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Chen J, Tu J, Huang S, Zhu Z, Tu Y. Is It Appropriate to Completely Eliminate Contact Shielding during CT Examination? A Discourse Based on Experimental Findings. HEALTH PHYSICS 2024; 126:46-55. [PMID: 37792391 DOI: 10.1097/hp.0000000000001742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Through the integration of experimental data and literature, this study examines whether complete elimination of contact shielding during CT examination is warranted, with a particular focus on potential impacts to children's thyroid and pregnant women, as well as limitations associated with contact shielding. Methods: The thermoluminescent dosimeter (TLD) tablets were inserted into the phantom's five organs and tissues. Select fixed exposure, automatic exposure control (AEC), and use contact shielding combined into four experimental modes, with scanning of the phantom's four parts. Obtain the absorbed dose measurements within or outside the FOV. Statistical analysis was conducted using SPSS software. Results: (1) The AEC significantly reduces dose within and outside the FOV, with a dose reduction of 40%-60%. (2) The application of contact shielding outside the FOV significantly reduced the dose adjoin the FOV. (3) Both the use of AEC mode and contact shielding can effectively minimize the dose, with a reduction of 50-80%. (4) The shielding within the FOV may introduce image artifacts or interfere with AEC, the implementation of contact shielding outside FOV provides little reduction in radiation exposure risk through previous literature. (5) Contact shielding exhibits certain drawbacks in all aspects. Conclusion: The utilization of AEC mode in clinical CT should be widely adopted to minimize patient radiation exposure. In general, contact shielding both inside and outside the FOV should be avoided during exposure. However for children under 12 years old with thyroid gland examination, contact shielding could maximally reduce external radiation and may be appropriate. Pregnant women require careful evaluation when considering the use of contact shielding. Contact shielding should not be entirely abandoned.
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Affiliation(s)
- Jiwei Chen
- Department of Medical Engineering, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu 215300, P.R. China
| | - Jianchun Tu
- Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu 215300, P.R. China
| | - Shengyan Huang
- Department of Nursing, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu 215300, P.R. China
| | - Zhenhua Zhu
- Department of Medical Engineering, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, Jiangsu 215300, P.R. China
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Sarıbal GŞ, Canger EM, Yaray K. Evaluation of the radiation protection effectiveness of a lead-free homopolymer in cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:91-101. [PMID: 37002015 DOI: 10.1016/j.oooo.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/26/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The objective was to compare the radiation protection effectiveness of a lead-free thermoplastic homopolymer (Anti-RAD) to conventional lead shielding in cone beam computed tomography (CBCT) exposures. STUDY DESIGN Thermoluminescent dosimeters were placed on a human bone- and soft tissue-equivalent phantom to record equivalent doses in the thyroid gland, thyroid skin, and breast areas. CBCT images were obtained with the following 3 protocols: (1) without radiation shielding; (2) with 0.5-mm lead equivalent lead-containing shielding; and (3) with 0.5-mm lead equivalent Anti-RAD shielding. Independent t tests were used to evaluate the results. RESULTS Compared with exposures without shielding, both lead and Anti-RAD protective devices reduced thyroid gland equivalent doses by approximately 40%, thyroid skin doses by approximately 75%, right breast skin doses by approximately 80%, and left breast skin doses by 75%. The differences in equivalent dose for both types of shielding compared with exposure with no shielding were statistically significant (P ≤ .042). However, there were no significant differences in dose reduction at any site between lead and Anti-RAD shielding (P ≥ .135). CONCLUSIONS Radiation protection equivalent to lead can be provided with the Anti-RAD shield. With the use of this material, disadvantages such as damage to the aprons, lead toxicity, weight of lead aprons, and microbial contamination can be reduced.
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Affiliation(s)
- Gamze Şirin Sarıbal
- Research Assistant, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey.
| | - Emin Murat Canger
- Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University-Kayseri, Turkey
| | - Kadir Yaray
- Department of Radiation Oncology, University of Erciyes Faculty of Medicine, Kayseri, Turkey
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A phantom study of a protective trolley for neonatal radiographic imaging: new equipment to protect the operator from scatter radiation. Pediatr Radiol 2023; 53:332-336. [PMID: 36018348 PMCID: PMC9415260 DOI: 10.1007/s00247-022-05488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/04/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
Abstract
Chest radiography is commonly performed as a diagnostic tool of neonatal diseases. Contact-based radiation personal protective equipment (RPPE) has been widely used for radiation protection, but it does not provide full body protection and it is often shared between users, which has become a major concern during the coronavirus disease 2019 (COVID-19) pandemic. To address these issues, we developed a novel trolley to protect radiographers against X-ray radiation by reducing scatter radiation during neonatal radiographic examinations. We measured the scatter radiation doses from a standard neonatal chest radiograph to the radiosensitive organs using a phantom operator in three protection scenarios (trolley, radiation personal protective equipment [RPPE], no protection) and at three distances. The results showed that the scatter radiation surface doses were significantly reduced when using the trolley compared with RPPE and with no protection at a short distance (P<0.05 for both scenarios in all radiosensitive organs). The novel protective trolley provides a non-contact protective tool for radiographers against the hazard of scatter radiation during neonatal radiography examinations.
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Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission. Vaccines (Basel) 2022; 10:vaccines10122060. [PMID: 36560470 PMCID: PMC9781912 DOI: 10.3390/vaccines10122060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Infections contracted during healthcare delivery in a hospital or ambulatory setting are collectively referred to as healthcare-associated infections (HAIs). Healthcare workers and patients alike are vulnerable to serious problems as a result of the risk of HAIs. In the healthcare system, HAIs are considered among the most common and serious health problems. However, the occurrence of HAIs differs between different types of clinical departments within the hospital. Recently, the risk of HAIs has been increasing in radiology departments globally due to the central role of radiology in guiding clinical decisions for the diagnosis, treatment, and monitoring of different diseases from almost all medical specialties. The radiology department is particularly vulnerable to HAIs because it serves as a transit hub for infected patients, non-infected patients, and healthcare workers. Furthermore, as the number of patients referred to radiology and the length of patient contact time has increased, thanks to modern imaging techniques such as computed tomography and magnetic resonance imaging, the risk of HAIs has also increased significantly. With the increasing use of interventional radiological procedures, patients and healthcare workers face a potentially greater risk of contracting HAIs due to the invasive nature of such procedures. Although not exhaustive, we attempted through a literature search to provide a general overview of infection prevention and control practices, address HAIs in the radiology departments, and highlight the challenges and measures taken to control infection transmission in the radiology departments.
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Insights Imaging 2021; 12:194. [PMID: 34939154 PMCID: PMC8695402 DOI: 10.1186/s13244-021-01085-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/19/2021] [Indexed: 12/25/2022] Open
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- Peter Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - Patrick Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Mater Private Hospital, Eccles St., Dublin, Ireland
| | - John Damilakis
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,University of Crete, Iraklion, Crete, Greece
| | - Eric Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - Cristian Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - Dario Faj
- European Radiation Dosimetry Group, Neuherberg, Germany.,Faculty of Dental Medicine and Health, Osijek, Croatia
| | - Shane Foley
- European Federation of Radiographer Societies, Utrecht, Belgium.,Radiography and Diagnostic Imaging, University College Dublin, Dublin, Ireland
| | - Guy Frija
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,Université de Paris, Paris, France
| | - Claudio Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France.,Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Hugo de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands.,Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - Marta Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany.,Geneva University Hospitals, Geneva, Switzerland
| | - Georgios Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany.,Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - Eliseo Vano
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria.,Radiology Department, Complutense University, Madrid, Spain
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Radiography (Lond) 2021; 28:353-359. [PMID: 34953726 DOI: 10.1016/j.radi.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- P Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - P Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Mater Private Hospital, Eccles St., Dublin 7, Ireland
| | - J Damilakis
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; University of Crete, Iraklion, Crete, Greece
| | - E Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - C Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - D Faj
- European Radiation Dosimetry Group, Neuherberg, Germany; Faculty of Dental Medicine and Health, Osijek, Croatia
| | - S Foley
- European Federation of Radiographer Societies, Utrecht, the Netherlands; Radiography & Diagnostic Imaging, University College Dublin, Ireland
| | - G Frija
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; Université de Paris, France
| | - C Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - H de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, the Netherlands; Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - R Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Denmark
| | - M Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany; Geneva University Hospitals, Geneva, Switzerland
| | - G Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany; Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - E Vano
- European Society of Radiology, EuroSafe Imaging, Vienna, Austria; Radiology Department, Complutense University, Spain
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7
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Hiles P, Gilligan P, Damilakis J, Briers E, Candela-Juan C, Faj D, Foley S, Frija G, Granata C, de Las Heras Gala H, Pauwels R, Sans Merce M, Simantirakis G, Vano E. European consensus on patient contact shielding. Phys Med 2021; 96:198-203. [PMID: 34955383 DOI: 10.1016/j.ejmp.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.
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Affiliation(s)
- Peter Hiles
- Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK.
| | - Patrick Gilligan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Mater Private Hospital, Eccles St., Dublin 7, Ireland
| | - John Damilakis
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; University of Crete, Iraklion, Crete, Greece
| | - Eric Briers
- Member ESR-Patient Advisory Group, Patient Advocate, Hasselt, Belgium
| | - Cristian Candela-Juan
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, Spain
| | - Dario Faj
- European Radiation Dosimetry Group, Neuherberg, Germany; Faculty of Dental Medicine and Health, Osijek, Croatia
| | - Shane Foley
- European Federation of Radiographer Societies, Utrecht, The Netherlands; Radiography & Diagnostic Imaging, University College Dublin, Ireland
| | - Guy Frija
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; Université de Paris, France
| | - Claudio Granata
- European Society of Paediatric Radiology, Le Kremlin-Bicêtre, France; Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Hugo de Las Heras Gala
- European Federation of Organizations for Medical Physics, Utrecht, The Netherlands; Federal Office for Radiation Protection, Oberschleißheim, Germany
| | - Ruben Pauwels
- Aarhus Institute of Advanced Studies, Aarhus University, Denmark
| | - Marta Sans Merce
- European Radiation Dosimetry Group, Neuherberg, Germany; Geneva University Hospitals, Geneva, Switzerland
| | - Georgios Simantirakis
- European Radiation Dosimetry Group, Neuherberg, Germany; Greek Atomic Energy Commission, Agia Paraskevi, Athens, Greece
| | - Eliseo Vano
- European Society of Radiology - EuroSafe Imaging, Vienna, Austria; Radiology Department, Complutense University, Spain
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