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Sagehashi K, Haga Y, Takahira S, Tanabe M, Nakamura M, Sota M, Kaga Y, Abe M, Tada N, Chida K. Evaluation of radiation dose to the lens in interventional cardiology physicians before and after dose limit regulation changes. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:031512. [PMID: 39142296 DOI: 10.1088/1361-6498/ad6f19] [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: 05/14/2024] [Accepted: 08/14/2024] [Indexed: 08/16/2024]
Abstract
In response to the International Commission on Radiological Protection, which lowered the lens equivalent dose limit, Japan lowered the lens dose limit from 150 mSv y-1to 100 mSv/5 years and 50 mSv y-1, with this new rule taking effect on 1 April 2021. DOSIRIS®is a dosimeter that can accurately measure lens dose. Herein, we investigated lens dose in interventional cardiology physicians 1 year before and after the reduction of the lens dose limit using a neck dosimeter and lens dosimeter measurements. With an increase in the number of cases, both personal dose equivalent at 0.07 mm depth [Hp(0.07), neck dosimeter] and personal dose equivalent at 3 mm depth [Hp(3), lens dosimeter] increased for most of the physicians. The Hp(3) of the lens considering the shielding effect of the Pb glasses using lens dosimeter exceeded 20 mSv y-1for two of the 14 physicians. Protection from radiation dose will become even more important in the future, as these two physicians may experience radiation dose exceeding 100 mSv/5 years. The average dose per procedure increased, but not significantly. There was a strong correlation between the neck dosimeter and lens dosimeter scores, although there was no significant change before and after the lens dose limit was lowered. This correlation was particularly strong for physicians who primarily treated patients. As such, it is possible to infer accurate lens doses from neck doses in physicians who primarily perform diagnostics. However, it is desirable to use a dosimeter that can directly measure Hp(3) because of the high lens dose.
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Affiliation(s)
- Kodai Sagehashi
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
| | - Yoshihiro Haga
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
- Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi 980-0873, Japan
| | - Saki Takahira
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
| | - Mako Tanabe
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
- Disaster Medical Radiology, Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, 468-1, Aoba, Aramaki, Aoba-Ku, Sendai, Miyagi 980-8572, Japan
| | - Mio Nakamura
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
- Disaster Medical Radiology, Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, 468-1, Aoba, Aramaki, Aoba-Ku, Sendai, Miyagi 980-8572, Japan
| | - Masahiro Sota
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
- Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi 980-0873, Japan
| | - Yuji Kaga
- Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi 980-0873, Japan
| | - Mitsuya Abe
- Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi 980-0873, Japan
| | - Norio Tada
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan
| | - Koichi Chida
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine, 2-1, Seiryo-Machi, Aoba-Ku, Sendai, Miyagi 980-8575, Japan
- Disaster Medical Radiology, Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, 468-1, Aoba, Aramaki, Aoba-Ku, Sendai, Miyagi 980-8572, Japan
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Nessipkhan A, Matsuda N, Takamura N, Oriuchi N, Ito H, Kiguchi M, Nishihara K, Tamaru T, Awai K, Kudo T. Occupational radiation exposure among medical personnel in university and general hospitals in Japan. Jpn J Radiol 2024; 42:1067-1079. [PMID: 38705937 DOI: 10.1007/s11604-024-01579-3] [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: 01/24/2024] [Accepted: 04/20/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE This study aimed to compare the occupational radiation exposure of medical workers between general hospitals and university hospitals. METHODS Radiation exposure data from three hospitals in Hiroshima city, including one university hospital and two general hospitals, were collected using personal dosimeters. Monthly radiation doses were analyzed, and the annual sum of radiation exposure dose was calculated for 538 subjects in general hospitals and 1224 subjects in the university hospital. To assess the impact of locality, additional data from Nagasaki University Hospital and Fukushima Medical University Hospital were included for comparative analysis. Professional affiliations, such as doctors, nurses, and radiological technologists, were considered in the evaluation. RESULTS The study revealed slight but significant differences in radiation doses between general and university hospitals. In general hospitals, except for radiological technologists, a slightly higher radiation dose was observed compared to university hospitals. Despite the annual increase in the use of medical radiation, the majority of hospital workers in both settings adhered to safety guidelines, with occupational radiation exposure remaining below the limit of detection (LOD). Workers who involved in fluoroscopic procedure, whether at university or general hospitals, had higher radiation doses than those who did not. CONCLUSION The study's primary conclusion is that workers in general hospitals experience a slight but significantly higher radiation dose and a lower percentage below the LOD compared to university hospitals. The observed difference is attributed to the greater workload at general hospitals than at university hospitals, and also may be due to the different nature of university hospital and general hospital. University hospitals, characterized by greater academic orientation, tend to benefit from comprehensive support systems, specialized expertise, and advanced technology, leading to more structured and regulated radiation control. These findings provide a basis for targeted interventions, improved safety protocols.
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Affiliation(s)
- Arman Nessipkhan
- Department of Radioisotope Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-12-4, Nagasaki, 852-8523, Japan.
| | - Naoki Matsuda
- Department of Radiation Biology and Protection, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Takamura
- Department of Global Health, Medicine and Welfare, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Noboru Oriuchi
- Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Ito
- Department of Radiology, Faculty of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masao Kiguchi
- Department of Clinical Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Kiyoto Nishihara
- Department of Radiological Technology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Takayuki Tamaru
- Department of Radiology, JA Hiroshima General Hospital, Hiroshima, Japan
| | - Kazuo Awai
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Kudo
- Department of Radioisotope Medicine, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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Oikawa T, Saito K, Kurihara K, Horikawa D, Uruno K, Kajiwara H, Ohashi S, Hotta M, Yagi N, Kitamura H, Hasegawa S, Minamimoto R. Evaluation of X-ray protective goggles in mitigating eye lens radiation exposure during radiopharmaceutical handling and patient care in nuclear medicine. Glob Health Med 2024; 6:244-250. [PMID: 39219587 PMCID: PMC11350357 DOI: 10.35772/ghm.2024.01023] [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: 03/04/2024] [Revised: 07/27/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024]
Abstract
The aim of this study is to estimate eye lens exposure dose when handling radiopharmaceuticals and interacting with patients receiving radiopharmaceuticals, and to verify the usefulness of X-ray protective goggles in mitigating such radiation exposure using phantoms. To evaluate radiation exposure during the handling of radiopharmaceuticals, we employed a fluorescent glass dosimeter to measure the radiation doses associated with 99mTc, 123I, 131I, 111In, and 18F at distances of 30 cm and 60 cm, followed by calculation of the 3 mm dose equivalent rate (3DER). We then estimated the dose reduction rates for various scenarios, including the use of syringe shields and X-ray protective goggles with lead equivalences of 0.07, 0.15, 0.75, and 0.88 mmPb, as well as their combined application. X-ray protective goggles with lead equivalence of 0.75 mmPb outperformed those with 0.07 mmPb and 0.15 mmPb, for all radionuclides and at both source distances. X-ray protective goggles with 0.88 mmPb outperformed those with 0.75 mmPb during handling of 131I and 111In at a distance of 30 cm. In the remaining scenarios, X-ray protective goggles with 0.88 mmPb resulted in marginal reductions or no discernible additional effects. The overall shielding effect of X-ray protective goggles was less pronounced for 131I and 18F, but the combined use of a syringe shield with X-ray protective goggles with 0.75 or 0.88 mmPb improved the dose reduction rate for all scenarios. In simulating patient care, X-ray protective goggles with 0.88 mmPb demonstrated a dose reduction effect of approximately 50% or more. X-ray protective goggles could reduce the 3DER for the eye lens, and were more effective when combined with a syringe shield. It is valid to use a lead equivalence of 0.88 mmPb to fully harness the protective capabilities of X-ray shielding goggles when dealing with all five types of nuclides in clinical settings.
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Affiliation(s)
- Tomoko Oikawa
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaori Saito
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keiichi Kurihara
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Daisuke Horikawa
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Katsuhiko Uruno
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hironori Kajiwara
- Department of Radiological Technology, National Cancer Center Hospital East, Chiba, Japan
| | - Shuhei Ohashi
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masatoshi Hotta
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naoyuki Yagi
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hideaki Kitamura
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Hasegawa
- Department of Radiological Physics and Technology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Integrated Image Information Analysis, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Ohno S, Konta S, Shindo R, Yamamoto K, Isobe R, Inaba Y, Suzuki M, Zuguchi M, Chida K. Effect of backscatter radiation on the occupational eye-lens dose. JOURNAL OF RADIATION RESEARCH 2024; 65:450-458. [PMID: 38818635 PMCID: PMC11262866 DOI: 10.1093/jrr/rrae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/21/2024] [Indexed: 06/01/2024]
Abstract
We quantified the level of backscatter radiation generated from physicians' heads using a phantom. We also evaluated the shielding rate of the protective eyewear and optimal placement of the eye-dedicated dosimeter (skin surface or behind the Pb-eyewear). We performed diagnostic X-rays of two head phantoms: Styrofoam (negligible backscatter radiation) and anthropomorphic (included backscatter radiation). Radiophotoluminescence glass dosimeters were used to measure the eye-lens dose, with or without 0.07-mm Pb-equivalent protective eyewear. We used tube voltages of 50, 65 and 80 kV because the scattered radiation has a lower mean energy than the primary X-ray beam. The backscatter radiation accounted for 17.3-22.3% of the eye-lens dose, with the percentage increasing with increasing tube voltage. Furthermore, the shielding rate of the protective eyewear was overestimated, and the eye-lens dose was underestimated when the eye-dedicated dosimeter was placed behind the protective eyewear. We quantified the backscatter radiation generated from physicians' heads. To account for the effect of backscatter radiation, an anthropomorphic, rather than Styrofoam, phantom should be used. Close contact of the dosimeter with the skin surface is essential for accurate evaluation of backscatter radiation from physician's own heads. To assess the eye-lens dose accurately, the dosimeter should be placed near the eye. If the dosimeter is placed behind the lens of the protective eyewear, we recommend using a backscatter radiation calibration factor of 1.2-1.3.
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Affiliation(s)
- Saya Ohno
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Satoe Konta
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Ryota Shindo
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Keisuke Yamamoto
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Rio Isobe
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
| | - Masatoshi Suzuki
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai 980-8579, Japan
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Shindo R, Ohno S, Yamamoto K, Konta S, Inaba Y, Suzuki M, Zuguchi M, Chida K. Comparison of shielding effects of over-glasses-type and regular eyewear in terms of occupational eye dose reduction. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:023501. [PMID: 38701771 DOI: 10.1088/1361-6498/ad4714] [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: 01/17/2024] [Accepted: 05/03/2024] [Indexed: 05/05/2024]
Abstract
Given the new recommendations for occupational eye lens doses, various lead glasses have been used to reduce irradiation of interventional radiologists. However, the protection afforded by lead glasses over prescription glasses (thus over-glasses-type eyewear) has not been considered in detail. We used a phantom to compare the protective effects of such eyewear and regular eyewear of 0.07 mm lead-equivalent thickness. The shielding rates behind the eyewear and on the surface of the left eye of an anthropomorphic phantom were calculated. The left eye of the phantom was irradiated at various angles and the shielding effects were evaluated. We measured the radiation dose to the left side of the phantom using RPLDs attached to the left eye and to the surface/back of the left eyewear. Over-glasses-type eyewear afforded good protection against x-rays from the left and below; the average shielding rates on the surface of the left eye ranged from 0.70-0.72. In clinical settings, scattered radiation is incident on physicians' eyes from the left and below, and through any gap in lead glasses. Over-glasses-type eyewear afforded better protection than regular eyewear of the same lead-equivalent thickness at the irradiation angles of concern in clinical settings. Although clinical evaluation is needed, we suggest over-glasses-type Pb eyewear even for physicians who do not wear prescription glasses.
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Affiliation(s)
- Ryota Shindo
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Saya Ohno
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Keisuke Yamamoto
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Satoe Konta
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
| | - Masatoshi Suzuki
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai 980-8575, Japan
- Division of Radiological Disasters and Medical Science, Department of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4 Aoba, Sendai 980-8579, Japan
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Yamamoto K, Shindo R, Ohno S, Konta S, Isobe R, Inaba Y, Suzuki M, Hosoi Y, Chida K. Basic Performance Evaluation of a Radiation Survey Meter That Uses a Plastic-Scintillation Sensor. SENSORS (BASEL, SWITZERLAND) 2024; 24:2973. [PMID: 38793828 PMCID: PMC11125092 DOI: 10.3390/s24102973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
After the Fukushima nuclear power plant accident in 2011, many types of survey meters were used, including Geiger-Müller (GM) survey meters, which have long been used to measure β-rays. Recently, however, a novel radiation survey meter that uses a plastic-scintillation sensor has been developed. Although manufacturers' catalog data are available for these survey meters, there have been no user reports on performance. In addition, the performance of commercial plastic-scintillation survey meters has not been evaluated. In this study, we experimentally compared the performance of a plastic-scintillation survey meter with that of a GM survey meter. The results show that the two instruments performed very similarly in most respects. The GM survey meter exhibited count losses when the radiation count rate was high, whereas the plastic-scintillation survey meter remained accurate under such circumstances, with almost no count loss at high radiation rates. For measurements at background rates (i.e., low counting rates), the counting rates of the plastic-scintillation and GM survey meters were similar. Therefore, an advantage of plastic-scintillation survey meters is that they are less affected by count loss than GM survey meters. We conclude that the plastic-scintillation survey meter is a useful β-ray measuring/monitoring instrument.
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Affiliation(s)
- Keisuke Yamamoto
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
- Department of Radiation Biology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan;
| | - Ryota Shindo
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
| | - Saya Ohno
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
| | - Satoe Konta
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
| | - Rio Isobe
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Yoshio Hosoi
- Department of Radiation Biology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan;
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (K.Y.); (R.S.); (S.O.); (S.K.); (R.I.); (Y.I.); (M.S.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
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Matsunaga Y, Haba T, Kobayashi M, Suzuki S, Asada Y, Chida K. Assessment of fetal radiation exposure in pregnant women undergoing computed tomography and rotational angiography examinations for pelvic trauma. RADIATION PROTECTION DOSIMETRY 2024; 200:580-587. [PMID: 38486458 DOI: 10.1093/rpd/ncae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/18/2024] [Accepted: 02/26/2024] [Indexed: 04/23/2024]
Abstract
This study aimed to assess fetal radiation exposure in pregnant women undergoing computed tomography (CT) and rotational angiography (RA) examinations for the diagnosis of pelvic trauma. In addition, this study aimed to compare the dose distributions between the two examinations. Surface and average fetal doses were estimated during CT and RA examinations using a pregnant phantom model and real-time dosemeters. The pregnant model phantom was constructed using an anthropomorphic phantom, and a custom-made abdominal phantom was used to simulate pregnancy. The total average fetal dose received by pregnant women from both CT scans (plain, arterial and equilibrium phases) and a single RA examination was ~60 mGy. Because unnecessary repetition of radiographic examinations, such as CT or conventional 2D angiography can increase the radiation risk, the irradiation range should be limited, if necessary, to reduce overall radiation exposure.
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Affiliation(s)
- Yuta Matsunaga
- Department of Imaging, Nagoya Kyoritsu Hospital, 1-172, Hokke, Nakagawa-ku, Nagoya, Aichi, Japan
- Department of Radiological Technology, Faculty of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomonobu Haba
- Faculty of Radiological Technology, School of Medical Science, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho,Toyoake, Aichi, Japan
| | - Masanao Kobayashi
- Faculty of Radiological Technology, School of Medical Science, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho,Toyoake, Aichi, Japan
| | - Shoichi Suzuki
- Faculty of Radiological Technology, School of Medical Science, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho,Toyoake, Aichi, Japan
| | - Yasuki Asada
- Faculty of Radiological Technology, School of Medical Science, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho,Toyoake, Aichi, Japan
| | - Koichi Chida
- Department of Radiological Technology, Faculty of Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
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Matsumoto H, Tokushige S, Takei Y, Uyama Y, Mura M, Hitomi G. [The Need for Lens Radiation Protection for Healthcare Provider in Open and Internal Fixation of the Hip Joint]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2024; 80:287-295. [PMID: 38296460 DOI: 10.6009/jjrt.2024-1422] [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] [Indexed: 03/22/2024]
Abstract
Increased occupational exposure of radiation workers is a major problem during open reduction and internal fixation (ORIF) of the hip joint, as the surgeon's eye lens is in close proximity to the patient and the X-ray tube. The purposes of this study were to clarify the occupational exposure of radiation workers during ORIF of the hip joint and to examine the need for radiation protection measures. The radiation exposure of radiation workers was evaluated by making an airborne dose distribution map using phantom experiments. The radiation goggles attached with a small optically stimulated luminescence dosimeter were used in clinical practice to measure the lens dose received by the surgeon, and the necessity of radiation goggles was examined. The airborne dose distribution in ORIF of the hip joint showed a wider area of high dose rate during axial fluoroscopy of the femoral neck than during posterior-anterior fluoroscopy. In axial fluoroscopy of the femoral neck, the surgeon was always in the high dose rate range of 10 µGy/min or higher, the nurses were in the dose rate range of 4 to 10 µGy/min, and the radiologic technologists were in the dose rate range of 0.5 µGy/min or lower. The maximum 3 mm dose equivalent to the surgeon per case was 0.38 mSv. In contradiction, radiation goggles were useful in ORIF because they provided approximately 60% shielding. It is advisable to work with radiation goggles to avoid cataracts.
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Affiliation(s)
- Hiroki Matsumoto
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Shoya Tokushige
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Yasutaka Takei
- Department of Radiological Technology, Kawasaki University of Medical Welfare
| | - Yuji Uyama
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Masakatsu Mura
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Go Hitomi
- Department of Radiological Technology, Kawasaki Medical School Hospital
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Serna Santos J, Kaasalainen T, Laukontaus S, Björkman P, Heinola I, Laine M, Vikatmaa P, Pekkarinen A, Venermo M, Aho P. The Effect of a Suspended Radiation Protection System on Occupational Radiation Doses During Infrarenal EVAR Procedures: A Randomised Controlled Study. Eur J Vasc Endovasc Surg 2024; 67:435-443. [PMID: 37611731 DOI: 10.1016/j.ejvs.2023.08.039] [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: 11/11/2022] [Revised: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE To compare the protective effect of Zero Gravity (ZG) with conventional radiation protection during endovascular aneurysm repair (EVAR). Secondly, user experience was surveyed with a questionnaire on ergonomics. METHODS This was a single centre, prospective, randomised, two arm trial where 71 consecutive elective infrarenal EVAR procedures were randomised into two groups: (1) operator using ZG and assistant using conventional protection (n = 36), and (2) operator and assistant using conventional radiation protection (n = 35). A movable floor unit ZG system consists of a lead shield (1.0 mm Pb equivalent) for the front of the body and 0.5 mm Pb equivalent acrylic shielding for the head and neck. The ZG also includes arm flaps of 0.5 mm Pb equivalent covering the arm up to the elbow. Deep dose equivalent values, Hp(10) were measured with direct ion storage dosimeters (DIS) placed on various anatomical regions of the operator (axilla, chest, abdomen, and lower leg). Personal dose equivalent values, Hp(3) to eye lenses were measured in the operating and assisting surgeon using thermoluminescence dosimeters. The study was registered at the US National Institute of Health #NCT04078165. RESULTS Protection with the standard protection was superior in chest (0.0 vs. 0.1 μSv), abdomen (0.0 vs. 0.6 μSv), and lower leg (0.4 vs. 2.2 μSv) (p < .001). On the other hand, the ZG system yielded better shielding for the axilla (1.5 vs. 0.0 μSv) and eyes (6.3 vs. 1.1 μSv) of the operator. The use of ZG hampered the deployment of ancillary shields, which is particularly relevant for protection of the assisting surgeon. Users found ZG more cumbersome than conventional garments, it also impaired communication and reduced field of view. CONCLUSION Both ZG and conventional radiation protection reduced radiation exposure. Conventional protection allows better manoeuvrability at the price of wider exposure of the upper arm and axilla. ZG indirectly impaired protection of the assistant.
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Affiliation(s)
- Juan Serna Santos
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland.
| | - Touko Kaasalainen
- HUS Diagnostic Centre, Radiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Sani Laukontaus
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Patrick Björkman
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Ivika Heinola
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Matti Laine
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Pirkka Vikatmaa
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Antti Pekkarinen
- Radiation Practices Regulation, Radiation and Nuclear Safety Authority (STUK), Helsinki, Finland; Department of Medical Physics, Kymsote, Kymenlaakso Central Hospital
| | - Maarit Venermo
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
| | - Pekka Aho
- Department of Vascular Surgery, University of Helsinki and Helsinki University Hospital, Finland
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Lian ME, Yee WG, Yu KL, Wu GY, Yang SM, Tsai HY. Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:011502. [PMID: 38194908 DOI: 10.1088/1361-6498/ad1cd3] [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: 08/31/2023] [Accepted: 01/09/2024] [Indexed: 01/11/2024]
Abstract
Cancer is a major health challenge and causes millions of deaths worldwide each year, and the incidence of lung cancer has increased. Augmented fluoroscopic bronchoscopy (AFB) procedures, which combine bronchoscopy and fluoroscopy, are crucial for diagnosing and treating lung cancer. However, fluoroscopy exposes patients and physicians to radiation, and therefore, the procedure requires careful monitoring. The National Council on Radiation Protection and Measurement and the International Commission on Radiological Protection have emphasised the importance of monitoring patient doses and ensuring occupational radiation safety. The present study evaluated radiation doses during AFB procedures, focusing on patient skin doses, the effective dose, and the personal dose equivalent to the eye lens for physicians. Skin doses were measured using thermoluminescent dosimeters. Peak skin doses were observed on the sides of the patients' arms, particularly on the side closest to the x-ray tube. Differences in the procedures and experience of physicians between the two hospitals involved in this study were investigated. AFB procedures were conducted more efficiently at Hospital A than at Hospital B, resulting in lower effective doses. Cone-beam computed tomography (CT) contributes significantly to patient effective doses because it has higher radiographic parameters. Despite their higher radiographic parameters, AFB procedures resulted in smaller skin doses than did image-guided interventional and CT fluoroscopy procedures. The effective doses differed between the two hospitals of this study due to workflow differences, with cone-beam CT playing a dominant role. No significant differences in left and right eyeHp(3) values were observed between the hospitals. For both hospitals, theHp(3) values were below the recommended limits, indicating that radiation monitoring may not be required for AFB procedures. This study provides insights into radiation exposure during AFB procedures, concerning radiation dosimetry, and safety for patients and physicians.
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Affiliation(s)
- Meng-En Lian
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Wong Guang Yee
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Kai-Lun Yu
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Guan-Yi Wu
- Scientific Research Division, National Synchrotron Radiation Research Center, Hsinchu, Taiwan
| | - Shun-Mao Yang
- Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hui-Yu Tsai
- Institute of Nuclear Engineering and Science, National Tsing Hua University, Hsinchu, Taiwan
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11
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Ishii H, Chida K, Inaba Y, Abe K, Onodera S, Zuguchi M. Fundamental study on diagnostic reference level quantities for endoscopic retrograde cholangiopancreatography using a C-arm fluoroscopy system. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:041510. [PMID: 37939385 DOI: 10.1088/1361-6498/ad0a9d] [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: 08/18/2023] [Accepted: 11/08/2023] [Indexed: 11/10/2023]
Abstract
The diagnostic reference level (DRL) is an effective tool for optimising protection in medical exposures to patients. However regarding air kerma at the patient entrance reference point (Ka,r), one of the DRL quantities for endoscopic retrograde cholangiopancreatography (ERCP), manufacturers use a variety of the International Electrotechnical Commission and their own specific definitions of the reference point. The research question for this study was whetherKa,ris appropriate as a DRL quantity for ERCP. The purpose of this study was to evaluate the difference betweenKa,rand air kerma incident on the patient's skin surface (Ka,e) at the different height of the patient couch for a C-arm system. Fluoroscopy and radiography were performed using a C-arm system (Ultimax-i, Canon Medical Systems, Japan) and a over-couch tube system (CUREVISTA Open, Fujifilm Healthcare, Japan).Ka,ewas measured by an ion chamber placed on the entrance surface of the phantom. Kerma-area product (PKA) andKa,rwere measured by a built-inPKAmeter and displayed on the fluoroscopy system.Ka,edecreased whileKa,rincreased as the patient couch moved away from the focal spot. The uncertainty of theKa,e/Ka,rratio due to the different height of the patient couch was estimated to be 75%-94%.Ka,rmay not accurately representKa,e.PKAwas a robust DRL quantity that was independent of the patient couch height. We cautioned against optimising patient doses in ERCP with DRLs set in terms ofKa,rwithout considering the patient couch height of the C-arm system. Therefore, we recommend thatKa,ris an inappropriate DRL quantity in ERCP using the C-arm system.
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Affiliation(s)
- Hiroki Ishii
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai 980-8572, Japan
| | - Yohei Inaba
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
- Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai 980-8572, Japan
| | - Keisuke Abe
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Shu Onodera
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan
| | - Masayuki Zuguchi
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
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12
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Nagamoto K, Kawachino T, Suetsugu Y, Saruwatari H, Nihei SI, Kunugita N. Eye lens dose in spine surgeons during myelography procedures: a dosimetry study. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:041509. [PMID: 37944177 DOI: 10.1088/1361-6498/ad0b3a] [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: 07/16/2023] [Accepted: 11/09/2023] [Indexed: 11/12/2023]
Abstract
To determine the eye lens dose (3 mm dose equivalent [Hp(3)]) received by spine surgeons during myelography and evaluate the effectiveness of radiation-protective glasses and x-ray tube system positioning in reducing radiation exposure. This study included spine surgeons who performed myelography using over- or under-table x-ray tube systems. Hp(3) was measured for each examination using a radio-photoluminescence glass dosimeter (GD-352M) mounted on radiation-protective glass. This study identified significantly high Hp(3) levels, especially in the right eye lens in spinal surgeons. The median Hp(3) values in the right eye were 524 (391-719) and 58 (42-83)μSv/examination for over- and under-table x-ray tube systems, respectively. Further, Hp(3)AK, which was obtained by dividing the cumulative air kerma from Hp(3), was 8.09 (6.69-10.21) and 5.11 (4.06-6.31)μSv mGy-1for the over- and under-table x-ray tube systems, respectively. Implementing radiation-protective glasses resulted in dose reduction rates of 54% (50%-57%) and 54% (51%-60%) for the over- and under-table x-ray tube systems, respectively. The use of radiation protection glasses significantly reduced the radiation dose in the eye lens during myelography, with the most effective measures being the combination of using radiation protection glasses and an under-table x-ray tube system.
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Affiliation(s)
- Keisuke Nagamoto
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Tomonori Kawachino
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Yoshiki Suetsugu
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Hiromi Saruwatari
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Shun-Ichi Nihei
- Department of Emergency and Intensive Care Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Naoki Kunugita
- Department of Occupational and Community Health Nursing School of Health Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
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13
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Sakafu L, Kiango V, Khasim Z, Shoo A, Ndossa M, Kagaruki G, Manyama D, Magandi J, Lee AY. Radiation safety in an era of diagnostic radiology growth in Africa: Lessons learned from Tanzania. Clin Imaging 2023; 102:65-70. [PMID: 37625349 DOI: 10.1016/j.clinimag.2023.08.006] [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: 07/05/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE As radiology continues to grow in low- and middle-income countries (LMICs), radiation exposure and risk to patients and staff will concurrently increase. This study aims to assess the knowledge of radiation safety among medical staff in Tanzania. METHODS A survey was distributed to 350 staff members at a national referral hospital in Tanzania over a 7-month period (February-August 2021). This consisted of a structured questionnaire evaluating participants' knowledge and awareness ionizing radiation and radiation safety. Chi-square and Fisher's exact tests were used to determine the association between independent and dependent categorical variables. RESULTS A total of 300 surveys were completed (86% response rate). Mean age was 31 and 53% of participants were female. The majority (89%) were clinical staff employed in direct patient care. Most reported having heard of radiation protection (85%) but only 61% reported receiving training in radiation protection. Regarding radiation knowledge, 73% correctly answered how to protect oneself from radiation and 74% knew which medical staff were at greater risk of radiation exposure. However, only 32% correctly answered which imaging tests emit more radiation and only 53% correctly answered which age group was at greatest risk of radiation effects. Non-clinical staff had a significantly lower radiation awareness than clinical staff, with 69.7% reporting having heard about radiation protection, compared to 88.3% of clinical staff (p = 0.004). Female participants were more knowledgeable of radiation risks in pregnancy (p = 0.002). More early career staff reported receiving radiation protection training (64.5%) compared to those with >5 years work experience (53.9%), though this difference was not statistically significant (p = 0.09). When stratifying radiation knowledge by high (score of 80-100%), moderate (60-79.9%) and low (<60%), 20% of participants scored high, 47% moderate, and 33% low. CONCLUSION Most staff had low to moderate knowledge on radiation safety. Our findings highlight the importance of education on ionizing radiation as medical imaging continues to rise in Africa.
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Affiliation(s)
- Lulu Sakafu
- Department of Radiology, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania.
| | - Violet Kiango
- Department of Radiology, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Zuwena Khasim
- Department of Radiology, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Aikankira Shoo
- Department of Radiology, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Mariam Ndossa
- Department of Radiology, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Gibson Kagaruki
- National Institute of Medical Research (NIMR), Mbeya, Tanzania
| | - Deogratius Manyama
- Department of Surgery, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Julieth Magandi
- Department of Surgery, Muhimbili National Hospital-Mloganzila, Dar es Salaam, Tanzania
| | - Amie Y Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States of America
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14
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Yamada A, Haga Y, Sota M, Abe M, Kaga Y, Inaba Y, Suzuki M, Tada N, Zuguchi M, Chida K. Eye Lens Radiation Dose to Nurses during Cardiac Interventional Radiology: An Initial Study. Diagnostics (Basel) 2023; 13:3003. [PMID: 37761370 PMCID: PMC10528633 DOI: 10.3390/diagnostics13183003] [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: 08/21/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Although interventional radiology (IVR) is preferred over surgical procedures because it is less invasive, it results in increased radiation exposure due to long fluoroscopy times and the need for frequent imaging. Nurses engaged in cardiac IVR receive the highest lens radiation doses among medical workers, after physicians. Hence, it is important to measure the lens exposure of IVR nurses accurately. Very few studies have evaluated IVR nurse lens doses using direct dosimeters. This study was conducted using direct eye dosimeters to determine the occupational eye dose of nurses engaged in cardiac IVR, and to identify simple and accurate methods to evaluate the lens dose received by nurses. Over 6 months, in a catheterization laboratory, we measured the occupational dose to the eyes (3 mm dose equivalent) and neck (0.07 mm dose equivalent) of nurses on the right and left sides. We investigated the relationship between lens and neck doses, and found a significant correlation. Hence, it may be possible to estimate the lens dose from the neck badge dose. We also evaluated the appropriate position (left or right) of eye dosimeters for IVR nurses. Although there was little difference between the mean doses to the right and left eyes, that to the right eye was slightly higher. In addition, we investigated whether it is possible to estimate doses received by IVR nurses from patient dose parameters. There were significant correlations between the measured doses to the neck and lens, and the patient dose parameters (fluoroscopy time and air kerma), implying that these parameters could be used to estimate the lens dose. However, it may be difficult to determine the lens dose of IVR nurses accurately from neck badges or patient dose parameters because of variation in the behaviors of nurses and the procedure type. Therefore, neck doses and patient dose parameters do not correlate well with the radiation eye doses of individual IVR nurses measured by personal eye dosimeters. For IVR nurses with higher eye doses, more accurate measurement of the radiation doses is required. We recommend that a lens dosimeter be worn near the eyes to measure the lens dose to IVR nurses accurately, especially those exposed to relatively high doses.
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Affiliation(s)
- Ayumi Yamada
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Masahiro Sota
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Mitsuya Abe
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Yuji Kaga
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan; (M.A.); (Y.K.)
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Norio Tada
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan;
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan; (A.Y.); (Y.H.); (M.S.); (Y.I.); (M.S.); (M.Z.)
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
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15
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Khafaji M, Ashour TM, Mozahim NF, Tashkandi A, Alqarni B, Malaikah AA, Bagabas AK, Alwasabi AA, Albahiti SK. Measurement of Occupational Eye and Thyroid Radiation Doses in Pediatric Interventional Cardiologists at a Tertiary Hospital. Cureus 2023; 15:e44894. [PMID: 37814769 PMCID: PMC10560443 DOI: 10.7759/cureus.44894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/11/2023] Open
Abstract
Background Advances in imaging techniques have led to increased utilization of imaging devices in catheterization laboratories. Invasive surgical procedures for cardiac disorders have been largely replaced by fluoroscopic cardiac catheterization. With this increase, concerns and risks associated with exposure to ionizing radiation among interventional cardiologists are growing. This study aims to measure and compare the occupational doses to the eye lens and thyroid of pediatric interventional cardiologists during different procedures in the catheterization laboratory and its significance. Methodology In this study, cardiologists wore bandanas with attached dosimeters to measure the absorbed doses to the eyes and thyroid gland. The dosimeters were collected for reading. The procedure types were also collected. In addition, the total fluoroscopy time and tube voltage of the biplane machine were measured. SPSS version 23 (IBM Corp., Armonk, NY, USA) was used to analyze the data. The characteristics of the study sample were described using simple counts and percentages, whereas means and standard deviations were used for continuous variables. Statistical significance was set at p-values <0.05. Results A total of 93 procedures were evaluated. The mean absorbed doses for all 93 procedures in both eyes and thyroid were 0.09 mGy and 0.08 mGy, respectively. A significant difference was found between the left and right eye measurements (p = 0.034), with higher doses administered to the left eye. However, no significant difference was observed between the right and left thyroid doses (p = 0.281). Significant correlations were found between the eye and thyroid doses and the procedure type (p = 0.02 and p = 0.009, respectively). Conclusions A significant amount of radiation was measured in the measurements of both organs. In addition, radiation dose measurements varied between different types of procedures. Our current results indicate the importance and necessity of applying the radiation protection concept of dose optimization.
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Affiliation(s)
- Mawya Khafaji
- Radiology Department, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Tariq M Ashour
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Naif F Mozahim
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Basil Alqarni
- Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | | | | | - Sarah K Albahiti
- Radiology Department, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Kawauchi S, Chida K, Hamada Y, Tsuruta W. Image Quality and Radiation Dose of Conventional and Wide-Field High-Resolution Cone-Beam Computed Tomography for Cerebral Angiography: A Phantom Study. Tomography 2023; 9:1683-1693. [PMID: 37736987 PMCID: PMC10514806 DOI: 10.3390/tomography9050134] [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: 06/20/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/23/2023] Open
Abstract
There has been an increase in the use of interventional neuroradiology procedures because of their non-invasiveness compared to surgeries and the improved image quality of fluoroscopy, digital subtraction angiography, and rotational angiography. Although cone-beam computed tomography (CBCT) images are inferior to multi-detector CT images in terms of low-contrast detectability and lower radiation doses, CBCT scans are frequently performed because of their accessibility. This study aimed to evaluate the image quality and radiation dose of two different high-resolution CBCTs (HR CBCT): conventional (C-HR CBCT) and wide-field HR CBCT (W-HR CBCT). The modulation transfer function (MTF), noise power spectrum (NPS), and contrast-to-noise ratio (CNR) were used to evaluate the image quality. On comparing the MTF of C-HR CBCT with a 256 × 256 matrix and that of W-HR CBCT with a 384 × 384 matrix, the MTF of W-HR CBCT with the 384 × 384 matrix was larger. A comparison of the NPS and CNR of C-HR CBCT with a 256 × 256 matrix and W-HR CBCT with a 384 × 384 matrix showed that both values were comparable. The reference air kerma values were equal for C-HR CBCT and W-HR CBCT; however, the value of the kerma area product was 1.44 times higher for W-HR CBCT compared to C-HR CBCT. The W-HR CBCT allowed for improved spatial resolution while maintaining the image noise and low-contrast detectability by changing the number of image matrices from 256 × 256 to 384 × 384. Our study revealed the image characteristics and radiation dose of W-HR CBCT. Given its advantages of low-contrast detectability and wide-area imaging with high spatial resolution, W-HR CBCT may be useful in interventional neuroradiology for acute ischemic stroke.
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Affiliation(s)
- Satoru Kawauchi
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan; (S.K.); (Y.H.)
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Miyagi, Japan
- Okinaka Memorial Institute for Medical Research, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Miyagi, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Miyagi, Japan
| | - Yusuke Hamada
- Department of Radiology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan; (S.K.); (Y.H.)
| | - Wataro Tsuruta
- Department of Endovascular Neurosurgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan;
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17
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Tam SY, Fung YY, Lau SY, Lam WN, Wong ETH. Scatter Radiation Distribution to Radiographers, Nearby Patients and Caretakers during Portable and Pediatric Radiography Examinations. Bioengineering (Basel) 2023; 10:779. [PMID: 37508806 PMCID: PMC10376625 DOI: 10.3390/bioengineering10070779] [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: 05/19/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Scatter radiation from portable and pediatric X-rays could pose a risk to radiographers, nearby patients, and caretakers. We aim to evaluate the spatial scatter radiation distribution to the radiographers, nearby patients, and caretakers during common projections in portable and pediatric X-rays. We evaluated the three-dimensional scatter dose profiles of four and three commonly used portable and pediatric X-ray projections, respectively, by anthropomorphic phantoms and scatter probes. For portable X-ray, the AP abdomen had the highest scatter radiation dose recorded. Radiographer scatter radiation doses were 177 ± 8 nGy (longest cord extension) and 14 ± 0 nGy (hiding behind the portable X-ray machine). Nearby patient scatter radiation doses were 3323 ± 28 nGy (40 cm bed distance), 1785 ± 50 nGy (80 cm bed distance), and 580 ± 42 nGy (160 cm bed distance). The AP chest and abdomen had the highest scatter radiation dose in pediatric X-rays. Caretaker scatter radiation doses were 33 ± 1 nGy (50 cm height) and 659 ± 7 nGy (140 cm height). Although the estimated lens doses were all within safe levels, the use of shielding and caution on dose estimation by inverse square law is suggested to achieve the ALARA principle and dose optimization.
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Affiliation(s)
- Shing-Yau Tam
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 999077, China
| | - Yuen-Ying Fung
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 999077, China
| | - Sum-Yi Lau
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 999077, China
| | - Wang-Ngai Lam
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 999077, China
| | - Edward Ting-Hei Wong
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 999077, China
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18
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Imai S, Yamahata A, Kakimoto A, Kawaji Y, Gotanda T, Akagawa T, Yatake H. Evaluation of factors associated with the effectiveness of radiation protection glasses. RADIATION PROTECTION DOSIMETRY 2023; 199:1002-1006. [PMID: 37225197 DOI: 10.1093/rpd/ncad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The effects of lead equivalent and lens area of radiation-protective eyewear on lens exposure control were examined. The simulated patient underwent 10-min X-ray fluoroscopy, and the lens dose of the simulated surgeon wearing radiation protection glasses was measured using lens dosemeters attached to the corner of the eye and eyeball. In total, 10 types of radiation protection glasses were selected for measurement. Correlation analysis of the equivalent dose in the lens of the eye with lead equivalence and lens area was performed. The equivalent dose in the lens of the eye of the corner of the eye was negatively correlated with the area of the lens. The equivalent dose in the lens of the eye and the eyeball showed a strong negative correlation with lead equivalence. Lens dosemeters worn at the corner of the eye may overestimate the equivalent dose in the lens of the eye. Moreover, the reduction in exposure of the lens was significantly influenced by the lead equivalent.
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Affiliation(s)
- Shinya Imai
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Asuka Yamahata
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Akihiro Kakimoto
- Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Yasuyuki Kawaji
- Faculty of Health Sciences, Junshin Gakuen University, Fukuoka, Japan
| | - Tatsuhiro Gotanda
- Faculty of Health Sciences and Technology, Kawasaki University of Medical Welfare, Okayama, Japan
| | - Takuya Akagawa
- Department of Radiological Technology, Tokushima Red Cross Hospital, Tokushima, Japan
| | - Hidetoshi Yatake
- Department of Breast Cancer Center, Kaizuka City Hospital, Osaka, Japan
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19
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Ikezawa K, Hayashi S, Takenaka M, Yakushijin T, Nagaike K, Takada R, Yamai T, Matsumoto K, Yamamoto M, Omoto S, Minaga K, Ishii S, Shimizu T, Nagai K, Hosono M, Nishida T. Occupational radiation exposure to the lens of the eyes and its protection during endoscopic retrograde cholangiopancreatography. Sci Rep 2023; 13:7824. [PMID: 37188704 DOI: 10.1038/s41598-023-34740-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 05/06/2023] [Indexed: 05/17/2023] Open
Abstract
This study aimed to examine occupational radiation exposure to the lens of the eyes during endoscopic retrograde cholangiopancreatography (ERCP). In this multicenter, prospective, observational cohort study, we collected data regarding occupational radiation exposure to the lens of the eyes during ERCP. We measured radiation exposure of patients and examined its correlation with occupational exposure. In dosimetrically-measured ERCPs (n = 631), the median air kerma at the patient entrance reference point, air kerma-area product, and fluoroscopy time were 49.6 mGy, 13.5 Gycm2, and 10.9 min, respectively. The median estimated annual radiation dose to the lens of the eyes was 3.7, 2.2, and 2.4 mSv for operators, assistants, and nurses, respectively. Glass badge over lead aprons and eye dosimeter results were similar in operators but differed in assistants and nurses. A strong correlation was shown between eye dosimeter measurements and patients' radiation exposure. The shielding rates of the lead glasses were 44.6%, 66.3%, and 51.7% for operators, assistants, and nurses, respectively. This study revealed the actual occupational exposure dose for the lens of the eyes during ERCP and the efficacy of lead glass. Values of radiation exposure to patients can help estimate exposure to the lens of the eyes of medical staff.
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Affiliation(s)
- Kenji Ikezawa
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan.
| | - Shiro Hayashi
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
- Department of Gastroenterology and Internal Medicine, Hayashi Clinic, Suita, Osaka, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Takayuki Yakushijin
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Osaka, Japan
| | - Koji Nagaike
- Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Suita, Osaka, Japan
| | - Ryoji Takada
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan
| | - Takuo Yamai
- Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Osaka, Japan
| | - Kengo Matsumoto
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Masashi Yamamoto
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
| | - Shunsuke Omoto
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Kosuke Minaga
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
| | - Shuji Ishii
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Osaka, Japan
| | - Takeshi Shimizu
- Department of Gastroenterology and Hepatology, Osaka General Medical Center, Osaka, Osaka, Japan
| | - Kengo Nagai
- Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Suita, Osaka, Japan
| | - Makoto Hosono
- Department of Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan
| | - Tsutomu Nishida
- Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, Osaka, Japan
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20
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Fukushima K, Matsubara K, Tanabe M, Ito H. Eye lens dose for medical staff assisting patients during computed tomography: comparison of several types of radioprotective glasses. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:021505. [PMID: 37023744 DOI: 10.1088/1361-6498/accaf1] [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: 01/18/2023] [Accepted: 04/06/2023] [Indexed: 06/19/2023]
Abstract
Medical staff sometimes assists patients in the examination room during computed tomography (CT) scans for several purposes. This study aimed to investigate the dose reduction effects of four radioprotective glasses with different lead equivalents and lens shapes. A medical staff phantom was positioned assuming body movement restraint of the patient during chest CT, and Hp(3) at the eye surfaces of the medical staff phantom and inside the lens of the four types of radioprotective glasses were measured by changing the distance of the staff phantom from the gantry, eye height, and width of the nose pad. The Hp(3) at the right eye surface with glasses of 0.50-0.75 mmPb and 0.07 mmPb was approximately 83.5% and 58.0%, respectively, lower than that without radioprotective glasses. The dose reduction rates at left eye surface increased with over-glass type glasses by 14%-28% by increasing the distance from the CT gantry to the staff phantom from 25 to 65 cm. The dose reduction rates at the left eye surface decreased with over-glass type glasses by 26%-31% by increasing the height of the eye lens for the medical staff phantom from 130 to 170 cm. The Hp(3) on the left eye surface decreased by 46.9% with the widest nose pad width compared to the narrowest nose pad width for the glasses with adjustable nose pad width. The radioprotective glasses for staff assisting patients during CT examinations should have a high lead equivalent and no gap around the nose and under the front lens.
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Affiliation(s)
- Kotaro Fukushima
- Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Mariko Tanabe
- Department of Radiological Technology, School of Health Sciences, College of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
| | - Hajime Ito
- Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, Japan
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba, Japan
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21
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Ingleby HR, Bonilha HS, Steele CM. A Tutorial on Diagnostic Benefit and Radiation Risk in Videofluoroscopic Swallowing Studies. Dysphagia 2023; 38:517-542. [PMID: 34254167 DOI: 10.1007/s00455-021-10335-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
The videofluoroscopic swallowing study (VFSS) is a key tool in assessing swallowing function. As with any diagnostic procedure, the probable benefits of the study must be weighed against possible risks. The probable benefit of VFSS is an accurate assessment of swallowing function, enabling patient management decisions potentially leading to improved patient health status and quality of life. A possible (though highly unlikely) risk in VFSS is carcinogenesis, arising from the use of ionizing radiation. Clinicians performing videofluoroscopic swallowing studies should be familiar with both sides of the risk benefit equation in order to determine whether the study is medically justified. The intent of this article is to provide the necessary background for conversations about benefit and risk in videofluoroscopic swallowing studies.
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Affiliation(s)
- Harry R Ingleby
- Division of Medical Physics, CancerCare Manitoba; Departments of Radiology and Physics & Astronomy, University of Manitoba, 675 McDermot Avenue, Winnipeg, MB, R3E 0V9, Canada.
| | - Heather S Bonilha
- Departments of Rehabilitation Sciences; Health Science and Research; and Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - Catriona M Steele
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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22
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Yamashita K, Ueno H, Haba T, Ito Y, Matsunaga Y, Hirosawa A, Ishizaki S, Mizui M, Osawa M, Nomura T, Mogi S. [Efficacy of L-shaped Shielding in Interventional Radiology by Transradial Approach and Consideration of Methods for Appropriate Use]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:241-251. [PMID: 36724920 DOI: 10.6009/jjrt.2023-1325] [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] [Indexed: 02/03/2023]
Abstract
The present study investigated how effective an L-shaped shield was, depending on its position, in reducing a doctor's exposure to radiation during catheterization to access the transradial approach (TRA). The shield's effectiveness was evaluated by measuring the air kerma where the doctor stood under four conditions: with and without the shield, and with and without the shield in conjunction with conventional protection. To enable the shield to be positioned correctly in clinical practice, an illustrated instruction decal affixable to the shield's doctor-facing surface was produced, and the effectiveness of the decal was verified by means of a crossover test in which, as subjects of the study, different nurses set up the shield with and without the decal affixed to it. In the test, in which a human body phantom was used, the C-arm set at the PA angle, and the shield positioned 10 cm from the axilla of the phantom, the shield's effectiveness at 100 cm, 130 cm, and 160 cm above the floor where the doctor stood was 55%, 77%, and 47%, respectively. The effectiveness increased when the shield was positioned closer to the axilla. A significant difference in the positioning of the shield by the subjects was observed depending on whether or not the decal was affixed ( p<0.05, Wilcoxon signed-rank test), indicating that the use of the decal improved the positioning. It was concluded that, positioned correctly, the shield could effectively reduce the doctor's exposure to radiation during TRA.
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Affiliation(s)
| | | | | | - Yusuke Ito
- Department of Radiological Technology, Daiyukai Health System
| | | | - Ayaka Hirosawa
- Department of Medical Technology, Toyama Prefectural Central Hospital
| | | | | | | | | | - Satoshi Mogi
- Internal Medicine 3, Hamamatsu University School of Medicine
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23
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Kaasalainen T, Pekkarinen A, Kylänpää L, Rainio M, Tenca A, Jokelainen K, Barner-Rasmussen N, Puustinen L, Udd M, Lindström O. Occupational radiation dose from gastrointestinal endoscopy procedures with special emphasis on eye lens doses in endoscopic retrograde cholangiopancreatography. Endosc Int Open 2023; 11:E237-E246. [PMID: 36910845 PMCID: PMC9995179 DOI: 10.1055/a-2022-2663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/25/2023] [Indexed: 03/14/2023] Open
Abstract
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) procedures may result in remarkable radiation doses to patients and staff. The aim of this prospective study was to determine occupational exposures in gastrointestinal endoscopy procedures, with a special emphasis on eye lens dose in ERCP. Methods Altogether 604 fluoroscopy-guided procedures, of which 560 were ERCPs belonging to four American Society for Gastrointestinal Endoscopy procedural complexity levels, were performed using two fluoroscopy systems. Personal deep-dose equivalent H p (10), shallow-dose equivalent H p (0.07), and eye lens dose equivalent H p (3) of eight interventionists and H p (3) for two nurse dosimeters were measured. Thereafter, conversion coefficients from kerma-area product (KAP) for H p (10), H p (0.07), and H p (3) were determined and dose equivalents per procedure to an operator and assisting staff were estimated. Further, mean conversion factors from H p (10) and H p (0.07) to H p (3) were calculated. Results The median KAP in ERCP was 1.0 Gy·cm 2 , with mobile c-arm yielding higher doses than a floor-mounted device ( P < 0.001). The median H p (3) per ERCP was estimated to be 0.6 µSv (max. 12.5 µSv) and 0.4 µSv (max. 12.2 µSv) for operators and assisting staff, respectively. The median H p (10) and H p (0.07) per procedure ranged from 0.6 to 1.8 µSv. ERCP procedural complexity level ( P ≤ 0.002) and interventionist ( P < 0.001) affected dose equivalents. Conclusions Occupational dose limits are unlikely to be exceeded in gastrointestinal endoscopy practice when following radiation-hygienic working methods and focusing on dose optimization. The eye lens dose equivalent H p (3) may be estimated with sufficient agreement from the H p (10) and H p (0.07).
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Affiliation(s)
- Touko Kaasalainen
- HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Antti Pekkarinen
- Radiation and Nuclear Safety Authority - STUK, Helsinki, Finland.,Department of Physics, University of Helsinki, Helsinki, Finland.,Department of Medical Physics, Kymsote, Kymenlaakso Central Hospital, Helsinki, Finland
| | - Leena Kylänpää
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Mia Rainio
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Andrea Tenca
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Kalle Jokelainen
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Nina Barner-Rasmussen
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Lauri Puustinen
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Marianne Udd
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
| | - Outi Lindström
- HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
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24
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Otomo K, Inaba Y, Abe K, Onodera M, Suzuki T, Sota M, Haga Y, Suzuki M, Zuguchi M, Chida K. Spatial Scattering Radiation to the Radiological Technologist during Medical Mobile Radiography. Bioengineering (Basel) 2023; 10:bioengineering10020259. [PMID: 36829753 PMCID: PMC9952711 DOI: 10.3390/bioengineering10020259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Mobile radiography allows for the diagnostic imaging of patients who cannot move to the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have difficulty with movement. However, staff are exposed to scattered radiation from the patient, and they can receive potentially harmful radiation doses during radiography. We estimated occupational exposure during mobile radiography using phantom measurements. Scattered radiation distribution during mobile radiography was investigated using a radiation survey meter. The efficacy of radiation-reducing methods for mobile radiography was also evaluated. The dose decreased as the distance from the X-ray center increased. When the distance was more than 150 cm, the dose decreased to less than 1 μSv. It is extremely important for radiological technologists (RTs) to maintain a sufficient distance from the patient to reduce radiation exposure. The spatial dose at eye-lens height increases when the bed height is high, and when the RT is short in stature and abdominal imaging is performed. Maintaining sufficient distance from the patient is also particularly effective in limiting radiation exposure of the eye lens. Our results suggest that the doses of radiation received by staff during mobile radiography are not significant when appropriate radiation protection is used. To reduce exposure, it is important to maintain a sufficient distance from the patient. Therefore, RTs should bear this is mind during mobile radiography.
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Affiliation(s)
- Kazuki Otomo
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Keisuke Abe
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Mana Onodera
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Tomohiro Suzuki
- Department of Radiology, Tohoku University Hospital, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan
| | - Masahiro Sota
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-22-717-7943
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25
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Matsumoto H, Takei Y, Matsuda E, Masuda T. [Measurement of the Lens Dose for Radiological Technologists during Mobile Radiography]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:38-45. [PMID: 36418072 DOI: 10.6009/jjrt.2023-1295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The radiological technologists often assist patients near the X-ray area during mobile radiography. Therefore, it is expected that the lens of eye of radiological technologists is exposed to much radiation. The purposes of this study were to measure the lens dose received by radiological technologists during mobile radiography using radiation protection goggles with a personal dosimeter and a small optically stimulated luminescence dosimeter and discuss the need for radiation protection goggles and additional radiation protection measures. From October 2017 to March 2018, lens doses were measured for eight radiological technologists during mobile radiography using radiation protection goggles with a small optically stimulated luminescence dosimeter and a personal dosimeter. The maximum value of the lens dose received by radiological technologists in mobile radiography was 0.3 mSv per month with a personal dosimeter attached to the neck. The dose-reduction effect of radiation protection glasses during mobile radiography was about 45%. The radiation protection goggles are effective for reducing radiation exposure of lens of eye during mobile radiography. Since there is concern about an increase in lens dose, it is desirable to use the radiation protection goggles for reducing the lens of eye exposure.
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Affiliation(s)
- Hiroki Matsumoto
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Yasutaka Takei
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare
| | - Eiji Matsuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare
| | - Takanori Masuda
- Department of Radiological Technology, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare
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Hattori K, Inaba Y, Kato T, Fujisawa M, Yasuno H, Yamada A, Haga Y, Suzuki M, Zuguchi M, Chida K. Evaluation of a New Real-Time Dosimeter Sensor for Interventional Radiology Staff. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23010512. [PMID: 36617110 PMCID: PMC9823962 DOI: 10.3390/s23010512] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 06/01/2023]
Abstract
In 2011, the International Commission on Radiological Protection (ICRP) recommended a significant reduction in the lens-equivalent radiation dose limit, thus from an average of 150 to 20 mSv/year over 5 years. In recent years, the occupational dose has been rising with the increased sophistication of interventional radiology (IVR); management of IVR staff radiation doses has become more important, making real-time radiation monitoring of such staff desirable. Recently, the i3 real-time occupational exposure monitoring system (based on RaySafeTM) has replaced the conventional i2 system. Here, we compared the i2 and i3 systems in terms of sensitivity (batch uniformity), tube-voltage dependency, dose linearity, dose-rate dependency, and angle dependency. The sensitivity difference (batch uniformity) was approximately 5%, and the tube-voltage dependency was <±20% between 50 and 110 kV. Dose linearity was good (R2 = 1.00); a slight dose-rate dependency (~20%) was evident at very high dose rates (250 mGy/h). The i3 dosimeter showed better performance for the lower radiation detection limit compared with the i2 system. The horizontal and vertical angle dependencies of i3 were superior to those of i2. Thus, i3 sensitivity was higher over a wider angle range compared with i2, aiding the measurement of scattered radiation. Unlike the i2 sensor, the influence of backscattered radiation (i.e., radiation from an angle of 180°) was negligible. Therefore, the i3 system may be more appropriate in areas affected by backscatter. In the future, i3 will facilitate real-time dosimetry and dose management during IVR and other applications.
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Affiliation(s)
- Kenshin Hattori
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Yohei Inaba
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Toshiki Kato
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Masaki Fujisawa
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Hikaru Yasuno
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Ayumi Yamada
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Yoshihiro Haga
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiology, Sendai Kousei Hospital, 4-5 Hirose-machi, Aoba-ku, Sendai 980-0873, Japan
| | - Masatoshi Suzuki
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
| | - Masayuki Zuguchi
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba-ku, Sendai 980-8575, Japan
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Aoba-ku, Sendai 980-0845, Japan
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Yashima S, Chida K. Awareness of Medical Radiologic Technologists of Ionizing Radiation and Radiation Protection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010497. [PMID: 36612833 PMCID: PMC9819470 DOI: 10.3390/ijerph20010497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 06/02/2023]
Abstract
Japanese people experienced the Hiroshima and Nagasaki atomic bombings, the Japan Nuclear Fuel Conversion Co. criticality accident, it was found that many human resources are needed to respond to residents' concerns about disaster exposure in the event of a radiation disaster. Medical radiologic technologists learn about radiation from the time of their training, and are engaged in routine radiographic work, examination explanations, medical exposure counseling, and radiation protection of staff. By learning about nuclear disasters and counseling, we believe they can address residents' concerns. In order to identify items needed for training, we examined the perceptions of medical radiologic technologists in the case of different specialties, modalities and radiation doses. In 2016, 5 years after the Fukushima Daiichi nuclear power plant accident, we conducted a survey of 57 medical radiologic technologists at two medical facilities with different specialties and work contents to investigate their attitudes toward radiation. 42 participants answered questions regarding sex, age group, presence of children, health effects of radiation exposure, radiation control, generation of X rays by diagnostic X ray equipment, and radiation related units. In a comparison of 38 items other than demographic data, 14 showed no significant differences and 24 showed significant differences. This study found that perceptions of radiation were different among radiology technologists at facilities with different specialties. The survey suggested the possibility of identifying needed training items and providing effective training.
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Affiliation(s)
- Sachiko Yashima
- Division of Radiation, Miyagi Cancer Society, Sendai 980-0011, Miyagi, Japan
- Division of Radiological Disasters and Medical Science, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Sendai 980-8577, Miyagi, Japan
| | - Koichi Chida
- Division of Radiological Disasters and Medical Science, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Sendai 980-8577, Miyagi, Japan
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Miyagi, Japan
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Osawa M, Tawada Y, Kaneda N, Fujita N, Koyama S. EXAMINATION OF LENS EXPOSURE DOSES OF CARDIOLOGISTS, NEUROSURGEONS AND RADIOLOGISTS IN INTERVENTIONAL RADIOLOGY. RADIATION PROTECTION DOSIMETRY 2022; 198:1585-1597. [PMID: 36321327 DOI: 10.1093/rpd/ncac205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
The International Commission on Radiological Protection (ICRP) 118th recommendation significantly reduced the threshold dose for cataract development from 8 to 0.5 Gy. Equivalent dose limits for the crystalline lenses of radiation workers are being reviewed for individual countries. Interventional radiology (IR) procedures are less invasive than surgery and have become widespread; however, there are concerns about exposure not only to patients but also to staff, including operators. Therefore, in this study, we used a human phantom to measure the near-lens dose of the operators (cardiologists, neurosurgeons and radiologists) and estimated the operator's lens dose for every major procedure in each clinical department; this was found to vary. Owing to the different imaging and fluoroscopy conditions of each department, and the varying ratio of fluoroscopy to radiography, it is necessary to measure the lens dose for each condition, as in this study. In addition, this study explains the differences between the protective effect of various safety equipment and the appropriate use of protective plates; it can contribute to the reduction of lens doses for operators.
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Affiliation(s)
- Mitsuharu Osawa
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Yuka Tawada
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Naoki Kaneda
- Department of Radiology, Aichi Medical University Hospital, Nagakute, 480-1195, Japan
| | - Naotoshi Fujita
- Department of Radiological Technology, Nagoya University Hospital, Nagoya, 466-8560, Japan
| | - Shuji Koyama
- Brain and Mind Research Center, Nagoya University, Department of Brain and Mind Sciences, Nagoya University Graduate School of Medicine, Nagoya, 461-8673, Japan
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Masubuchi Y, Chida K, Inaba Y, Kageyama M, Shimada S, Yamashita A. [Patient Radiation Dose for Percutaneous Coronary Intervention by Treatment Area: Dosimetry Using DRLs 2020]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:1306-1313. [PMID: 36198569 DOI: 10.6009/jjrt.2022-1309] [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] [Indexed: 06/16/2023]
Abstract
PURPOSE Skin injury in patients due to radiation exposure has been a complication in percutaneous coronary intervention (PCI) for a long time. To the best of our knowledge, there have been no reports comparing radiation dose by treatment area with diagnostic reference levels (DRLs) 2020, although the radiation dose varies by treatment area in PCI. METHODS In this study, the treatment areas were classified into four segments (i.e., AHA #1-3, AHA #4, AHA #5-10, and AHA #11-15), and each segment was compared with DRLs 2020. This retrospective study included 984 consecutive patients with single-vessel disease and non-chronic total occlusion. PCI was performed on a single device. RESULTS The median radiation dose was 1640.8 mGy, and the radiation dose for AHA #4 was 2732.0 mGy, which was significantly higher than the other treatment areas (p<0.001). In AHA #4, the radiation dose increased due to the heavy use of the left cranial view, and the patient background contributed to the increased lesion complexity. Therefore, it was challenging to evaluate AHA #4 and the other treatment areas with a uniform DRL value. CONCLUSION Establishing a subdivided index for each treatment area is crucial if DRLs are used as a reference during procedures and as a guide for dose optimization.
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Affiliation(s)
- Yusuke Masubuchi
- Department of Radiology, Nasu Red Cross Hospital
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine
| | - Koichi Chida
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine
- Disaster Medical Radiology, Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University
| | - Yohei Inaba
- Department of Radiological Examination and Technology, Tohoku University Graduate School of Medicine
- Disaster Medical Radiology, Division of Disaster Medical Science, International Research Institute of Disaster Science, Tohoku University
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Morishima Y, Chida K, Meguro T, Hirota M, Chiba H, Fukuda H. LENS EQUIVALENT DOSE OF STAFF DURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY: DOSE COMPARISON USING TWO TYPES OF DOSEMETERS. RADIATION PROTECTION DOSIMETRY 2022; 198:1368-1376. [PMID: 36055968 DOI: 10.1093/rpd/ncac160] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
This study aimed to compare the lens equivalent dose (LED) measured during endoscopic retrograde cholangiopancreatography (ERCP) using DOSIRIS™ as a dedicated dosemeter to that measured using glass badges to determine if glass badges can be alternative tools for LED measurement. LEDs for physicians during ERCP were measured using the DOSIRIS™ [3-mm dose equivalent] worn on the outer edge of the eyes and personal dosemeters (glass badges) [0.07-mm dose equivalent] worn on the right and left sides of the neck. The cumulated doses over 6 months for the left eye using DOSIRIS™ were 9.5 and 11.8 mSv for physicians A and B, whereas doses measured using glass badges were 7.5 and 11.6 mSv, respectively. The LEDs of the physicians at the left eye and left neck side showed almost similar values and were significantly correlated (r = 0.95; p < 0.01). For an accurate LED measurement during ERCP, using a dosemeter such as DOSIRIS™ is recommended, although similar LED estimation values were reported using glass badges on the left neck side.
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Affiliation(s)
- Yoshiaki Morishima
- Department of Radiological Technology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, Japan
- Department of Radiological Technology, Tohoku University School of Health Sciences, Sendai 980-8575, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University School of Health Sciences, Sendai 980-8575, Japan
| | - Takayoshi Meguro
- Gastroenterology Center, Tohoku Medical and Pharmaceutical University Hospital, Sendai 983-8512, Japan
| | - Morihisa Hirota
- Gastroenterology Center, Tohoku Medical and Pharmaceutical University Hospital, Sendai 983-8512, Japan
| | - Hiroo Chiba
- Department of Radiological Technology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai 983-8512, Japan
| | - Hiroshi Fukuda
- Department of Radiology Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai 983-8356, Japan
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Kowatari M, Nagamoto K, Nakagami K, Yoshitomi H, Moritake T, Kunugita N. DOSE MEASUREMENT PRECISION OF AN RPLD-BASED EYE LENS DOSEMETER APPLICABLE TO THE MEDICAL SECTOR. RADIATION PROTECTION DOSIMETRY 2022; 198:1303-1312. [PMID: 35909091 DOI: 10.1093/rpd/ncac167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 05/23/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Abstract
We demonstrate a practical calibration method and its applicability for a commercially available radiophotoluminescence dosemeter (RPLD), i.e. the GD-352M (AGC Techno Glass, Shizuoka, Japan) to eye lens dose monitoring, by performing the calibration according to the ISO recommendations. The calibration was then verified through a series of experiments. For verification of the derived calibration factor (1.21 ± 0.04, k = 1) of the RPLD, we performed standard irradiations in the ISO narrow series X-ray reference fields and the simulation measurements in the actual radiation fields in a hospital. The TLD-based commercially available dosemeters, DOSIRIS™ was also put on the ISO cylinder phantom and the RANDO phantom together with the GD-352M in the verification experiments. The personal dose equivalents Hp(3) obtained from the GD-352M and those obtained from the DOSIRIS™ were in good agreement with each other. Our results demonstrate the proper calibration of a commercially available RPLD that is applicable to the additional monitoring of the lens of the eyes for medical staff.
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Affiliation(s)
- Munehiko Kowatari
- National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 Japan
| | - Keisuke Nagamoto
- University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Koichi Nakagami
- University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Hiroshi Yoshitomi
- Nuclear Science Research Institute, Japan Atomic Energy Agency, 2-4, Shirakata, Tokai, Naka, Ibaraki, 319-1195, Japan
| | - Takashi Moritake
- National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555 Japan
- University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
| | - Naoki Kunugita
- University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan
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Sato T, Eguchi Y, Yamazaki C, Hino T, Saida T, Chida K. Development of a New Radiation Shield for the Face and Neck of IVR Physicians. Bioengineering (Basel) 2022; 9:354. [PMID: 36004878 PMCID: PMC9404996 DOI: 10.3390/bioengineering9080354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/20/2022] [Accepted: 07/23/2022] [Indexed: 11/20/2022] Open
Abstract
Interventional radiology (IVR) procedures are associated with increased radiation exposure and injury risk. Furthermore, radiation eye injury (i.e., cataract) in IVR staff have also been reported. It is crucial to protect the eyes of IVR physicians from X-ray radiation exposure. Many IVR physicians use protective Pb eyeglasses to reduce occupational eye exposure. However, the shielding effects of Pb eyeglasses are inadequate. We developed a novel shield for the face (including eyes) of IVR physicians. The novel shield consists of a neck and face guard (0.25 mm Pb-equivalent rubber sheet, nonlead protective sheet). The face shield is positioned on the left side of the IVR physician. We assessed the shielding effects of the novel shield using a phantom in the IVR X-ray system; a radiophotoluminescence dosimeter was used to measure the radiation exposure. In this phantom study, the effectiveness of the novel device for protecting against radiation was greater than 80% in almost all measurement situations, including in terms of eye lens exposure. A large amount of scattered radiation reaches the left side of IVR physicians. The novel radiation shield effectively protects the left side of the physician from this scattered radiation. Thus, the device can be used to protect the face and eyes of IVR physicians from occupational radiation exposure. The novel device will be useful for protecting the face (including eyes) of IVR physicians from radiation, and thus could reduce the rate of radiation injury. Based on the positive results of this phantom study, we plan to perform a clinical experiment to further test the utility of this novel radiation shield for IVR physicians.
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Affiliation(s)
- Toshimitsu Sato
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Yoichi Eguchi
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Sendai 980-8575, Japan;
| | - Chika Yamazaki
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Takanobu Hino
- Department of Radiology, Yamagata University Hospital, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan; (T.S.); (C.Y.); (T.H.)
| | - Toshikazu Saida
- Department of Central Radiology, Nara Prefecture Seiwa Medical Center, 1-14-16 Mimuro, Nara 636-0802, Japan;
| | - Koichi Chida
- Course of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Sendai 980-8575, Japan;
- Department of Radiation Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aramaki Aza-Aoba, Sendai 980-0845, Japan
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Kawauchi S, Chida K, Moritake T, Hamada Y, Yoda S, Sakuma H, Tsuruta W, Matsumaru Y. Evaluation of Peak Skin Doses and Lens Doses during Interventional Neuroradiology Using a Direct Measurement System. JOURNAL OF NEUROENDOVASCULAR THERAPY 2022; 16:491-497. [PMID: 37502201 PMCID: PMC10370819 DOI: 10.5797/jnet.oa.2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/31/2022] [Indexed: 07/29/2023]
Abstract
Objective In interventional neuroradiology (INR), the evaluation of the peak skin dose (PSD) and lens dose is important because the patient radiation dose increases in cases in which the procedure is more difficult and complex. This study evaluated the radiation doses during INR procedures using a direct measurement system. Methods Radiation dose measurements during INR were performed in 332 patients with unruptured aneurysm (URAN), dural arteriovenous fistula (DAVF), and arteriovenous malformation (AVM). The PSD and bilateral lens doses were analyzed for each disease. The Pearson correlation test was used to determine whether the PSD and lens doses were linearly related to the reference air kerma (Ka,r). Results In all cases, the PSD and right and left lens doses were 2.36 ± 1.28 Gy, 114.2 ± 54.6 mGy, and 189.8 ± 160.3 mGy, respectively. The PSD and lens doses of the DAVF and AVM cases were significantly higher than those of the URAN case. The Pearson correlation test revealed statistically significant positive correlations between Ka,r and PSD, Ka,r and right lens dose, and Ka,r and left lens dose. Conclusion The characteristics of radiation dose in INR were clarified. Owing to the concern of increased radiation doses exceeding the threshold values in DAVF and AVM cases, protection from radiation is required. Simple regression analysis revealed the possibility of precisely predicting PSD using Ka,r.
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Affiliation(s)
- Satoru Kawauchi
- Department of Radiology, Toranomon Hospital, Tokyo, Japan
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Okinaka Memorial Institute for Medical Research, Tokyo, Japan
| | - Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Moritake
- Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences, National Institute for Quantum Science and Technology, Chiba, Chiba, Japan
| | - Yusuke Hamada
- Department of Radiology, Toranomon Hospital, Tokyo, Japan
| | - Shogo Yoda
- Department of Radiology, Toranomon Hospital, Tokyo, Japan
| | | | - Wataro Tsuruta
- Department of Endovascular Neurosurgery, Toranomon Hospital, Tokyo, Japan
| | - Yuji Matsumaru
- Division for Stroke Prevention and Treatment, Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Miyaji N, Miwa K, Iimori T, Wagatsuma K, Tsushima H, Yokotsuka N, Murata T, Kasahara T, Terauchi T. Determination of a reliable assessment for occupational eye lens dose in nuclear medicine. J Appl Clin Med Phys 2022; 23:e13713. [PMID: 35775691 PMCID: PMC9359038 DOI: 10.1002/acm2.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 05/31/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022] Open
Abstract
The most recent statement published by the International Commission on Radiological Protection describes a reduction in the maximum allowable occupational eye lens dose from 150 to 20 mSv/year (averaged over 5‐year periods). Exposing the eye lens to radiation is a concern for nuclear medicine staff who handle radionuclide tracers with various levels of photon energy. This study aimed to define the optimal dosimeter and means of measuring the amount of exposure to which the eye lens is exposed during a routine nuclear medicine practice. A RANDO human phantom attached to Glass Badge and Luminess Badge for body or neck, DOSIRIS and VISION for eyes, and nanoDot for body, neck, and eyes was exposed to 99mTc, 123I, and 18F radionuclides. Sealed syringe sources of each radionuclide were positioned 30 cm from the abdomen of the phantom. Estimated exposure based on measurement conditions (i.e., air kerma rate constants, conversion coefficient, distance, activity, and exposure time) was compared measured dose equivalent of each dosimeter. Differences in body, neck, and eye lens dosimeters were statistically analyzed. The 10‐mm dose equivalent significantly differed between the Glass Badge and Luminess Badge for the neck, but these were almost equivalent at the body. The 0.07‐mm dose equivalent for the nanoDot dosimeters was greatly overestimated compared to the estimated exposure of 99mTc and 123I radionuclides. Measured dose equivalents of exposure significantly differed between the body and eye lens dosimeters with respect to 18F. Although accurately measuring radiation exposure to the eye lenses of nuclear medicine staff is conventionally monitored using dosimeters worn on the chest or abdomen, eye lens dosimeters that provide a 3‐mm dose equivalent near the eye would be a more reliable means of assessing radiation doses in the mixed radiation environment of nuclear medicine.
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Affiliation(s)
- Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Takashi Iimori
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Kei Wagatsuma
- School of Allied Health Science, Kitasato University, Kanagawa, Japan
| | - Hiroyuki Tsushima
- Department of Radiological Technology, Faculty of Health Sciences, Kobe Tokiwa University, Hyogo, Japan
| | - Noriyo Yokotsuka
- Department of Radiological Technology, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Taisuke Murata
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | | | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
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35
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Akahane M, Yoshioka N, Kiryu S. Radiation Protection of the Eye Lens in Fluoroscopy-guided Interventional Procedures. INTERVENTIONAL RADIOLOGY 2022; 7:44-48. [PMID: 36196387 PMCID: PMC9527101 DOI: 10.22575/interventionalradiology.2022-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/25/2022] [Indexed: 11/04/2022]
Abstract
The medical staff involved in fluoroscopy-guided procedures are at potential risks of radiation-induced cataract. Therefore, proper monitoring of the lens doses is critical, and radiation protection should be provided to the maximum extent that is reasonably achievable. The collar dosimeter is necessary to avoid underestimation of the lens dose, and the third dosimeter behind the protective eyewear would be helpful for those who are likely to exceed the dose limit. The reduction of the patient doses will correspondingly reduce the staff doses. Proper placement of the ceiling-mounted shields and minimization of the face-to-glass gap are the keys to effective shielding. The optimization of procedures and devices that help maintain a distance from the irradiated area and to prevent the looking-up posture will substantially reduce the lens dose.
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Affiliation(s)
- Masaaki Akahane
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Naoki Yoshioka
- Department of Radiology, School of Medicine, International University of Health and Welfare
| | - Shigeru Kiryu
- Department of Radiology, School of Medicine, International University of Health and Welfare
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36
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Hirakawa M, Nakatake H, Tsuruta S, Matsuura S, Motomura Y, Hiraki Y, Mimori K, Ishigami K. Dosimetry of Occupational Eye Lens Dose Using a Novel Direct Eye Dosimeter, DOSIRIS, during Interventional Radiology Procedures. INTERVENTIONAL RADIOLOGY 2022; 7:40-43. [PMID: 36196388 PMCID: PMC9527102 DOI: 10.22575/interventionalradiology.2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/25/2022] [Indexed: 12/04/2022]
Abstract
In response to the recommendation by the International Commission on Radiological Protection to lower the equivalent eye dose limit, the Japanese Government in April 2021 lowered the equivalent dose limit for the eye lens for occupational exposure. A considerable number of interventional radiology operators are exposed to levels above the new limit. For this reason, a need exists to more accurately evaluate eye lens dose in interventional radiology operators by using a novel direct eye dosimeter, the DOSIRIS™(IRSN, France), which is capable of measuring a 3-mm dose equivalent under protective glasses. The DOSIRIS is a thermoluminescent dosimeter that exhibits good energy dependence and better directional properties than other dosimeters. Dosimetry using DOSIRIS might be accurate and compatible with the latest regulations.
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Affiliation(s)
| | | | | | | | | | - Yoshiki Hiraki
- Department of Radiology, Kyushu University Beppu Hospital
| | - Koshi Mimori
- Department of Surgery, Kyushu University Beppu Hospital
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University
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Ito H, Matsubara K, Kobayashi I, Sakai T, Isobe T, Yanagawa N, Ochi S. Usefulness of a lead-acrylic shield for reducing lens dose of assistant in x-ray CT examination. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:021529. [PMID: 35705067 DOI: 10.1088/1361-6498/ac7919] [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: 04/27/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
In computed tomography (CT) examinations, the usefulness of protective glasses for reducing lens exposure to assistants has been reported. The present study aimed to compare the dose reduction effect for assistants with lead-acrylic shields and protective glasses (0.07 mm Pb, 0.5 mm Pb) during CT examination. The air dose distribution in a CT examination room with and without a lead-acrylic shield was compared. It was found that the amount of scattered radiation was significantly reduced by installing a lead-acrylic shield at the CT gantry aperture. Moreover, the reduction rate of air kerma at the assistant's lens was higher using the lead acrylic shield than with the protective glasses-95.7% during head holding and 76.1% during assisted ventilation.
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Affiliation(s)
- Hajime Ito
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan
- Department of Quantum Medical Technology, Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Ikuo Kobayashi
- Research Institute of Nuclear Engineering, University of Fukui, 1-3-33 Kanawa, Tsuruga, Fukui 914-0055, Japan
| | - Takayuki Sakai
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan
| | - Tomonori Isobe
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Noriyuki Yanagawa
- Department of Radiological Technology, Faculty of Health Sciences, Tsukuba International University, 6-20-1 Manabe, Tsuchiura, Ibaraki 300-0051, Japan
| | - Shigehiro Ochi
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2 Okayamadai, Togane, Chiba 283-8686, Japan
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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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Staff eye lens dose in interventional radiology and cardiology in Finland. Phys Med 2022; 98:1-7. [DOI: 10.1016/j.ejmp.2022.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/29/2022] [Accepted: 04/09/2022] [Indexed: 11/20/2022] Open
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Chida K. What are useful methods to reduce occupational radiation exposure among radiological medical workers, especially for interventional radiology personnel? Radiol Phys Technol 2022; 15:101-115. [PMID: 35608759 DOI: 10.1007/s12194-022-00660-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
Abstract
Protection against occupational radiation exposure in clinical settings is important. This paper clarifies the present status of medical occupational exposure protection and possible additional safety measures. Radiation injuries, such as cataracts, have been reported in physicians and staff who perform interventional radiology (IVR), thus, it is important that they use shielding devices (e.g., lead glasses and ceiling-suspended shields). Currently, there is no single perfect radiation shield; combinations of radiation shields are required. Radiological medical workers must be appropriately educated in terms of reducing radiation exposure among both patients and staff. They also need to be aware of the various methods available for estimating/reducing patient dose and occupational exposure. When the optimizing the dose to the patient, such as eliminating a patient dose that is higher than necessary, is applied, exposure of radiological medical workers also decreases without any loss of diagnostic benefit. Thus, decreasing the patient dose also reduces occupational exposure. We propose a novel four-point policy for protecting medical staff from radiation: patient dose Optimization, Distance, Shielding, and Time (pdO-DST). Patient dose optimization means that the patient never receives a higher dose than is necessary, which also reduces the dose received by the staff. The patient dose must be optimized: shielding is critical, but it is only one component of protection from radiation used in medical procedures. Here, we review the radiation protection/reduction basics for radiological medical workers, especially for IVR staff.
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Affiliation(s)
- Koichi Chida
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba-ku, Sendai, 980-8575, Japan. .,Division of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, 980-8572, Japan.
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41
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Occupational radiation dose and protection to the eye lens for interventional cardiology operators. RADIAT MEAS 2022. [DOI: 10.1016/j.radmeas.2022.106778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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42
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Kozuma K, Chikamori T, Hashimoto J, Honye J, Ikeda T, Ishiwata S, Kato M, Kondo H, Matsubara K, Matsumoto K, Matsumoto N, Motoyama S, Obunai K, Sakamoto H, Soejima K, Suzuki S, Abe K, Amano H, Hioki H, Iimori T, Kawai H, Kosuge H, Nakama T, Suzuki Y, Takeda K, Ueda A, Yamashita T, Hirao K, Kimura T, Nagai R, Nakamura M, Shimizu W, Tamaki N. JCS 2021 Guideline on Radiation Safety in Cardiology. Circ J 2022; 86:1148-1203. [DOI: 10.1253/circj.cj-21-0379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ken Kozuma
- Division of Cardiology, Teikyo University Hospital
| | | | - Jun Hashimoto
- Department of Radiology, Tokai University School of Medicine
| | - Junko Honye
- Department of Cardiology, Kikuna Memorial Hospital
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | | | - Mamoru Kato
- Department of Radiology, Akita Cerebrospinal and Cardiovascular Center
| | | | - Kosuke Matsubara
- Department of Quantum Medical Technology, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
| | - Kazuma Matsumoto
- Department of Radiological Technology, Hyogo College of Medicine College Hospital
| | | | | | | | - Hajime Sakamoto
- Department of Radiological Technology, Faculty of Health Science, Juntendo University
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University Hospital
| | - Shigeru Suzuki
- Department of Radiology, Totsuka Kyouritsu Daini Hospital
| | - Koichiro Abe
- Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University
| | - Hideo Amano
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine
| | | | | | - Hideki Kawai
- Department of Cardiology, Fujita Health University
| | | | | | | | | | - Akiko Ueda
- Division of Advanced Arrhythmia Management, Kyorin University Hospital
| | | | - Kenzo Hirao
- Division of Cardiovascular Medicine, AOI Universal Hospital
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Ryozo Nagai
- Department of Cardiovascular Medicine, Jichi Medical University
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School
| | - Nagara Tamaki
- Department of Radiology, Kyoto Prefectural University of Medicine
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Matsutomo N, Fukami M, Koike T, Yamamoto T. [Estimation of Eye Lens Dose during the Handling of Radiopharmaceuticals and Using X-ray Protective Goggles for Dose Reduction in Nuclear Medicine]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:348-356. [PMID: 35264549 DOI: 10.6009/jjrt.2022-1201] [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] [Indexed: 06/14/2023]
Abstract
PURPOSE The purposes of this study were to estimate the eye lens dose during the handling of radiopharmaceuticals and to validate the requirement of X-ray protective goggles in nuclear medicine. METHOD Simulated eye lens radiation exposure (3-mm dose equivalent rate) was measured using a radiophotoluminescent glass dosimeter (RPLD) positioned at distances of 30 and 60 cm from 99mTc, 111In, and 123I radiation sources. Reduction rates were evaluated for the following means of radiation protection: X-ray protective goggles (0.07-, 0.50-, and 0.75-mm lead equivalent), a syringe shield, and a lead glass plate. RESULT 3-mm dose equivalent rates without protection were obtained at 6.13±0.13 µSv/min/GBq for 99mTc, 23.08±0.19 µSv/min/GBq for 111In, and 11.07±0.11 µSv/min/GBq for 123I. Reduction rates for each source were over 90% for the syringe shield and the lead glass plate. The 0.75-mm lead equivalent X-ray protective goggles decreased the 3-mm dose equivalent rate by 68.8% for 99mTc, 60.6% for 111In, and 68.1% for 123I. CONCLUSION Although the estimated eye lens equivalent dose during the handling of radiopharmaceuticals did not exceed the threshold dose, our results suggest that 0.75-mm lead equivalent X-ray protective goggles are needed to reduce the exposure of the lens while handling 99mTc, 111In, and 123I radiation sources.
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Affiliation(s)
- Norikazu Matsutomo
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
- Graduate School of Health Sciences, Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
| | - Mitsuha Fukami
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
| | - Takahisa Koike
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
- Graduate School of Health Sciences, Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
| | - Tomoaki Yamamoto
- Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
- Graduate School of Health Sciences, Department of Medical Radiological Technology, Faculty of Health Sciences, Kyorin University
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44
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Yashima S, Chida K. Effective Risk Communications through Personalized Consultations with Pregnant Women and Parents by Radiologic Technologists after the 2011 Fukushima Daiichi Nuclear Disaster. TOHOKU J EXP MED 2022; 256:259-269. [PMID: 35264512 DOI: 10.1620/tjem.2022.j001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Koichi Chida
- International Research Institute of Disaster Science
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45
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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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46
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Moroi S, Nakashima J, Miyasaka K, Hoshina T, Kato K. [Development of the Radiation Protective Curtain for the Dose Reduction of Caregivers during Computed Tomography Examinations]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:140-151. [PMID: 35185093 DOI: 10.6009/jjrt.780201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE During computed tomography (CT) examinations, it may be necessary to assist the patient to maintain an appropriate body position. However, there is little protective equipment available for caregivers who approach the gantry. This study aimed to evaluate the effectiveness of novel radiation protective curtains in reducing radiation exposure to caregivers while assisting patients, especially during CT examinations of the head. METHOD The absorbed dose in air around the gantry during CT examinations of the head was measured using glass dosimeters. The measurement points from the center of the gantry were 40 to 120 cm in the front, 0 to 100 cm for each side in the right and left, and 60 to 180 cm from the floor. Measurements were performed at each 20-cm interval, and all points were accumulated 10 times. The absorbed dose in air in a CT room was compared with and without the protective curtains. Next, we assumed the height of the caregiver to be 170 cm, and measured the points for the crystalline lens, chest, and abdomen. Also, using the protective glasses and the protective apron, we measured the absorbed dose in air for the caregivers behind the protective curtains. RESULT The absorbed exposure dose in air toward the crystalline lenses, chest, and abdomen was reduced more than 90% by using the protective curtains and more than 95% by using the protective apron and protective glasses in addition to them. CONCLUSION This study showed the usefulness of protective curtains in reducing the absorbed exposure dose in air to caregivers.
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Affiliation(s)
- Satoka Moroi
- Department of Radiological Technology, Showa University Fujigaoka Hospital
| | - Junya Nakashima
- Department of Radiological Technology, Showa University Koto Toyosu Hospital.,Graduate School of Health Sciences, Showa University
| | - Koji Miyasaka
- Department of Radiological Technology, Showa University Fujigaoka Hospital (Current address: Yamato Municipal Hospital)
| | | | - Kyoichi Kato
- Graduate School of Health Sciences, Showa University.,Department of Radiology, Showa University
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Radiation Eye Dose for Physicians in CT Fluoroscopy-Guided Biopsy. Tomography 2022; 8:438-446. [PMID: 35202201 PMCID: PMC8878526 DOI: 10.3390/tomography8010036] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 01/29/2023] Open
Abstract
It is important to evaluate the radiation eye dose (3 mm dose equivalent, Hp (3)) received by physicians during computed tomography fluoroscopy (CTF)-guided biopsy, as physicians are close to the source of scattered radiation. In this study, we measured the radiation eye dose in Hp (3) received by one physician during CTF in a timeframe of 18 months using a direct eye dosimeter, the DOSIRISTM. The physician placed eye dosimeters above and under their lead (Pb) eyeglasses. We recorded the occupational radiation dose received using a neck dosimeter, gathered CT dose-related parameters (e.g., CT-fluoroscopic acquisition number, CT-fluoroscopic time, and CT-fluoroscopic mAs), and performed a total of 95 procedures during CTF-guided biopsies. We also estimated the eye dose (Hp (3)) received using neck personal dosimeters and CT dose-related parameters. The physician eye doses (right and left side) received in terms of Hp (3) without the use of Pb eyeglasses for 18 months were 2.25 and 2.06 mSv, respectively. The protective effect of the Pb eyeglasses (0.5 mm Pb) on the right and left sides during CTF procedures was 27.8 and 37.5%, respectively. This study proved the existence of significant correlations between the eye and neck dose measurement (right and left sides, R2 = 0.82 and R2 = 0.55, respectively) in physicians. In addition, we found significant correlations between CT-related parameters, such as CT-fluoroscopy mAs, and radiation eye doses (right and left sides, R2 = 0.50 and R2 = 0.52, respectively). The eye dose of Hp (3) received in CTF was underestimated when evaluated using neck dosimeters. Therefore, we suggest that the physician involved in CTF use a direct eye dosimeter such as the DOSIRIS for the accurate evaluation of their eye lens dose.
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Occupational eye dose correlation with neck dose and patient-related quantities in interventional cardiology procedures. Radiol Phys Technol 2022; 15:54-62. [DOI: 10.1007/s12194-022-00650-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
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Hattori S, Monzen H, Tamura M, Kosaka H, Nakamura Y, Nishimura Y. Estimating radiation exposure of the brain of a physician with a protective flap in interventional radiology: A phantom study. J Appl Clin Med Phys 2022; 23:e13532. [PMID: 35045212 PMCID: PMC8906205 DOI: 10.1002/acm2.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 12/18/2021] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The efficiency of protective equipment for the brain has not been verified at the left anterior oblique (LAO) position, which is commonly used in clinical procedures. The purpose of this study was to investigate radiation exposure of the brain in interventional radiology (IR) and the shielding ability of a new protective flap. METHODS We made a flap that combined a protective cap with a left lateral face shield. The flap was made of tungsten-containing rubber (TCR). An anthropomorphic head phantom was placed at the physician's position, and air kerma rates (μGy/min and μGy/15s) were measured by electronic dosimeter at three locations: the surface of the left side of the head, and the left and right temporal lobes with the protective cap and the flap in fluoroscopy and cine modes. The X-ray tube was at the lower left side of the physician, and its angles were LAO60 and LAO60CAU40. The tube voltage (95-125 kV), tube current (4.7-732 mA), and air kerma rate (27.8-1078 mGy/min) were automatically adjusted by the X-ray system. We obtained the cap and the flap shielding efficiencies. RESULTS In cine mode at LAO60CAU40, the shielding efficiencies on the surface of the left side of the head and left temporal lobe with the cap were 92.6% and 5.1%, respectively, and the corresponding shielding efficiencies with the flap were 92.5% and 86.1%, respectively. The flap can reduce radiation exposure of the brain more than the cap alone. CONCLUSIONS At the left anterior oblique in interventional radiology, the flap can reduce exposure to the brain.
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Affiliation(s)
- Shota Hattori
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan.,Department of Radiological Center, Kindai University Hospital, Osakasayama, Osaka, Japan
| | - Hajime Monzen
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Mikoto Tamura
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Hiroyuki Kosaka
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan.,Department of Radiological Center, Kindai University Hospital, Osakasayama, Osaka, Japan
| | - Yasunori Nakamura
- Department of Medical Physics, Graduate School of Medical Sciences, Kindai University, Osakasayama, Osaka, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osakasayama, Osaka, Japan
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50
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Osanai M, Sato K, Sato H, Kudo K, Hosokawa S, Fujita A, Kitajima M, Tsushima M, Komiya N, Kudo M, Saito Y. [The Method for Estimation of Radiation Dose of Eye Lens Covered by Radiation Protection Glasses Using Personal Dosimeter for Trunk of the Body and X-ray Shielding Material]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:1432-1443. [PMID: 34924480 DOI: 10.6009/jjrt.2021_jsrt_77.12.1432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE Radiation protection glasses is a useful tool for dose reduction of eye lens. However, the method to evaluate the dose of eye lens, which is covered with radiation protection glasses in actual radiation management situation, has not been established. We invented the easy-to-use procedure to estimate the dose of eye lens inside of radiation protection glasses for occupationally exposed person using an X-ray shielding material and an additional personal dosimeter for trunk of the body. The objective of this study was to evaluate the feasibility of the new method. METHODS The radiation field in interventional radiology (IR) was reconstructed. A personal dosimeter was set to the eye position and neck position of medical staff phantom. Each dosimeter was covered by radiation protection glasses or X-ray shielding material, and the 1 cm or 70 mm dose equivalent quantity in the neck position was compared to the 3 mm dose equivalent quantity in the eye position. RESULTS The dose equivalent quantity measured inside of X-ray shielding material in the neck position was similar to that of inside radiation protection glasses. Thus, the X-ray attenuation by radiation protection glasses was able to be simulated using the X-ray shielding material. CONCLUSION It was suggested that the dose of eye lens inside of radiation protection glasses could be easily estimated by covering the conventional personal dosimeter for trunk of the body with the X-ray shielding material.
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Affiliation(s)
- Minoru Osanai
- Hirosaki University Graduate School of Health Sciences
| | - Kana Sato
- Hirosaki University School of Health Sciences (Current address: Division of Radiology, Towada City Hospital)
| | - Hidenori Sato
- Hirosaki University School of Health Sciences (Current address: Division of Radiology, Saiseikai Yokohamashi Tobu Hospital)
| | - Kohsei Kudo
- Hirosaki University Graduate School of Health Sciences
| | | | | | | | | | - Nobuhiro Komiya
- Hirosaki University Graduate School of Health Sciences (Current address: Department of Radiology, National Hospital Organization Hirosaki National Hospital)
| | - Masaya Kudo
- Hirosaki University Graduate School of Health Sciences (Current address: Department of Radiology, Southern TOHOKU Proton Therapy Center, Southern TOHOKU Research Institute for Neuroscience)
| | - Yoko Saito
- Hirosaki University Graduate School of Health Sciences
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