastic and non-stochastic (deterministic) effects of radiation dose in patients undergoing primary percutaneous coronary intervention (PPCI) have been investigated using data recorded by an angiographic monitoring system. A total of 132 patients with acute myocardial infarction referred to the angiography department of Vali-Asr hospital, Fasa, Iran, during the second half of 2016 were recruited. Quantities like dose–area product (DAP), total air kerma (Ka,r) and fluoroscopy time (FT) were calculated and converted into effective dose (ED) and peak skin dose (PSD). The values for Ka,r, DAP and FT equaled 80 399.20 ± 63 312 mGy cm2, 1392.80 ± 1155.373 mGy and 524.11 ± 423.057 s, respectively, which were within the ranges reported in previous studies. After considering standard dose thresholds for Ka,r and PSD, it was revealed that only a small portion of patients had reached these thresholds and exceeded them (<3%). Moreover, ED < 20 mSv for the majority of patients was fairly consistent with results from a recent research in eight Belgian hospitals. It was shown that angiographic records are reliable for assessing radiation dose in patients.

A MULTICENTRE SURVEY OF LOCAL DIAGNOSTIC REFERENCE LEVELS AND ACHIEVABLE DOSE FOR CORONARY ANGIOGRAPHY AND PERCUTANEOUS TRANSLUMINAL CORONARY INTERVENTION PROCEDURES IN KOREA

2019 ◽  
Vol 187 (3) ◽  
pp. 378-382
Author(s):  
Jung Su Kim ◽  
Bong-Ki Lee ◽  
Dong Ryeol Ryu ◽  
Kwang Jin Chun ◽  
Hyun-Hee Choi ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Radiation Doses ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
High Radiation ◽  
Exposure Data ◽  
Area Product ◽  
Percutaneous Transluminal

Abstract Interventional cardiology procedures can involve relatively high radiation doses compared to general radiography. During coronary angiography (CAG) and percutaneous transluminal coronary intervention (PCI), the same area is exposed to radiation for a long period. In this study, radiation exposure data of 1071 examinations in Korean hospitals were collected, and the achievable dose (AD) and diagnostic reference levels (DRLs) in actual medical practice for two types of interventional cardiology procedures in Korea were established. In CAG, 75th percentile DRLs and AD of the total kerma-area product were 47.0 and 33.1 Gy·cm 2, respectively. In PCI, those values were 171.3 and 102.6 Gy·cm2, respectively. This is the first study to introduce the DRLs for cardiovascular interventional procedures in Korea. These results will help optimise the interventional cardiology procedures for Korean cardiac centres.

scholarly journals Establishing local diagnostic reference levels for common orthopaedic procedures using the mini C-arm fluoroscope

2021 ◽  
Vol 94 (1117) ◽  
pp. 20190878
Author(s):  
Anna Kropelnicki ◽  
Rosemary Eaton ◽  
Alexandra Adamczyk ◽  
Jacqueline Waterman ◽  
Pegah Mohaghegh
Keyword(s):  
Radiation Exposure ◽  
Best Practice ◽  
District General Hospital ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Data Set ◽  
Dose Area Product ◽  
The Third ◽  
Retrospective Audit ◽  
Area Product

Objective: Mini C-arm fluoroscopes are widely used by orthopaedic surgeons for intraoperative image guidance without the need for radiographers. This puts the responsibility for radiation exposure firmly with the operating surgeon. In order to maintain safe and best practice under U.K. Ionising Radiation (Medical Exposure) Regulations, one must limit radiation exposure and audit performance using national diagnostic reference levels (DRLs). In the case of the mini C-arm, there are no national DRLs. IR(ME)R, therefore, require the establishment of local DRLs by each hospital to act as an alternative guideline for safe radiation use. The aim of our audit was to establish local DRLs based on our experience operating with the use of the mini C-arm over the last 7 years. Methods: This retrospective audit evaluates the end dose–area product (DAP) recorded for common trauma and orthopaedic procedures using the mini C-arm in a busy district general hospital. We present the quartile data and have set the cut-off point as the third quartile for formulating the local DRLs, consistent with the methodology for the conventional fluoroscope. Results: For our data set (n = 1664), the third quartile DAP values were lowest for surgeries to the forearm (5.38 cGycm2), hand (7.62 cGycm2), and foot/ankle (8.56 cGycm2), and highest for wrist (10.64 cGycm2) and elbow (14.61 cGycm2) procedures. Advances in knowledge: To our knowledge, this is the largest data set used to establish local DRLs. Other centres may find our guidelines useful whilst they establish their own local DRLs.

A prospective case control comparison of the ZeroGravity system versus a standard lead apron as radiation protection strategy in neuroendovascular procedures

2015 ◽  
Vol 8 (10) ◽  
pp. 1052-1055 ◽  
Author(s):  
Diogo C Haussen ◽  
Imramsjah Martijn John Van Der Bom ◽  
Raul G Nogueira
Keyword(s):  
Radiation Exposure ◽  
Radiation Protection ◽  
Protection System ◽  
Skin Dose ◽  
Lead Apron ◽  
Dose Area Product ◽  
Primary Operator ◽  
The Mean ◽  
Area Product ◽  
Peak Skin Dose

Background and purposeWe aimed to compare the performance of the ZeroGravity (ZG) system (radiation protection system composed by a suspended lead suit) against the use of standard protection (lead apron (LA), thyroid shield, lead eyeglasses, table skirts, and ceiling suspended shield) in neuroangiography procedures.Materials and methodsRadiation exposure data were prospectively collected in consecutive neuroendovascular procedures between December 2014 and February 2015. Operator No 1 was assigned to the use of an LA (plus lead glasses, thyroid shield, and a 1 mm hanging shield at the groin) while operator No 2 utilized the ZG system. Dosimeters were used to measure peak skin dose for the head, thyroid, and left foot.ResultsThe two operators performed a total of 122 procedures during the study period. The ZG operator was more commonly the primary operator compared with the LA operator (85% vs 71%; p=0.04). The mean anterior-posterior (AP), lateral, and cumulative dose area product (DAP) radiation exposure as well as the mean fluoroscopy time were not statistically different between the operators’ cases. The peak skin dose to the head of the operator with LA was 2.1 times higher (3380 vs 1600 μSv), while the thyroid was 13.9 (4460 vs 320 μSv), the mediastinum infinitely (520 vs 0 μSv), and the foot 3.3 times higher (4870 vs 1470 μSv) compared with the ZG operator, leading to an overall accumulated dose 4 times higher. The ratio of cumulative operator received dose/total cumulative DAP was 2.5 higher on the LA operator.ConclusionsThe ZG radiation protection system leads to substantially lower radiation exposure to the operator in neurointerventional procedures. However, substantial exposure may still occur at the level of the lens and thyroid to justify additional protection.

scholarly journals Patient Peak Skin Dose and Dose Area Product from Interventional Cardiology Procedures

2015 ◽  
Vol 04 (01) ◽  
pp. 7-12 ◽  
Author(s):  
Antar E. Aly ◽  
Ibrahim M. Duhaini ◽  
Samia M. Manaa ◽  
Sayed M. Tarique ◽  
Shehim E. Kuniyil ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Skin Dose ◽  
Dose Area Product ◽  
Area Product ◽  
Peak Skin Dose

scholarly journals SPOT REGION OF INTEREST IMAGING: A NOVEL FUNCTIONALITY AIMED AT X-RAY DOSE REDUCTION IN NEUROINTERVENTIONAL PROCEDURES

2020 ◽  
Vol 188 (3) ◽  
pp. 322-331
Author(s):  
Ljubisa Borota ◽  
Andreas Patz
Keyword(s):  
Dose Reduction ◽  
Region Of Interest ◽  
Skin Dose ◽  
X Ray ◽  
Dose Area Product ◽  
Dose Saving ◽  
Area Product ◽  
Anatomical Area ◽  
Neurointerventional Procedures ◽  
Peak Skin Dose

Abstract Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.

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