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González-López NA, Parra-Riofrío KM, Batista-Zaldívar MA, Carrillo-Vallejo E, Yanchapanta-Bastidas VN. Niveles de referencia de dosis para adultos en procedimientos de cardiología intervencionista en Ecuador. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:415-421. [PMID: 33401285 PMCID: PMC8641475 DOI: 10.24875/acm.20000196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022] Open
Abstract
Antecedents and objective The knowledge of the reference levels for diagnoses and therapeutic studies is important, because it contributes to the optimization of the radiological protection of the patients, avoiding them to be exposed to unnecessarily high doses. However, there was no evidence of these levels in interventionist cardiology procedures in Ecuador, so the objective of this study was to estimate the diagnostic reference levels of dose at the entrance surface in adult patients undergoing interventional cardiology procedures (cinecoronariography, catheterization and coronary percutaneous interventionism) in the Unit of Hemodynamic of the Hospital of Specialties Carlos Andrade Marín in Ecuador. Materials and methods The measurements of product dose-area, dose in input surface, number of images and the time of fluoroscopy performed using the Axiom Artis angiographer, and the obtained data was tabulated and processed with the Excel computer program. For this study, 145 patients older than 18 years were selected, and the values obtained from diagnostic reference dose levels were compared with others reported in previous investigations and with the permissible limits for the appearance of deterministic effects on the skin. Results This study made it possible to establish reference levels for diagnosis in interventional cardiology procedures (coronary angiography, catheterization and percutaneous coronary intervention) in the Hemodynamics Unit of the Carlos Andrade Marín Specialty Hospital in Ecuador. Conclusions The results showed that the intake surface doses obtained were lower than the maximum levels recommended by the International Atomic Energy Agency.
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Affiliation(s)
- Nadia A. González-López
- Departamento de Física, Instituto de Ciencias Básicas, Universidad Técnica de Manabí, Portoviejo
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Park H, Yoon Y, Tanaka N, Kim J, Kim J, Morishita J. FEASIBILITY OF DISPLAYED EXPOSURE INDEX IN IEC STANDARD FRAMEWORK AS A DOSE OPTIMISATION TOOL FOR DIGITAL RADIOGRAPHY SYSTEMS. RADIATION PROTECTION DOSIMETRY 2020; 189:384-394. [PMID: 32364600 DOI: 10.1093/rpd/ncaa052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 02/22/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
International Electrotechnical Commission (IEC) established the framework for the use of exposure index (EI) for evaluating the exposure conditions with various digital systems. In this study, we investigated the feasibility of EI, as per the IEC, by comparing the EIs obtained through manual calculated and that displayed on the console of two computed radiography (CR) and digital radiography (DR) systems with radiation beam qualities of RQA3,5,7 and 9. As a result, both two systems indicated an uncertainty of less than 20% for both calculated and displayed EI with all beam qualities except displayed EI obtained by RQA3. However, the displayed EI values were different even under the same exposure conditions because of the characteristics of the imaging receptor materials, such as BaFI or CsI, of two systems. Therefore, when an operator attempts to introduce displayed EI for managing radiation dose, it is essential to understand the characteristics of the digital system.
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Affiliation(s)
- Hyemin Park
- Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea
| | - Yongsu Yoon
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobukazu Tanaka
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jungsu Kim
- Department of Radiologic Technology, Daegu Health College, Daegu, Republic of Korea
| | - Jungmin Kim
- Department of Health and Safety Convergence Science, Korea University, Seoul, Republic of Korea
| | - Junji Morishita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
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Ou-Saada I, Boujemaa S, Campoleoni M, Brambilla R, Bentayeb F. Local Diagnostic Reference Levels in Interventional Radiology. J Med Imaging Radiat Sci 2020; 51:307-311. [PMID: 32278664 DOI: 10.1016/j.jmir.2020.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 01/30/2020] [Accepted: 02/12/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE Interventional cardiology procedures, during which live images are acquired, involve exposure to x-rays. The use of fluoroscopy can cause high radiation doses to patients and operators because of the prolonged duration of x-ray emission. For this reason, special attention and constant vigilance represent challenges for commissions and groups of experts in the field. The purpose of this study is to establish local diagnostic reference levels (DRLs) for these procedures, to improve radiological practice, and to optimize radiation doses. METHODS This work was carried out in two university hospitals and two private medical facilities in Rabat, the capital of Morocco, during the period 2017-2018. The study concerns 657 interventional cardiology procedures (457 coronary angiography [CA] and 200 percutaneous transluminal coronary angioplasty [PTCA]), performed by 11 cardiologists on different installations in 5 catheterization rooms. The data collected for each procedure were patient age, height and weight, dosimeter indicators in terms of dose area product (PKA), total air kerma at the reference point (Kar), fluoroscopy time (FT), and the number of frames, together with the primary beam parameters as kV and total mAs. The proposed DRLs were set from the 75th percentile of the PKA and FT. RESULTS The mean of PKA for CA and PTCA procedures were 29.2 Gy∗cm2 and 70.4 Gy∗cm2, respectively, the mean of fluoroscopy time were 4.0 min and 12.17 min for 334 and 685 frames, respectively. Results for the local DRLs were 37.3 and 87.1 Gy cm2 for PKA and 4.48 and 16.15 min for FT, corresponding to CA and PTCA procedures. CONCLUSION This work focuses on proposing local DRLs in Morocco for CA and PTCA procedures. The results show that the values found conform with those of international studies.
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Affiliation(s)
- Imane Ou-Saada
- Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco
| | - Soumaya Boujemaa
- Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco
| | - Mauro Campoleoni
- Unità Operativa di Fisica Medica "Fondazione Ca 'Granda - Ospedale Maggiore Policlinico", Milano, Italy
| | - Roberto Brambilla
- Unità Operativa di Fisica Medica "Fondazione Ca 'Granda - Ospedale Maggiore Policlinico", Milano, Italy
| | - Farida Bentayeb
- Laboratory of High Energy Physics, Modelisation and Simulation, Faculty of Sciences, Rabat, Morocco.
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Suliman II. Estimates of Patient Radiation Doses in Digital Radiography Using DICOM Information at a Large Teaching Hospital in Oman. J Digit Imaging 2020; 33:64-70. [PMID: 30891650 PMCID: PMC7064681 DOI: 10.1007/s10278-019-00199-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
In this study, we sought to estimate the patient radiation doses in the digital radiography X-ray examinations conducted in a large hospital. The patient exposure factors and kerma-area product (PKA) were retrospectively recorded via the Digital Imaging and Communications in Medicine (DICOM) header for 547 patients. The entrance surface air kerma (ESAK) was estimated from the measurements of the X-ray tube output and recorded exposure factors, as well as from the console that displayed PKA as an alternative method. Effective doses were estimated from ESAK and PKA values using the appropriate conversion coefficient. In the chest PA, chest LAT, cervical spine AP, cervical spine LAT, abdomen AP, pelvis AP, lumbar spine AP, and lumbar spine LAT, the median ESAK (mGy) was found to be 0.13, 0.27, 0.35, 0.52, 0.70, 1.06, 2.33, and 4.18 mGy, respectively. Median PKA values were 0.10, 0.26, 0.14, 0.17, 0.77, 0.68, 0.81, and 1.11 Gy cm2, respectively. The estimated effective dose from ESAK and PKA values yielded comparable results. The comparison revealed that the ESAK and PKA values fell far below the reported in the literature. The results showed that the information of the DICOM deader is valuable for dosimetry and optimization.
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Affiliation(s)
- Ibrahim I Suliman
- Sudan Atomic Energy Commission, Radiation Safety Institute, P.O. Box 3001, Khartoum, Sudan.
- Formerly at Medical Physics Section, College of Medicine & Health Sciences, Sultan Qaboos University, P.O. Box 35, Al-Khoudh, 123, Muscat, Oman.
- Physics Department, College of Science, Committee on Radiation and Environmental Pollution Protection, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, 11642, Saudi Arabia.
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Al-Jabri AJ, Alzimami K, Alsafi K, Alaamer AS, Al-Rajhi MA, Suliman II. RETROSPECTIVE ANALYSIS OF PATIENT RADIATION DOSES IN DIGITAL CORONARY ANGIOGRAPHY AND INTERVENTIONS. RADIATION PROTECTION DOSIMETRY 2019; 183:496-501. [PMID: 30260437 DOI: 10.1093/rpd/ncy168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/19/2018] [Accepted: 08/30/2018] [Indexed: 06/08/2023]
Abstract
This study sought to assess patient and operator eye lens doses in diagnostic coronary angiography (DCA) and percutaneous coronary interventions (PCI) in a University hospital in Oman. Kerma area product (PkA), cumulative air kerma (CAK) and fluoroscopic time (FT) were retrospectively recorded from the DICOM header for 264 patients. The median (interquartile range) of FT, PKA and CAK were: 5.3 min (2.6-10.5), 60.9 Gy cm2 (41.3-91.4) and 0.86 Gy (0.61-1.29), respectively, for DCA procedures, and they were 20.2 min (13.3-30.1), 174.0 Gy cm2 (113.7-253.3) and 2.6 Gy (1.8-3.9), respectively, for PCI procedures. The results revealed wide variability in patient doses among individual patients. Monitoring and recording patient dose data can be valuable for quality assurance and patient safety purposes. Feedback to the operator may help optimize radiation doses to patients and prompt further action, as needed.
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Affiliation(s)
- Amna J Al-Jabri
- Department of Radiology and Molecular Imaging, Medical Physics Section, College of Medicine & Health Sciences, Sultan Qaboos University, Al-Khod 123, Oman
| | - Khalid Alzimami
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - K Alsafi
- Department of Radiology, Medical Physics Unit, King Abdul Aziz University, Jeddah, Kingdom of Saudi Arabia
| | - Abdulaziz S Alaamer
- Al Imam Mohammad Ibn Saud Islamic University (IMSIU), College of Science, Physics Department, Committee on Radiation and Environmental Pollution Protection, Riyadh, Saudi Arabia
| | - M A Al-Rajhi
- Al Imam Mohammad Ibn Saud Islamic University (IMSIU), College of Science, Physics Department, Committee on Radiation and Environmental Pollution Protection, Riyadh, Saudi Arabia
| | - I I Suliman
- Al Imam Mohammad Ibn Saud Islamic University (IMSIU), College of Science, Physics Department, Committee on Radiation and Environmental Pollution Protection, Riyadh, Saudi Arabia
- Sudan Atomic Energy Commission, Institute of Nuclear and Radiological Safety, Khartoum, Sudan
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