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Kuriyama T, Moritake T, Nakagami K, Morota K, Hitomi G, Kitamura H. Background Factors Affecting the Radiation Exposure of the Lens of the Eye among Nurses in Interventional Radiology: A Quantitative Observational Study. NURSING REPORTS 2024; 14:413-427. [PMID: 38391077 PMCID: PMC10885035 DOI: 10.3390/nursrep14010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
With the International Commission on Radiological Protection's (ICRP) reduction in the radiation dose threshold for cataracts, evaluating and preventing radiation exposure to the lens of the eye among interventional radiology (IR) staff have become urgent tasks. In this study, we focused on differences in lens-equivalent dose (HT Lens) to which IR nurses in three hospitals were exposed and aimed to identify factors underlying these differences. According to analyses of time-, distance-, and shielding-related factors, the magnitude of the HT Lens dose to which IR nurses were exposed could be explained not by time or shielding but by the distance between the X-ray exposure field and the location of the IR nurse. This distance tended to be shorter in hospitals with fewer staff. The most effective means of reducing the exposure of the lenses of IR nurses' eyes to radiation is to position them at least two meters from the radiation source during angiography procedures. However, some hospitals must provide IR departments with comparatively few staff. In work environments where it is infeasible to reduce exposure by increasing distance, interventions to reduce time by managing working practices and investment in shielding equipment are also important. This study was not registered.
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Affiliation(s)
- Tomoko Kuriyama
- Department of Occupational and Community Health Nursing, School of Health Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
| | - Takashi Moritake
- Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences, National Institute for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Koichi Nakagami
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, Kitakyushu 807-8556, Japan
| | - Koichi Morota
- Department of Radiology, Shinkomonji Hospital, Kitakyushu 800-0057, Japan
| | - Go Hitomi
- Department of Radiological Technology, Kawasaki Medical School Hospital, Kurashiki 701-0192, Japan
| | - Hiroko Kitamura
- Occupational Health Training Center, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
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Koenig A, Akgöl A, Verbe J, Aigner R, Fiebich M, Thomas R, Mahnken A. Joint replacement increases radiation exposure to the staff in angiography: a phantom study. Eur J Radiol 2022; 151:110270. [DOI: 10.1016/j.ejrad.2022.110270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/09/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022]
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Kaku Y, Inoue T, Charlie Y, Imai S, Yamamichi F, Fujisawa M. Efficiency of novel shielding curtains combined with pulsed irradiation for reducing radiation exposure in an operating room: Human renal collecting system phantom study. Int J Urol 2022; 29:571-577. [PMID: 35165944 DOI: 10.1111/iju.14825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the impact of novel shielding curtains combined with pulsed irradiation mode to protect medical radiation workers from radiation exposure during ureteroscopy. METHODS 0.25 mm Pb equivalent novel shielding curtains were mounted to the caudal and bilateral sides of the operating table in the ureteroscopy setting. C-arm was positioned as per normal in the operating room with the X-ray tube under the patient table. A water-filled anthropomorphic renal collecting system phantom was positioned in the standard position on the operating table that was set at a height of 100 cm. The ionization chambers were also positioned at a height of 100 cm and set in eight positions. We took measurements at distances of 50, 100, 150, and 200 cm from the phantom with the focus directed toward the X-ray tube. We measured the spatial distribution of the scattered radiation dose in four combinations: (1) continuous irradiation mode without novel shielding curtains; (2) pulsed irradiation mode (11 films per second) without novel shielding curtains; (3) continuous irradiation mode with novel shielding curtains; and (4) pulsed irradiation mode with novel shielding curtains. Continuous or pulsed irradiation was activated for 30 s each time. RESULTS Pulsed irradiation mode with novel shielding curtains was a significantly more efficient method than other combinations to reduce scattered radiation exposure in this study (P < 0.001). There was approximately a 95% reduction in scattered radiation exposure with the pulsed irradiation mode with novel shielding curtains set up as compared with continuous irradiation mode without novel shielding curtains. CONCLUSION Combining a novel shielding curtain and using a low pulse radiation setting can greatly reduce radiation exposure during ureteroscopic procedures.
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Affiliation(s)
- Yasuhiro Kaku
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takaaki Inoue
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Urology and Stone Center, Hara Genitourinary Hospital, Kobe, Hyogo, Japan
| | | | - Satoshi Imai
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Fukashi Yamamichi
- Department of Urology and Stone Center, Hara Genitourinary Hospital, Kobe, Hyogo, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
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Gilligan P, Damilakis J. Patient shielding: The need for a European consensus statement. Phys Med 2021; 82:266-268. [PMID: 33684698 DOI: 10.1016/j.ejmp.2021.01.077] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 12/25/2022] Open
Abstract
Contact shielding has been in widespread use for the last 60-70 years aiming to protect against genetic effects, cancer, and other detriment. Since 2012, studies have begun to appear in the literature that question the continued use of such shielding, especially when radiographic technology has changed so much over the intervening period This literature has culminated in several professional bodies such as the American Association of Physicists in Medicine (AAPM) and the British Institute of Radiology (BIR) issuing guidance and statements recommending against the continued routine use of patient contact shielding. Many professional societies have also endorsed these statements. National statements on the matter continue to be produced. It is notable however that the major European bodies involved in diagnostic radiology and radiation safety have not to date issued a statement on patient shielding. This commentary looks at reasons for that and argues that it is now time for a European consensus statement on patient shielding. It is the authors belief that there are advantages to building on the work done by the AAPM and BIR, using the opportunity to amplify the statements, propagate the intent of the original statements, refine the message to deal with questions that have arisen since their publication. Α working group, Gonad and Patient Shielding (GAPS) has been formed by members from a) the European Federation of Organisations for Medical Physics (EFOMP), b) the Eurosafe Imaging initiative of the European Society of Radiology (ESR), c) the European Federation of Radiographers Societies (EFRS), d) EURADOS and e) the BIR to produce a joint statement on the proper application of patient shielding in diagnostic and interventional radiology.
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Affiliation(s)
- P Gilligan
- Mater Private Hospital, Eccles St., Dublin 7, Ireland; University of Crete, Iraklion, Crete, Greece
| | - J Damilakis
- Mater Private Hospital, Eccles St., Dublin 7, Ireland; University of Crete, Iraklion, Crete, Greece
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Lawson M, Kuganesan A, Parry G, Badawy MK. THE EFFICACY OF RADPAD AS A RADIATION PROTECTION TOOL IN CT FLUOROSCOPY GUIDED LUNG BIOPSIES. RADIATION PROTECTION DOSIMETRY 2020; 191:328-334. [PMID: 33120428 DOI: 10.1093/rpd/ncaa169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 08/04/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
Computed tomography fluoroscopy is now the preferred technique for percutaneous lung biopsies. However, concern regarding operator and patient radiation dose remains, which warrants further exploration into dose optimisation tools. This phantom-study aims to assess the dose reduction capabilities of RADPAD, a single-use patient drape designed to decrease staff exposure to scattered radiation. Dosemeters at the waist and eye levels were used to determine the whole-body and lens exposure during simulated lung biopsy procedures while using RADPAD and other combinations of personal protective equipment. RADPAD resulted in a 36% and 38% dose reduction for whole-body and eye exposure, respectively. However, when used in combination with radioprotective eyewear and aprons, RADPAD did not reduce the radiation dose further. Consequently, the use of standard personal protective equipment is a more cost-effective option for staff dose reduction. RADPAD is useful in the reduction of radiation dose to unprotected regions.
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Affiliation(s)
- Michael Lawson
- Monash Imaging, Monash Health, Clayton, VIC 3168, Australia
| | | | - Georgia Parry
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
| | - Mohamed Khaldoun Badawy
- Monash Imaging, Monash Health, Clayton, VIC 3168, Australia
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC 3800, Australia
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Byrne RA, Hanratty CG, Gilligan P. Occupational radiation exposure in interventional cardiology - time for further action. EUROINTERVENTION 2020; 16:613-616. [PMID: 33095162 DOI: 10.4244/eijv16i8a113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Robert A Byrne
- Cardiovascular Research Institute Dublin, Mater Private Hospital, Dublin, Ireland
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Koenig AM, Maas J, Viniol S, Etzel R, Fiebich M, Thomas RP, Mahnken AH. Scatter radiation reduction with a radiation-absorbing pad in interventional radiology examinations. Eur J Radiol 2020; 132:109245. [PMID: 33011604 DOI: 10.1016/j.ejrad.2020.109245] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/16/2020] [Accepted: 08/19/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Radiation-absorbing pads are an additional possibility to reduce scattered radiation at its source. The goal of this study is to investigate the efficacy of a new reusable radiation-absorbing pad at its origin in an experimental setup. MATERIAL AND METHODS All measurements were carried out using a clinical angiography system with a standardized fluoroscopy protocol, different C-arm angulations and an anthropomorphic torso phantom as a scattering body. An ionization chamber was used to measure the radiation exposure at five different heights of a simulated operator during a simulated transfemoral angiography intervention. Measurements were carried out with and without radiation-absorbing pads with lead equivalents of 0.25 and 0.5 mm placed onto the scattering body. For all measurements a mobile acrylic shield and an under-table lead curtain was used. RESULTS At all operator heights from 100 to 165 cm a significant radiation dose reduction of up to 80.6 % (p < 0.01) using the radiation-absorbing pad was measured, when compared to no radiation-absorbing pad. At the height of 165 cm the radiation-absorbing pad with a lead equivalence of 0.5 mm showed a significant radiation dose reduction (51.4 %, p < 0.01) in comparison to a lead equivalence of 0.25 mm. CONCLUSION The addition of a radiation-absorbing pad to the standard protection means results in a significant dose reduction for the operator, particularly for upper body parts.
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Affiliation(s)
- A M Koenig
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany.
| | - J Maas
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - S Viniol
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - R Etzel
- Mittelhessen University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - M Fiebich
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany; Mittelhessen University of Applied Sciences, Institute of Medical Physics and Radiation Protection, Giessen, Germany
| | - R P Thomas
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
| | - A H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, University Hospital Marburg, Germany
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Wilson‐Stewart K, Shanahan M, Fontanarosa D, Davidson R. Occupational radiation exposure to nursing staff during cardiovascular fluoroscopic procedures: A review of the literature. J Appl Clin Med Phys 2018; 19:282-297. [PMID: 30294978 PMCID: PMC6236819 DOI: 10.1002/acm2.12461] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/19/2018] [Accepted: 07/14/2018] [Indexed: 11/16/2022] Open
Abstract
Fluoroscopy is a method used to provide real time x-ray imaging of the body during medical procedures to assist with medical diagnosis and treatment. Recent technological advances have seen an increase in the number of fluoroscopic examinations being performed. Nurses are an integral part of the team conducting fluoroscopic investigations and are often located close to the patient resulting in an occupational exposure to radiation. The purpose of this review was to examine recent literature which investigates occupational exposure received by nursing staff during cardiovascular fluoroscopic procedures. Articles published between 2011 and 2017 have been searched and comprehensively reviewed on the referenced medical search engines. Twenty-four relevant studies were identified among which seventeen investigated nursing dose comparative to operator dose. Seven researched the effectiveness of interventions in reducing occupational exposure to nursing staff. While doctors remain at the highest risk of exposure during procedures, evidence suggests that nursing staff may be at risk of exceeding recommended dose limits in some circumstances. There is also evidence of inconsistent use of personal protection such as lead glasses and skull caps by nursing staff to minimize radiation exposure. Conclusions: The review has highlighted a lack of published literature focussing on dose to nurses. There is a need for future research in this area to inform nursing staff of factors which may contribute to high occupational doses and of methods for minimizing the risk of exposure, particularly regarding the importance of utilizing radiation protective equipment.
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Affiliation(s)
- Kelly Wilson‐Stewart
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQldAustralia
- Cardiovascular SuitesGreenslopes Private HospitalBrisbaneQldAustralia
- Faculty of HealthUniversity of CanberraCanberraACTAustralia
| | | | - Davide Fontanarosa
- School of Clinical SciencesQueensland University of TechnologyBrisbaneQldAustralia
- Institute of Health and Biomedical InnovationQueensland University of TechnologyBrisbaneQldAustralia
| | - Rob Davidson
- Faculty of HealthUniversity of CanberraCanberraACTAustralia
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Marcusohn E, Postnikov M, Musallam A, Yalonetsky S, Mishra S, Kerner A, Poliakov A, Roguin A. Usefulness of Pelvic Radiation Protection Shields During Transfemoral Procedures-Operator and Patient Considerations. Am J Cardiol 2018; 122:1098-1103. [PMID: 30057233 DOI: 10.1016/j.amjcard.2018.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 12/22/2022]
Abstract
Interventional cardiologists are increasingly exposed to radiation-induced hazards. The MAVIG shield is a lead-free drape and the RADPAD is a sterile, disposable, and lead-free shield, placed on the patient with the aim to minimize operator-received scatter radiation. The objective of the trial was to examine their efficacy in a real-world situation. We randomized 125 patients who underwent coronary procedures from the right femoral artery into 3 groups: Control group (n = 48 [39%]) without additional protection, MAVIG lead shield (n = 38 [30%]) and RADPAD shield (n = 39 [31%]). Multiple radiation dosimeters were used in each case. All 3 groups were with similar baseline and procedural characteristics. Fluoroscopy time and number of views were similar in all 3 study groups. Compared with the standard (no shield) protection [3.5 ± 5.57 mSv], the scatter radiation was reduced by a factor of 5 for the MAVIG group [0.46 ± 1.6 mSv and p = 0.001] and a factor of 4 for the RADPAD group [1.16 ± 2.29 mSv and p = 0.01]. The physician's radiation decreased with the 2 shields, but only the MAVIG shield showed statistically significant lower radiation: 0.49 ± 0.42 mSv in the standard group versus 0.26 ± 0.3 mSv in the MAVIG and 0.35 ± 0.44 mSv in the RADPAD (p = 0.135 for RADPAD and p = 0.005 for MAVIG). Patient's exposure was statistically similar to the control group. Although numerically there was an increase in radiation with the RADPAD and decrease with the MAVIG. CONCLUSIONS Our study found no statistically increase in patient radiation while the operator's radiation exposure was reduced. Decreasing scatter radiation can be done effectively using simple measurements and is of major importance.
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Etzel R, König AM, Keil B, Fiebich M, Mahnken AH. Effectiveness of a new radiation protection system in the interventional radiology setting. Eur J Radiol 2018; 106:56-61. [PMID: 30150051 DOI: 10.1016/j.ejrad.2018.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/30/2018] [Accepted: 07/07/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The goal of this study was to examine a new weightless-like radiation protection garment regarding its radiation protection efficacy and to compare it to a conventional two-piece apron suit plus thyroid collar and standard ancillary shields. MATERIAL AND METHODS All measurements were carried out using a clinical angiography system with a standardized fluoroscopy protocol for different C-arm angulations. An anthropomorphic torso phantom served as a scattering body. In addition, an ionization chamber was used to measure the radiation exposure on five different representative heights and at two different positions of an examiner during a typical fluoroscopic-guided intervention. RESULTS The new weightless-like radiation protection garment and the conventional protection concept showed a mean dose reduction of 98.1% (p < 0.01) and 90.1% (p < 0.01) when compared to no shielding, respectively. By adding ancillary shields to both systems, an average reduction of 99.0% (p < 0.01) and 98.2% (p < 0.01) was found. In addition, the efficacy of both systems varied depending on the height, the C-arm angulation and position of the examiner. CONCLUSION Combined with ancillary shields as an overall protection system, the recently introduced weightless-like radiation protection garment showed a significant better radiation protection efficacy when compared to conventional radiation protection measures.
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Affiliation(s)
- Robin Etzel
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany; Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
| | - Alexander M König
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
| | - Boris Keil
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany.
| | - Martin Fiebich
- Technische Hochschule Mittelhessen (THM) - University of Applied Sciences, Department of Life Science Engineering, Institute of Medical Physics and Radiation Protection, Wiesenstrasse 14, 35390 Giessen, Germany.
| | - Andreas H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Baldingerstrasse, 35043 Marburg, Germany.
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Karatasakis A, Brilakis ES. Shields and garb for decreasing radiation exposure in the cath lab. Expert Rev Med Devices 2018; 15:683-688. [PMID: 30092660 DOI: 10.1080/17434440.2018.1510771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Decreasing radiation exposure of the cardiac catheterization laboratory staff is critical for minimizing radiation-related adverse outcomes and can be accomplished by decreasing patient dose and by shielding. Areas covered: protection from ionizing radiation can be achieved with architectural, equipment-mounted, and disposable shields, as well as with personal protective equipment. Expert commentary: Radiation protective aprons are the most commonly used personal protective equipment and provide robust radiation protection but can cause musculoskeletal strain. Use of a thyroid collar is recommended, as is use of 'shin guards', lead glasses and radioprotective caps, although the efficacy of the latter is being debated. Alternatives to lead aprons include shielding suspended from the ceiling and robotic percutaneous coronary intervention. Radiation protective gloves and cream can be used to protect the hands, but the best protection is to not directly expose them to the radiation beam. Devices that provide real time operator radiation dose monitoring can enable real time adjustments in positioning and shield placement, reducing radiation dose. Shielding can be achieved with architectural, equipment-mounted, and disposable shields. Equipment-mounted shielding includes ceiling-suspended shields, table-suspended drapes, and radioabsorbent drapes. Personal protective equipment and shielding should be consistently and judiciously utilized by all catheterization laboratory personnel.
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Affiliation(s)
- Aris Karatasakis
- a Department of Medicine , Rutgers New Jersey Medical School , Newark , NJ , USA
| | - Emmanouil S Brilakis
- b Minneapolis Heart Institute , Minneapolis , MN , USA.,c Department of Cardiovascular Diseases , UT Southwestern Medical Center and VA North Texas Health Care System , Dallas , TX , USA
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Honorio da Silva E, Vanhavere F, Struelens L, Covens P, Buls N. Effect of protective devices on the radiation dose received by the brains of interventional cardiologists. EUROINTERVENTION 2018; 13:e1778-e1784. [DOI: 10.4244/eij-d-17-00759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Inoue T, Komemushi A, Murota T, Yoshida T, Taguchi M, Kinoshita H, Matsuda T. Effect of Protective Lead Curtains on Scattered Radiation Exposure to the Operator During Ureteroscopy for Stone Disease: A Controlled Trial. Urology 2017; 109:60-66. [DOI: 10.1016/j.urology.2017.07.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/18/2017] [Accepted: 07/28/2017] [Indexed: 11/25/2022]
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Pahl C, Ebelt H, Sayahkarajy M, Supriyanto E, Soesanto A. Towards Robot-Assisted Echocardiographic Monitoring in Catheterization Laboratories : Usability-Centered Manipulator for Transesophageal Echocardiography. J Med Syst 2017; 41:148. [PMID: 28812247 DOI: 10.1007/s10916-017-0786-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
This paper proposes a robotic Transesophageal Echocardiography (TOE) system concept for Catheterization Laboratories. Cardiovascular disease causes one third of all global mortality. TOE is utilized to assess cardiovascular structures and monitor cardiac function during diagnostic procedures and catheter-based structural interventions. However, the operation of TOE underlies various conditions that may cause a negative impact on performance, the health of the cardiac sonographer and patient safety. These factors have been conflated and evince the potential of robot-assisted TOE. Hence, a careful integration of clinical experience and Systems Engineering methods was used to develop a concept and physical model for TOE manipulation. The motion of different actuators of the fabricated motorized system has been tested. It is concluded that the developed medical system, counteracting conflated disadvantages, represents a progressive approach for cardiac healthcare.
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Affiliation(s)
- Christina Pahl
- Biomechatronics Group, Faculty of Mechanical Engineering, Technische Universitaet Ilmenau, 98693, Ilmenau, Germany. .,Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Malaysia.
| | - Henning Ebelt
- Klinik für Innere Medizin II/ Kardiologie und Internistische Intensivmedizin Katholisches Krankenhaus, "St. Johann Nepomuk", Haarbergstrasse 72, 99097, Erfurt, Germany
| | - Mostafa Sayahkarajy
- Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Malaysia
| | - Eko Supriyanto
- Advanced Diagnostics and Progressive Human Care Research Group, IJN-UTM Cardiovascular Engineering Centre, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, 81310, Johor Bahru, Malaysia
| | - Amiliana Soesanto
- Department Cardiology & Vascular Medicine, Faculty of Medicine Universitas Indonesia/ National Cardiovascular Center "Harapan Kita", 11420, Jakarta, Indonesia
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Ordiales JM, Nogales JM, Vano E, López-Mínguez JR, Alvarez FJ, Ramos J, Martínez G, Sánchez RM. Occupational dose reduction in cardiac catheterisation laboratory: a randomised trial using a shield drape placed on the patient. RADIATION PROTECTION DOSIMETRY 2017; 174:255-261. [PMID: 27247448 DOI: 10.1093/rpd/ncw139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/11/2016] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the occupational radiation dose in interventional cardiology by using a shielding drape on the patient. A random study with and without the protective material was conducted. The following control parameters were registered: demographic data, number of stents, contrast media volume, fluoroscopy time, number of cine images, kerma-area product and cumulative air kerma. Occupational dose data were obtained by electronic active dosemeters. No statistically significant differences in the analysed control parameters were registered. The median dose value received by the interventional cardiologist was 50% lower in the group with a shielding drape with a statistically significant p-value <0.001. In addition, the median value of the maximum scatter radiation dose was 31% lower in this group with a statistically significant p-value <0.001. This study showed that a shielding drape is a useful tool for reducing the occupational radiation dose in a cardiac catheterisation laboratory.
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Affiliation(s)
- J M Ordiales
- Medical Physics Department, Hospital de Mérida, Mérida, Spain
- Sensory Systems Research Group, University of Extremadura, Badajoz, Spain
| | - J M Nogales
- Department of Cardiology, Hemodynamics and Interventionist Cardiology Section, Hospital Universitario Infanta Cristina, Badajoz, Spain
| | - E Vano
- Medical Physics Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - J R López-Mínguez
- Department of Cardiology, Hemodynamics and Interventionist Cardiology Section, Hospital Universitario Infanta Cristina, Badajoz, Spain
| | - F J Alvarez
- Sensory Systems Research Group, University of Extremadura, Badajoz, Spain
- Department Electrical Engineering, Electronics and Automation, University of Extremadura Badajoz, Spain
| | - J Ramos
- Medical Physics Department, Hospital de Mérida, Mérida, Spain
| | - G Martínez
- Department of Cardiology, Hemodynamics and Interventionist Cardiology Section, Hospital de Mérida, Mérida, Spain
| | - R M Sánchez
- Medical Physics Department, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
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Roy JR, Sun P, Ison G, Prasan AM, Ford T, Hopkins A, Ramsay DR, Weaver JC. Selective anti-scatter grid removal during coronary angiography and PCI: a simple and safe technique for radiation reduction. Int J Cardiovasc Imaging 2017; 33:771-778. [DOI: 10.1007/s10554-017-1067-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 01/05/2017] [Indexed: 11/24/2022]
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17
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A Review of Radiation Protection Solutions for the Staff in the Cardiac Catheterisation Laboratory. Heart Lung Circ 2016; 25:961-7. [DOI: 10.1016/j.hlc.2016.02.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/03/2016] [Accepted: 02/23/2016] [Indexed: 12/22/2022]
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18
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Reeves RR, Mahmud E. Reports of a Possible Causal Link between Brain, Head, and Neck Tumors and Radiation Exposure during Coronary Interventional Procedures: A Sobering Look at the Data. CARDIOVASCULAR INNOVATIONS AND APPLICATIONS 2016. [DOI: 10.15212/cvia.2016.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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19
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Keep that radiation off of Me! Catheter Cardiovasc Interv 2015; 86:941. [DOI: 10.1002/ccd.26250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 09/05/2015] [Indexed: 11/07/2022]
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