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Tunçer N, Kuyucu E, Sayar Ş, Polat G, Erdil İ, Tuncay İ. Orthopedic surgeons' knowledge regarding risk of radiation exposition: a survey analysis. SICOT J 2017; 3:29. [PMID: 28387195 PMCID: PMC5384318 DOI: 10.1051/sicotj/2017008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/14/2017] [Indexed: 11/29/2022] Open
Abstract
Introduction: The purpose of this study is to evaluate the knowledge levels of orthopedic surgeons working in Turkey about the uses and possible risks of fluoroscopy and assess methods for preventing radiation damage. Methods: A questionnaire with a total of 12 questions was sent to 1121 orthopedic surgeons working in Turkey. The questionnaire evaluated participants’ knowledge about the uses and risks of fluoroscopy and methods for preventing damage. One thousand and twenty-four orthopedic surgeons were found to be suitable for inclusion in the study. The effects of fluoroscopy on patients were not assessed in our study. Results: The data obtained were statistically evaluated. Of the surveyed surgeons, 313 (30%) had used fluoroscopy in over 50% of their operations. The average number of fluoroscopy shots per case was 54.5. A lead apron was the most commonly used (88%) protection from the harmful effects of radiation. Fluoroscopy shots were performed with the help of operating room personnel (86%). A dosimeter was used 5% of the time. Conclusion: According to the survey results, the need for fluoroscopy was very high in orthopedic surgery. However, orthopedic surgeons have inadequate knowledge about the uses and risks of fluoroscopy and methods for preventing damage. Therefore, we believe that training on this topic should be provided to all orthopedic surgeons.
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Affiliation(s)
- Nejat Tunçer
- Bezmi-Alem University, Orthopedics and Traumatology, Istanbul, Turkey
| | - Ersin Kuyucu
- Medipol University, Orthopedics and Traumatology, Istanbul, Turkey
| | - Şafak Sayar
- Bezmi-Alem University, Orthopedics and Traumatology, Istanbul, Turkey
| | - Gökhan Polat
- Istanbul University, Orthopedics and Traumatology, Istanbul, Turkey
| | - İrem Erdil
- Bakırköy Sadi Konuk Education and Training Hospital, Radiology Department, Istanbul, Turkey
| | - İbrahim Tuncay
- Bezmi-Alem University, Orthopedics and Traumatology, Istanbul, Turkey
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Steele JR, Jones AK, Ninan EP. Quality initiatives: Establishing an interventional radiology patient radiation safety program. Radiographics 2011; 32:277-87. [PMID: 22095315 DOI: 10.1148/rg.321115002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The Interventional Radiology Patient Radiation Safety Program was created to better educate patients who are scheduled to undergo high-dose interventional radiologic procedures about the risks of radiation, better monitor the delivered doses, and reduce the risk for deterministic effects. The program combines preprocedure evaluation and counseling, intraprocedure monitoring, and postprocedure documentation and counseling with the guidelines of the National Cancer Institute and the Society of Interventional Radiology. Between July 2009, when the program was implemented, and September 2010, over 3500 interventional radiologic procedures were monitored and documented, and 63 procedures with an adjusted cumulative dose of more than 3 Gy were identified and further analyzed; four procedures were found to be outside the control limits. Additional review of these four procedures resulted in practice modifications. Anecdotal feedback from physician assistants and attending physicians indicated that the program had another positive effect: Patients who required postprocedure counseling about the potential for radiation-induced skin injuries were no longer surprised by this information. Implementation of this program is straightforward, requires little infrastructure and few resources, and may be applied in most interventional radiology practices. Supplemental material available at http://radiographics.rsna.org/lookup/suppl/doi:10.1148/rg.321115002/-/DC1.
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Affiliation(s)
- Joseph R Steele
- Departments of Diagnostic Radiology and Imaging Physics, Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1479, Houston, TX 77030-4009, USA.
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Reduction of Radiation Doses in Cardiac Imaging, Part I: Minimally Invasive Cardiovascular Procedures. CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Killewich LA, Singleton TA. Governmental regulations and radiation exposure. J Vasc Surg 2010; 53:44S-46S. [PMID: 20875710 DOI: 10.1016/j.jvs.2010.06.177] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 05/24/2010] [Accepted: 06/10/2010] [Indexed: 11/30/2022]
Abstract
BACKGROUND The use of radiation for medical purposes falls under the purview of the Food and Drug Administration (FDA) and individual states. Enhanced regulations are in place to promote the right exam for the right reason at the right time for every patient exposed to medical x-rays. METHODS The February 2010 FDA initiative to reduce unnecessary radiation exposure from fluoroscopy, CT, and nuclear medicine studies is reviewed along with regulations currently in place. RESULTS Facilities granting privileges to physicians performing fluoroscopic procedures need to ensure appropriate education so they can assess individual patient risk and benefit on a case-by-case basis. These are guidelines with individual states controlling requirements. CONCLUSION Regulation of education, training, and credentialing for physician operators of fluoroscopic equipment is currently controlled by individual states and is not uniform. There are strong indications that the FDA and or the Joint Commission will become increasingly involved to increase documentation of patient exposure and safety.
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Affiliation(s)
- Lois A Killewich
- The University of Texas Medical Branch, Galveston, TX 77555-0735, USA.
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Johnston J, Comello RJ, Vealé BL, Killion J. Radiation Exposure Dose Trends and Radiation Dose Reduction Strategies in Medical Imaging. J Med Imaging Radiat Sci 2010; 41:137-144. [DOI: 10.1016/j.jmir.2010.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 05/19/2010] [Accepted: 06/10/2010] [Indexed: 10/24/2022]
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Joint quality improvement guidelines for pediatric arterial access and arteriography: from the Societies of Interventional Radiology and Pediatric Radiology. Pediatr Radiol 2010; 40:237-50. [PMID: 20058129 DOI: 10.1007/s00247-009-1499-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Heran MK, Marshalleck F, Temple M, Grassi CJ, Connolly B, Towbin RB, Baskin KM, Dubois J, Hogan MJ, Kundu S, Miller DL, Roebuck DJ, Rose SC, Sacks D, Sidhu M, Wallace MJ, Zuckerman DA, Cardella JF. Joint Quality Improvement Guidelines for Pediatric Arterial Access and Arteriography: From the Societies of Interventional Radiology and Pediatric Radiology. J Vasc Interv Radiol 2010; 21:32-43. [DOI: 10.1016/j.jvir.2009.09.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 09/16/2009] [Accepted: 09/27/2009] [Indexed: 11/28/2022] Open
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Guiraudon GM, Jones DL, Bainbridge D, Peters TM. Off-Pump Positioning of a Conventional Aortic Valve Prosthesis through the Left Ventricular Apex with the Universal Cardiac Introducer under Sole Ultrasound Guidance, in the Pig. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2009. [DOI: 10.1177/155698450900400508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gerard M. Guiraudon
- Canadian Surgical Technologies and Advance Robotics, Lawson Health Research Institute, London, Ontario, Canada
- Imaging Group, Robarts Research Institute, London, Ontario, Canada
| | - Douglas L. Jones
- Canadian Surgical Technologies and Advance Robotics, Lawson Health Research Institute, London, Ontario, Canada
- Imaging Group, Robarts Research Institute, London, Ontario, Canada
- Departments of Physiology and Pharmacology
- Departments of Medicine
| | | | - Terence M. Peters
- Canadian Surgical Technologies and Advance Robotics, Lawson Health Research Institute, London, Ontario, Canada
- Imaging Group, Robarts Research Institute, London, Ontario, Canada
- Medical Biophysics, the University of Western Ontario, and the London Health Science Center, London, Ontario, Canada
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Off-Pump Positioning of a Conventional Aortic Valve Prosthesis through the Left Ventricular Apex with the Universal Cardiac Introducer under Sole Ultrasound Guidance, in the Pig. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2009; 4:269-77. [DOI: 10.1097/imi.0b013e3181bbe279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective To test an alternative to catheter and open-heart techniques, by documenting the feasibility of implanting an unmodified mechanical aortic valve (AoV) in the off pump, beating heart using the universal cardiac introducer (UCI) attached to the left ventricular (LV) apex. Methods In six pigs, the LV apex was exposed by a median sternotomy. The UCI was attached to the apex. A 12-mm punching tool (punch), introduced through the UCI, was used to create a cylindrical opening through the apex. Then, the AoV, secured to a holder, was introduced into the LV, using transesophageal echocardiographic, guided through the apical LV opening, navigated into the LV outflow tract, and positioned within the aortic annulus. Trans-esophageal echocardiographic guidance was useful for navigation and positioning by superimposing the aortic annulus and prosthetic ring while Doppler imaging verified preserved prosthetic function and absence of perivalvular leaks. The valve function and hemodynamics were observed before termination for macroscopic evaluation. Results The punch produced a clean opening without fragmentation or myocardial embolization. During advancement of the mechanical AoV, there were no arrhythmias, mitral valve dysfunctions, evidence of myocardial ischemia, or hemodynamic instability. The AoVs were well seated over the annulus, without obstructing the coronaries or contact with the conduction system. The ring of AoVs was well circumscribed by the aortic annulus. Conclusions This study documented the feasibility of positioning a mechanical AoV on the closed, beating heart. These results should encourage the development of adjunct technologies to deliver current tissue or mechanical AoV with minimal side effects.
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Ward VL, Strauss KJ, Barnewolt CE, Zurakowski D, Venkatakrishnan V, Fahey FH, Lebowitz RL, Taylor GA. Pediatric Radiation Exposure and Effective Dose Reduction during Voiding Cystourethrography. Radiology 2008; 249:1002-9. [DOI: 10.1148/radiol.2492062066] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Amis ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, Mettler FA, Morin RL, Pentecost MJ, Smith GG, Strauss KJ, Zeman RK. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol 2007; 4:272-84. [PMID: 17467608 DOI: 10.1016/j.jacr.2007.03.002] [Citation(s) in RCA: 567] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Indexed: 01/27/2023]
Abstract
The benefits of diagnostic imaging are immense and have revolutionized the practice of medicine. The increased sophistication and clinical efficacy of imaging have resulted in its dramatic growth over the past quarter century. Although data derived from the atomic bomb survivors in Japan and other events suggest that the expanding use of imaging modalities using ionizing radiation may eventually result in an increased incidence of cancer in the exposed population, this problem can likely be minimized by preventing the inappropriate use of such imaging and by optimizing studies that are performed to obtain the best image quality with the lowest radiation dose. The ACR, which has been an advocate for radiation safety since its inception in 1924, convened the ACR Blue Ribbon Panel on Radiation Dose in Medicine to address these issues. This white paper details a proposed action plan for the college derived from the deliberations of that panel.
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Affiliation(s)
- E Stephen Amis
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
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