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Wickramasinghe SU, Ramanathan V, Sarasanandarajah S. Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka. Radiol Phys Technol 2024; 17:258-268. [PMID: 38240885 DOI: 10.1007/s12194-023-00774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/06/2023] [Accepted: 12/27/2023] [Indexed: 03/01/2024]
Abstract
Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.
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Affiliation(s)
- Sachini Udara Wickramasinghe
- Department of Radiography and Radiotherapy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka.
| | - Vijitha Ramanathan
- Department of Radiography and Radiotherapy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Sivananthan Sarasanandarajah
- Department of Physical Sciences, Peter MacCallum Cancer Institute, Melbourne, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
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Salah H, Sulieman A, Alkhorayef M, Alkhybari E, Bradley DA. Evaluation of personal dose equivalents during positron emission tomography and computed tomography imaging. Appl Radiat Isot 2024; 203:111078. [PMID: 37907054 DOI: 10.1016/j.apradiso.2023.111078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/10/2023] [Accepted: 10/19/2023] [Indexed: 11/02/2023]
Abstract
This study aimed to evaluate the annual occupational radiation exposure of technologists during PET/CT imaging in 2020 and 2021. Eleven nuclear medicine technologists were monitored at the PET/CT department. The personal dose equivalents (PDEs) for staff members, measured in terms of Hp (10) and Hp (0.07), were assessed annually, considering both deep and surface doses. PDEs were quantified using a thermoluminescent detector (LiF:Mg:Ti)). The average and range of PDEs and extremity doses (mSv) for the technologists were as follows: 4.5 (0.1-13.4) for Hp (10), 4.63 (0.1-13.9) for Hp (0.07), and 2.5 (0.2-17.5) for extremity, respectively. The results indicated that staff members are exposed to high-energy gamma rays while preparing radiopharmaceuticals, injections, and image acquisition. Therefore, proper handling of radiopharmaceuticals and patient management during the acquisition of parameters are crucial for maintaining the occupational dose within the defined limit.
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Affiliation(s)
- H Salah
- INAYA Medical Collage, Nuclear Medicine Department, Riyadh, Saudi Arabia.
| | - A Sulieman
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia
| | - M Alkhorayef
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - E Alkhybari
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia
| | - D A Bradley
- Centre for Nuclear and Radiation Physics, Department of Physics, University of Surrey, Guildford, United Kingdom
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Sulieman A, Mahgoub O, Salah H, Tamam N, Taha A, Dawood S, Bradley DA. Assessment of patient and occupational exposure and radiation risk from cath-lab procedure. Appl Radiat Isot 2023; 202:111071. [PMID: 37871398 DOI: 10.1016/j.apradiso.2023.111071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 09/22/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023]
Abstract
Due to the extended localized fluoroscopy, many radiographic exposures, and multiple procedures that might result in tissue reaction, patients and personnel received a significant radiation dose during interventional cardiology (IR) procedures. This study aims to calculate the radiation risk and assess patient and staff effective doses during IC procedures. Thirty-two patients underwent a Cath lab treatment in total. Ten Cath lab personnel, including six nurses, two cardiologists, and two X-ray technologists. Optical stimulating-luminescent dosimeters (OSL) (Al2O3:C) calibrated for this purpose were used to monitor both occupational and ambient doses. Using an automated OSL reader, these badges were scanned. The Air Kerma (mGy) and Kerma Area Products (KAP, mGy.cm2) have a mean and standard deviation (SD) of 371 ± 132 and 26052, respectively. The average personal dose equivalent (mSv) and its range for cardiologists, nurses and X ray technologists were 1.11 ± 0.21 (0.96-1.26), 0.84 ± 0.11 (0.68-1.16), and 0.68 ± 0.014 (0.12-0.13), respectively. The current study findings showed that the annual effective dose for cardiologists, nurses, and X-ray technologists was lesser than the yearly occupational dose limit of 20 mSv recommended by national and international guidelines. The patients' doses are comparable with some previously published studies and below the tissue reaction limits.
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Affiliation(s)
- Abdelmoneim Sulieman
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia.
| | - Omer Mahgoub
- College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum, Sudan
| | - H Salah
- College of Medical Radiologic Science, Sudan University of Science and Technology, Khartoum, Sudan; INAYA Medical Collage, Nuclear Medicine Department, Riyadh, Saudi Arabia
| | - Nissren Tamam
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428 Riyadh 1167, Saudi Arabia
| | - Afaf Taha
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia
| | - Sali Dawood
- Prince Sattam Bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, Alkharj, Saudi Arabia
| | - D A Bradley
- Centre for Applied Physics and Radiation Technologies, School of Engineering and Technology, Sunway University, Bandar Sunway, 47500, Selangor, Malaysia; Centre for Nuclear and Radiation Physics, University of Surrey, Guildford, GU2 7XH, UK
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Meijer EJ, van Zandvoort DWH, Loos MJA, Tseng CMESN, van Pul C. The eye lens dose of the interventionalist: Measurement in practice. Phys Med 2022; 100:1-5. [PMID: 35690020 DOI: 10.1016/j.ejmp.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Early 2018, the new eye lens dose limit of 20 mSv per year for occupational exposure to ionising radiation was implemented in the European Union. Dutch guidelines state that monitoring is compulsory above an expected eye lens dose of 15 mSv/year. In this study we propose a method to investigate whether the eye lens dose of interventionalists would exceed 15 mSv/year and to determine if the eye lens dose can be derived from the regular personal dosimeter measurements. METHODS The eye lens dose, Hp(3), of interventional radiologists (n = 2), cardiologists (n = 2) and vascular surgeons (n = 3) in the Máxima Medical Centre, The Netherlands, was measured during six months, using thermoluminescence dosimeters on the forehead. Simultaneously, the surface dose, Hp(0,07), and whole body dose, Hp(10), were measured using regular dosimeters outside the lead skirt at chest level. The dosimeters were simultaneously refreshed every four weeks. The eye lens dose was compared to both the body-worn dosimeter values. Measurements were performed in the angiography suite, Cath lab and hybrid OR. RESULTS A clear relation was observed between the two dosimeters: Hp(3) ≈ 0,25 Hp(0,07). The extrapolated year dose for the eye lens did not exceed 15 mSv for any of the interventionalists (average 3 to 10 studies/month). CONCLUSIONS The eye lens dose can be monitored indirectly through the regular dosimeter at chest level. Additionally, based on the measurements we conclude that all monitored interventionalists remain below the dose limit and compulsory monitoring limit for the eye lens dose.
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Affiliation(s)
- E J Meijer
- Department of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands.
| | - D W H van Zandvoort
- Department of Radiology and Nuclear Medicine, Máxima Medical Centre, Veldhoven, The Netherlands; Fontys Paramedische Hogeschool Eindhoven, The Netherlands
| | - M J A Loos
- Department of General Surgery, Máxima Medical Centre, Veldhoven, The Netherlands
| | - C M E S N Tseng
- Department of Radiology and Nuclear Medicine, Máxima Medical Centre, Veldhoven, The Netherlands
| | - C van Pul
- Department of Clinical Physics, Máxima Medical Centre, Veldhoven, The Netherlands; Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
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Bohari A, Hashim S, Ahmad NE, Ghoshal SK, Mohd Mustafa SN. Fluoroscopy-guided intervention procedure norms for occupational eye radiation dose: An overall evaluation. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.108909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ghany HAA, Diab HM, Salah A, Taha AA. Senior interventional cardiologists are exposed to higher effective doses than other staff members. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:743-748. [PMID: 32676700 DOI: 10.1007/s00411-020-00862-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/11/2020] [Indexed: 06/11/2023]
Abstract
Those working in interventional cardiology are exposed to varying radiation doses during diagnostic and interventional procedures. The work presented in this paper aimed to monitor the effective doses received by different categories of medical staff members practicing interventional cardiology procedures including senior cardiologists, junior cardiologists, anesthetists and nurses. Thermo-luminescence dosimeter (TLD) badges that consisted of lithium fluoride doped with magnesium and titanium were used to quantify radiation doses. Measurements were performed with the dosimeters mounted under and above leaded aprons worn by medical staff. The results revealed that the effective doses to senior cardiologists were the highest compared to those to other participating staff members, due to their position close to the X-ray tube. The average daily effective doses for senior cardiologists, junior cardiologists, anesthetists and nurses were higher for dosimeters located above the aprons than those for dosimeters located under the aprons. Above the apron, the average effective doses accumulated during the study period were 0.44 ± 0.06, 0.34 ± 0.05, 0.29 ± 0.03 and 0.29 ± 0.04 mSv, respectively; whereas, under the apron, they were 0.20 ± 0.02, 0.18 ± 0.02, 0.17 ± 0.02 and 0.18 ± 0.02, respectively. Also, the fluoroscopy time was correlated with the dose acquired, especially for senior cardiologists. It is concluded that doses to senior cardiologists are quite high, and that many variables can affect staff exposure such as distance, direction, procedure and skills.
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Affiliation(s)
- H A Abdel Ghany
- Department of Physics, Faculty of Women for Arts, Science and Education, Ain-Shams University, Cairo, Egypt.
| | - H M Diab
- Radiation Protection Department, Nuclear and Radiological Regulatory Authority (ENRRA), Nasr City, Cairo, Egypt
| | - Asmaa Salah
- Radiation Protection Department, Nuclear and Radiological Regulatory Authority (ENRRA), Nasr City, Cairo, Egypt
| | - Ahmed A Taha
- Radiation Protection Department, Nuclear and Radiological Regulatory Authority (ENRRA), Nasr City, Cairo, Egypt
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Elshami W, Abuzaid M, Pekkarinen A, Kortesniemi M. ESTIMATION OF OCCUPATIONAL RADIATION EXPOSURE FOR MEDICAL WORKERS IN RADIOLOGY AND CARDIOLOGY IN THE UNITED ARAB EMIRATES: NINE HOSPITALS EXPERIENCE. RADIATION PROTECTION DOSIMETRY 2020; 189:466-474. [PMID: 32424394 DOI: 10.1093/rpd/ncaa060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/17/2020] [Accepted: 04/07/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Occupational radiation exposure for medical workers in radiology and cardiology was analyzed in nine hospitals in the UAE between 2002 and 2016. The purpose of the study was to determine the time trend and the differences in occupational radiation exposure among worker groups and hospitals in the country. METHODS Readings of 5700 thermoluminescence dosimeters (TLDs) were obtained from 1011 medical workers and grouped into 5 worker groups (radiographers, diagnostic radiologists, nurses, cardiologists and physicians). RESULTS The mean annual effective dose was from 0.38 to 0.62 mSv per worker. Even though an increase in the collective effective dose has been noticed during the study period, no significant time trend was observed in the mean effective dose. Furthermore, cardiologists received higher mean and maximum effective doses than the other worker groups. CONCLUSION The annual effective doses were below the limits set by national legislation and international standards, and for the average worker, the likelihood of high exposure is small. However, improvements in radiation protection practices could be implemented to reduce occupational radiation dose to cardiologists, who were the most exposed worker group in this study.
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Affiliation(s)
- Wiam Elshami
- Medical Diagnostic Imaging Department, College of Health Science, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed Abuzaid
- Medical Diagnostic Imaging Department, College of Health Science, University of Sharjah, Sharjah, United Arab Emirates
| | - Antti Pekkarinen
- Kymsote Radiotherapy and Oncology, Kymenlaakso Central Hospital, Kotka, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
- HUS Medical Imaging Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Mika Kortesniemi
- HUS Medical Imaging Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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Lahfi Y, Ismail A. EVALUATION OF RADIATION DOSE IN DIFFERENT POSITIONS AROUND THE PATIENT TABLE DURING INTERVENTIONAL CARDIOLOGY PROJECTIONS. RADIATION PROTECTION DOSIMETRY 2020; 188:199-204. [PMID: 31786614 DOI: 10.1093/rpd/ncz276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 10/03/2019] [Accepted: 10/30/2019] [Indexed: 06/10/2023]
Abstract
The aim of the present study was to evaluate the radiation exposure around the patient table as relative to the cardiologist position dose value. The dose rates at eight points presuming staff positions were measured for PA, LAO 30° and RAO 30° radiographic projections, and then normalized to the cardiologist's position dose-rate value. The results show that in PA and RAO 30° projections, the normalized dose rate was higher by 9-22% at the right side of the table at a distance of 50 cm, while it was higher up to 31% at the left side for the same measured points in the LAO 30°. The differences of normalized dose rates for the both table sides were lower and decreased at farther positions. The obtained results correspond to the recommendations of staff radiation protection in Cath-labs with regards to X-ray tube and detector positions.
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Affiliation(s)
| | - A Ismail
- Department of Protection and Safety, Atomic Energy Commission of Syria, P.O. Box 6091, Damascus, Syria
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Dalah EZ. Quantifying dose-creep for Skull and chest radiography using dose area product and entrance surface dose: Phantom study. Radiat Phys Chem Oxf Engl 1993 2020. [DOI: 10.1016/j.radphyschem.2019.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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