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Ito H, Matsubara K, Kobayashi I, Shimakawa Y, Murayama D, Sakai T, Isobe T, Yanagawa N, Ochi S. Relationship between assistant's lens exposure and dose information during computed tomography examinations. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2024; 44:021513. [PMID: 38722292 DOI: 10.1088/1361-6498/ad4903] [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: 01/28/2024] [Accepted: 05/09/2024] [Indexed: 05/18/2024]
Abstract
According to International Commission of Radiological Protection, the equivalent dose limit for the eye lens for occupational exposure is recommended to be 20 mSv yr-1, averaged over 5 years, with no single year above 50 mSv. Some studies reported the measurement of assistant's lens exposure in diagnostic computed tomography (CT) examinations, but further investigation is still required in the association between the lens dose for assistants and various dose parameters. Therefore, we measured the assistant's lens exposure using small optically stimulated luminescence dosimeters. The type of occupation, type of assistance, total scan time, total mAs, total scan length, and dose-length product (DLP) were recorded and analyzed in association with air kerma at the lens position. The assistance was classified into four types: 'assisted ventilation,' 'head holding,' 'body holding,' and 'raising patient's arm.' The air kerma of lens position was not significantly different for each assistance type (p< 0.05, Kruskal-Wallis test). Further, the lens doses for assistants correlated with DLP, but with various strengths of correlation with the assistance type and were influenced by the distance from the CT gantry. In conclusion, lens dose during assistance and DLP demonstrated the strongest correlation. 'Raising patient's arm' and 'head holding' exhibited stronger correlations, which required less table movement during the CT scan than 'assisted ventilation' and 'body holding'.
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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
| | - Yurie Shimakawa
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane, Chiba 283-8686, Japan
| | - Daichi Murayama
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane, Chiba 283-8686, Japan
| | - Takayuki Sakai
- Department of Radiology, Eastern Chiba Medical Center, 3-6-2, Okayamadai, Togane, Chiba 283-8686, Japan
| | - Tomonori Isobe
- Institute 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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Komiya R, Ishitsuka R, Ota J, Higashida R, Kawasaki T, Masuda Y. [Measurement of Absorbed Dose in the Air in X-ray CT Examination Rooms Using a Special Protective Shield for CT]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:1341-1348. [PMID: 36273874 DOI: 10.6009/jjrt.2022-1313] [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 X-ray CT examinations are required not only in routine medical examinations but also in various situations such as emergency medical care. Although medical staff may be exposed to radiation when assisting patients, the distribution of air-absorbed doses in the CT examination room when using a special protective shield for CT has not been clarified. Here, we measured air-absorbed doses at several points simultaneously to clarify the distribution of these doses and the effect of a special protective shield for CT in reducing them. METHOD A human phantom was imaged with an X-ray CT system. The absorbed dose in the air dose profile distribution was measured with an OSL dosimeter in the presence and absence of a special protective shield for CT. RESULTS The highest air absorbed doses of 4.27 mGy were at 0 cm in the horizontal direction, 120 cm in the vertical direction, and 50 cm in the body axis direction. The largest reduction in air absorbed dose following installation of the special protective shield for CT was 91.7%, obtained at 0 cm in the horizontal direction, 150 cm in the vertical direction, and 50 cm in the body axis direction. CONCLUSION A 91.7% reduction in air-absorbed dose was o directly behind the special protective shield for CT. The reduction in air-absorbed dose was 65.8% at the location of a gap between the special protective shield for CT and gantry.
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Affiliation(s)
- Ryota Komiya
- Department of Radiology, Chiba University Hospital
| | | | - Joji Ota
- Department of Radiology, Chiba University Hospital
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Ozaki K, Fukawa T, Kawanaka T, Daizumoto K, Sasaki Y, Ueno Y, Tsuda M, Kusuhara Y, Yamamoto Y, Yamaguchi K, Takahashi M, Kanayama H. Appropriate management reduces radiation exposure in daily urological practice. Int J Urol 2022; 29:1207-1212. [DOI: 10.1111/iju.14971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 06/15/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Keisuke Ozaki
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Tomoya Fukawa
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Takashi Kawanaka
- Department of Radiology and Radiation Oncology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Kei Daizumoto
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Yutaro Sasaki
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Yoshiteru Ueno
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Megumi Tsuda
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Yoshito Kusuhara
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Yasuyo Yamamoto
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Kunihisa Yamaguchi
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Masayuki Takahashi
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
| | - Hiro‐omi Kanayama
- Department of Urology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan
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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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Kaartinen S, Husso M, Matikka H. Operator's eye lens dose in computed tomography-guided interventions. Eur Radiol 2021; 31:4377-4385. [PMID: 33349894 PMCID: PMC8128838 DOI: 10.1007/s00330-020-07576-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To survey (1) operator's eye lens doses in typical computed tomography (CT)-guided interventions, (2) correlation between dose length product (DLP) and the operator's dose, and (3) different ways for estimating the eye lens dose in clinical settings. METHODS Doses of 16 radiologists in 164 CT-guided interventional procedures were prospectively measured during a 6-month time period upon radioprotective garments and descriptive statistical outcomes were calculated. The correlations between DLP and measured doses were surveyed. RESULTS On average, the operator's dose at the eye level (DEL, Hp(0.07)) was 22 μSv per procedure and the personal equivalent dose Hp(10) at the collar level was 21 μSv per procedure. The mean DLP of a procedure was 320 mGy cm, where 54% resulted from the fluoroscopy, the mean exposure time being 18 s. Based on the results, the operator's DEL could be estimated from DLP using the equation DEL (μSv) = 0.10 μSv/mGy cm × patient fluoro DLP (mGycm) (p < 0.001), and the dose at the collar level (DCL) using the equation DCL (μSv) = 0.12 μSv/mGy cm × patient fluoro DLP (mGy cm) (p < 0.001). In addition, DEL (μSv) = 0.7 × DCL (μSv). CONCLUSIONS The eye lens doses in CT-guided interventions are generally low even without protective equipment, and it is unlikely that the recommended annual equivalent dose limit of 20 mSv for the lens of the eye will be exceeded by conducting CT-guided interventions solely. Eye lens dose can be roughly estimated based on either DLP of the procedure or dose measured at the operator's collar level. KEY POINTS • Eye lens doses in CT-guided operations are generally low. • It is unlikely that the ICRP recommendation of the yearly equivalent dose limit of 20 mSv will be exceeded by conducting CT-guided interventions solely. • Magnitude of eye lens dose can be estimated based on either DLP of the procedure or dose measured at the operator's collar level.
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Affiliation(s)
- Siru Kaartinen
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland.
| | - Minna Husso
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Hanna Matikka
- Department of Clinical Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
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Ota J, Yokota H, Kawasaki T, Taoka J, Kato H, Chida K, Masuda Y, Uno T. Evaluation of Radiation Protection Methods for Assistant Staff during CT Imaging in High-energy Trauma: Lens Dosimetry with a Phantom Study. HEALTH PHYSICS 2021; 120:635-640. [PMID: 33879645 DOI: 10.1097/hp.0000000000001391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Staff are exposed to radiation in the scanning room when assisting with CT scans of patients requiring ventilatory support during procedures. We measured lens doses using a phantom during a high-energy trauma protocol. Dosimetry showed that the unprotected lens received 2.02 mGy on the right and 1.91 mGy on the left, which are not negligible doses. Respective exposures to the right and left lens were 53.6% and 55.1% when wearing 0.07 mm Pb protective glasses with side covers; 53.7% and 64.2% when wearing 0.7 mm Pb glasses without side covers when facing away from the patient couch; and 92.1% and 91.2% using protective shielding in the gantry. Since the face direction may change during assistance with CT imaging, it is desirable that the protective glasses have a shape with a side cover. The protective shielding had a major radiation reduction effect, although it is expensive to acquire, install, and maintain.
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Affiliation(s)
| | - Hajime Yokota
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
| | - Tatsuya Kawasaki
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan
| | - Junichi Taoka
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan
| | - Hideyuki Kato
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan
| | - Koichi Chida
- School of Radiological Technology, Health Sciences, Graduate School of Medicine, Tohoku University, 2-1 Seiryo, Aoba, Sendai, Miyagi, Japan
| | - Yoshitada Masuda
- Department of Radiology, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8677, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan
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Fujibuchi T, Fujita K, Igarashi T, Nishimaru E, Horita S, Sakurai R, Ono K. [Proposal for Reduction Measures of Eye Lens Exposure Based on Actual Exposure Management in Radiation-exposed Medical Staff]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:160-171. [PMID: 33612694 DOI: 10.6009/jjrt.2021_jsrt_77.2.160] [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 To investigate the actual condition of the crystalline lens equivalent dose and effective dose according to the type of job and the type of duties in a medical institution. We also sought to clarify effective exposure reduction strategies. METHODS Equivalent crystalline lens doses, effective doses, job type, and duties for 8656 persons · year were obtained from 17 medical facilities. We analyzed the relationship between the effective dose and the crystalline lens equivalent dose in uniform exposure control and non-uniform exposure control conditions. Exposure data were obtained for 13 unique job types and duties. RESULTS The ratio of the lens equivalent dose to the effective dose of non-uniform exposure managers was 2 to 6 times and varied depending on the occupation. The percentage of persons whose annual lens equivalent dose exceeded 20 mSv was 4.75% for medical doctors, 1.17% for nurses, and 0.24% for radiological technologists. Highly exposed tasks included doctors in cardiology and gastroenterology performing angiography and endoscopy, nurses in endoscopy, and radiological technologists in radiography and CT examinations. CONCLUSION Thorough unequal exposure control for operations with high crystalline lens exposure, radiation protection education, and effective use of proper personal protective equipment such as the use of radiation protection glasses may reduce lens exposure levels.
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Affiliation(s)
- Toshioh Fujibuchi
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University
| | - Katsuya Fujita
- Department of Radiology, National Hospital Organization Kanagawa Hospital
| | - Takayuki Igarashi
- Department of Radiological Technology, International University of Health and Welfare Narita Hospital
| | - Eiji Nishimaru
- Department of Clinical Practice and Support, Hiroshima University Hospital
| | - Shogo Horita
- Tachikawa Faculty of Nursing, Tokyo Healthcare University
| | - Reiko Sakurai
- Tachikawa Faculty of Nursing, Tokyo Healthcare University
| | - Koji Ono
- Higashigaoka Faculty of Nursing · Postgraduate School of Nursing, Tokyo Healthcare University
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Nagamoto K, Moritake T, Nakagami K, Morota K, Matsuzaki S, Nihei SI, Kamochi M, Kunugita N. Occupational radiation dose to the lens of the eye of medical staff who assist in diagnostic CT scans. Heliyon 2021; 7:e06063. [PMID: 33553745 PMCID: PMC7851788 DOI: 10.1016/j.heliyon.2021.e06063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/08/2020] [Accepted: 01/19/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We investigated occupational dose to the lens of the eye for CT-assisting personnel for diagnostic purposes using a radio-photoluminescent glass dosimeter (RPLD) and evaluate compliance with the new equivalent dose limit for the lens of the eye (20 mSv/year). Further, we proposed the implementation of "multiple protective measures" and estimated its effect. METHOD An eye lens dosimeter clip was developed specifically to attach RPLDs inside radiation safety glasses in an L-shape. Using a total of six RPLDs attached to the radiation safety glasses, the 3-mm dose-equivalent (Hp(3)) to the lens of the eye for medical staff (n = 11; 6 intensive care physicians, 2 pediatricians, 3 radiological technologists) who assisted patients during CT scan for "diagnostic" purpose (n = 91) was measured. We evaluated the dose reduction efficiencies with radiation safety glasses and bag-valve-mask extension tube. We also estimated the protection efficiency with radiation protection curtain introduced in front of the staff's face via the phantom experiment. RESULTS Without wearing radiation safety glasses, Hp(3) to the lens of the eye was greatest for intensive care physicians (0.49 mSv/procedure; allowing 40 procedures to be performed annually), followed by pediatricians (0.30 mSv/procedure; 66 procedures annually) and radiological technologists (0.28 mSv/procedure; 71 procedures annually). Use of each type of protective tools: radiation safety glasses (0.07-mm-Pb), bag-valve-mask extension tube (20 cm) and radiation protective curtain (0.25-mm-Pb), reduced Hp(3) to the lens of the eye by 51%, 31% and 61%, respectively. CONCLUSION Intensive care physicians perform most assisted ventilations with the bag-valve-mask during "diagnostic" CT scans, and may exceed the equivalent dose limit for the lens of the eye if radiation safety glasses are not worn. If "multiple protective measures" are implemented, compliance with the equivalent dose limit for the lens of the eye should be achievable without placing significant burdens on physicians or medical institutions.
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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
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Takashi Moritake
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koichi Nakagami
- Department of Radiology, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Koichi Morota
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiology, Shinkomonji Hospital, 2-5 Dairishinmachi, Moji-ku, Kitakyushu, Fukuoka, Japan
| | - Satoru Matsuzaki
- Department of Radiobiology and Hygiene Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
- Department of Radiology, Shinkomonji Hospital, 2-5 Dairishinmachi, Moji-ku, Kitakyushu, Fukuoka, Japan
| | - Shun-ichi Nihei
- Intensive Care Unit, Hospital of the University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, Japan
| | - Masayuki Kamochi
- Intensive Care Unit, Hospital of the 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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Theilig D, Mayerhofer A, Petschelt D, Elkilany A, Hamm B, Gebauer B, Geisel D. Impact of interventionalist's experience and gender on radiation dose and procedural time in CT-guided interventions-a retrospective analysis of 4380 cases over 10 years. Eur Radiol 2020; 31:569-579. [PMID: 32851446 PMCID: PMC8263432 DOI: 10.1007/s00330-020-07185-x] [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: 04/28/2020] [Revised: 06/30/2020] [Accepted: 08/12/2020] [Indexed: 11/09/2022]
Abstract
Objectives To investigate the impact of the interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions. Methods We retrospectively analyzed 4380 CT-guided interventions performed at our institution with the same CT scanner from 2009 until 2018, 1287 (29%) by female and 3093 (71%) by male interventionalists. Radiation dose, number of CT fluoroscopy images taken per intervention, total procedural time, type of intervention, and degree of difficulty were derived from the saved dose reports and images. All 16 interventionalists included in this analysis performed their first CT-guided interventions during the study period, and interventions performed by each interventionalist were counted to assess the level of experience for each intervention in terms of the number of prior interventions performed by her or him. The Mann-Whitney U test (MWU test), multivariate regression, and linear mixed model analysis were performed. Results Assessment of the impact of gender with the MWU test revealed that female interventionalists took a significantly smaller number of images (p < 0.0001) and achieved a lower dose-length product per intervention (p < 0.0001) while taking more time per intervention (p = 0.0001). This finding was confirmed for most types of interventions when additionally accounting for other possible impact factors in multivariate regression analysis. In linear mixed model analysis, we found that radiation dose, number of images taken per intervention, and procedural time decreased statistically significantly with interventionalist’s experience. Conclusions Radiation doses of CT-guided interventions are reduced by interventionalist’s experience and, for most types of interventions, when performed by female interventionalists. Key Points • Radiation doses in CT-guided interventions are lower when performed by female interventionalists. • Procedural times of CT-guided interventions are longer when performed by female interventionalists. • Radiation doses of CT-guided interventions decrease with the interventionalist’s experience. Electronic supplementary material The online version of this article (10.1007/s00330-020-07185-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dorothea Theilig
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Anna Mayerhofer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - David Petschelt
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Aboelyazid Elkilany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernd Hamm
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Bernhard Gebauer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Dominik Geisel
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Department of Diagnostic and Interventional Radiology, Augustenburger Platz 1, 13353, Berlin, Germany
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10
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Pedraza de Leistl MC, Silber M, Knez P, Adili F. [Monitoring Radiation Exposure During Surgery with Real Time Measurements: Opportunities and Limitations]. Zentralbl Chir 2020; 145:531-540. [PMID: 31940669 DOI: 10.1055/a-1073-8293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND In Germany, staff exposed to radiation is monitored with official individual dosimeters. Commercially available real-time dosimeters (RTD) can be used as radiation protection dosimeters. They are worn over the apron and display the radiation dose being measured at the desired location at intervals of one second. These real-time radiation exposure measurements enable the surgical staff to take suitable measures to reduce the radiation during the operation. The objective of our study was to monitor the accuracy of the measurements taken from the real-time dosimeter and to determine the radiation scatter for individual members of the surgical staff. MATERIALS AND METHODS Prospective measurements of the operating team's exposure to radiation were carried out using a real-time dosimeter system in an operating room for vascular surgery equipped with a C-arm. Firstly the calibration of the RTD at the operating table was checked using a water phantom. Subsequently, measurements were taken during vascular interventions and surgery. RESULTS When calibrated, the values of the individual RTD revealed internal significant deviations, thus a corrective factor was calculated for each RTD. In total 55 interventions on 53 patients were studied. The average dose for the RTD of the surgeon during endovascular aortic repair (n = 11) amounted to 9 ± 9 µSv (range 3.6 - 50 µSv) and during thoracic endovascular aortic repair (n = 6) 35 ± 49 µSv (3.8 - 190.3 µSv). In the case of percutaneous transluminal angioplasty of the pelvis and of the lower extremities (n = 20), the average dose for the RTD of the surgeon was 7 ± 7 µSv (1.2 - 35 µSv) and for the angiographies of the lower extremities (n = 12) at 2 ± 3 µSv (0.2 - 15.9 µSv). The real-time dosimetry provided data which contributed to the operating team changing their behaviour in the operating room. DISCUSSION Since the dose values determined by the official dosimetry are generally very low, it is not possible to optimise the behaviour and thus the radiation protection using these dose values. This can be achieved with the radiation protection dosimeter and the dose reference levels can be defined in the new Radiation Protection Ordinance (StrlSchV). Instant feedback of the current dose rate at the place where the RTD is worn can lead to both the individual adjusting his or her personal behaviour and to optimisation of the individual's radiation protection. It is only possible to compare the measured data obtained with the RTD when calibration is carried out in advance.
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Affiliation(s)
| | - Martin Silber
- Institut für Radioonkologie und Strahlentherapie, Bereich Medizinische Physik, Klinikum Darmstadt, Deutschland
| | - Peter Knez
- Gefäßchirurgie, Lahn-Dill-Kliniken GmbH, Wetzlar, Deutschland
| | - Farzin Adili
- Klinik für Gefäßmedizin - Gefäß- und Endovascularchirurgie, Klinikum Darmstadt, Deutschland
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11
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Sun W, Zhang L, Wang L, Ren Y, She Y, Su H, Jiang G, Chen C. Three-Dimensionally Printed Template for Percutaneous Localization of Multiple Lung Nodules. Ann Thorac Surg 2019; 108:883-888. [PMID: 31009631 DOI: 10.1016/j.athoracsur.2019.03.060] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/21/2019] [Accepted: 03/18/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND When multiple target lung nodules exist, the computed tomography (CT)-guided percutaneous localization procedure becomes complicated. In this study, a three-dimensional (3D)-printed template was designed that could guide hook wire localization of multiple lung nodules. The pilot study aimed for preliminary validation of the feasibility of template-guided localization for multiple lesions. METHODS Patients with multiple lung nodules (<2 cm) and who were scheduled for surgical resection were recruited for participation in this study. After securing their preadmission CT images, the study investigators reconstructed a 3D thorax model from which they designed a digital model as a navigational template. A physical template was then printed for guiding the percutaneous localization of lung nodules. The localization accuracy was evaluated on the basis of the deviation between the localizer and the nodule. RESULTS From April 2018 to November 2018, the study enrolled 16 patients with 34 lung nodules. All nodules were successfully localized under template guidance, with a median procedural time of 10.0minutes (interquartile range [IQR], 8.5-12.6 minutes) and a median radiation exposure of 235 mGy • cm (IQR, 195-254 mGy • cm). The median deviation from the hook wires and nodule centers was 9.0 mm (IQR, 6.2-11.8 mm). Except for 2 cases of pneumothorax without need for further intervention, no complications occurred. CONCLUSIONS Navigational templates built using 3D printing may serve as an effective approach for facilitating localization of multiple lung nodules.
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Affiliation(s)
- Weiyan Sun
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lei Zhang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Long Wang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yijiu Ren
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yunlang She
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hang Su
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chang Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
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12
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Cornacchia S, Errico R, La Tegola L, Maldera A, Simeone G, Fusco V, Niccoli-Asabella A, Rubini G, Guglielmi G. The new lens dose limit: implication for occupational radiation protection. LA RADIOLOGIA MEDICA 2019; 124:728-735. [PMID: 30919221 DOI: 10.1007/s11547-019-01027-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
AIM AND OBJECTIVES The aim of this article was to explore the implications of the new Euratom dose limit for occupational radiation protection in the context of medical occupational radiation exposures. The European Directive 2013/59/Euratom takes into account the new recommendations on reduction in the dose limit for the lens of the eye for planned occupational exposures released in 2012 by the International Commission on Radiological Protection (ICRP 118). MATERIALS AND METHODS Different dose-monitoring procedures and devices were considered. Occupational eye lens doses reported by previous studies were analyzed, mainly considering workers involved in interventional procedures with X-rays. The current status of eye lens radiation protection and the main methods for dose reduction were investigated. RESULTS The analysis showed that the workers, potentially exceeding the new limit, are clinical staff performing interventional procedures with a relatively high X-ray dose. Regarding radiological protection issues, the considered literature reports that the proper use of personal protective equipment may reduce the eye lens absorbed dose. CONCLUSION The evaluation of the occupational eye lens dose is essential to establish which method of personal dose monitoring should be preferred. Furthermore, education and training about the right use of personal protective equipment are important for medical staff working with ionizing radiation.
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Affiliation(s)
| | | | | | | | | | - Vincenzo Fusco
- IRCCS-CROB, Radiation Oncology, Rionero in Vulture, Italy
| | | | - Giuseppe Rubini
- Nuclear Medicine Unit, University of Bari Aldo Moro, Bari, Italy
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13
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Pekkarinen A, Siiskonen T, Lehtinen M, Savolainen S, Kortesniemi M. Potential occupational exposures in diagnostic and interventional radiology: statistical modeling based on Finnish national dose registry data. Acta Radiol 2019; 60:68-77. [PMID: 29665709 DOI: 10.1177/0284185118770902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Radiation worker categorization and exposure monitoring practices must be proportional to the current working environment. PURPOSE To analyze exposure data of Finnish radiological workers and to estimate the magnitude and frequency of their potential occupational radiation exposure, and to propose appropriate radiation worker categorization. MATERIAL AND METHODS Estimates of the probabilities of annual effective doses exceeding certain levels were obtained by calculating the survival function of a lognormal probability density function (PDF) fitted in the measured occupational exposure data. RESULTS The estimated probabilities of exceeding annual effective dose limits of 1 mSv, 6 mSv, and 20 mSv were in the order of 1:200, 1:10,000, and 1:500,000 per person, respectively. CONCLUSION It is very unlikely that the Category B annual effective dose limit of 6 mSv could even potentially be exceeded using modern equipment and appropriate working methods. Therefore, in terms of estimated effective dose, workers in diagnostic and interventional radiology could be placed into Category B in Finland. Current national personal monitoring practice could be replaced or supplemented using active personal dosimeters, which offer more effective means for optimizing working methods.
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Affiliation(s)
- Antti Pekkarinen
- HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teemu Siiskonen
- STUK - Radiation and Nuclear Safety Authority of Finland, Helsinki, Finland
| | - Maaret Lehtinen
- STUK - Radiation and Nuclear Safety Authority of Finland, Helsinki, Finland
| | - Sauli Savolainen
- HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Physics, University of Helsinki, Helsinki, Finland
| | - Mika Kortesniemi
- HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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14
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Miyajima R, Fujibuchi T, Miyachi Y, Tateishi S, Uno Y, Amakawa K, Ohura H, Orita S. [Effective Techniques to Reduce Radiation Exposure to Medical Staff during Assist of X-ray Computed Tomography Examination]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:326-334. [PMID: 29681599 DOI: 10.6009/jjrt.2018_jsrt_74.4.326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Medical staffs like radiological technologists, doctors, and nurses are at an increased risk of exposure to radiation while assisting the patient in a position or monitor contrast medium injection during computed tomography (CT). However, methods to protect medical staff from radiation exposure and protocols for using radiological protection equipment have not been standardized and differ among hospitals. In this study, the distribution of scattered X-rays in a CT room was measured by placing electronic personal dosimeters in locations where medical staff stands beside the CT scanner gantry while assisting the patient and the exposure dose was measured. Moreover, we evaluated non-uniform exposure and revealed effective techniques to reduce the exposure dose to medical staff during CT. The dose of the scattered X-rays was the lowest at the gantry and at the examination table during both head and abdominal CT. The dose was the highest at the trunk of the upper body of the operator corresponding to a height of 130 cm during head CT and at the head corresponding to a height of 150 cm during abdominal CT. The maximum dose to the crystalline lens was approximately 600 μSv during head CT. We found that the use of volumetric CT scanning and X-ray protective goggles, and face direction toward the gantry reduced the exposure dose, particularly to the crystalline lens, for which lower equivalent dose during CT scan has been recently recommended in the International Commission on Radiological Protection Publication 118.
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Affiliation(s)
- Ryuichi Miyajima
- Department of Radiology, National Hospital Organization Kyushu Medical Center (Current address: Department of Radiology, National Hospital Organization Kokura Medical Center)
| | - Toshioh Fujibuchi
- Division of Medical Quantum Science, Department of Health Sciences Faculty of Medical Sciences, Kyushu University
| | - Yusuke Miyachi
- Department of Radiology, National Hospital Organization Kyushu Medical Center
| | - Satoshi Tateishi
- Department of Radiology, National Hospital Organization Kyushu Medical Center
| | - Yoshinori Uno
- Department of Radiology, National Hospital Organization Kyushu Medical Center
| | - Kazutoshi Amakawa
- Department of Radiology, National Hospital Organization Kyushu Medical Center (Current address: Department of Radiology, National Sanatorium Okinawa Airakuen)
| | - Hiroki Ohura
- Department of Radiology, National Hospital Organization Kyushu Medical Center (Current address: Department of Radiology, National Hospital Organization Saga Hospital)
| | - Shinichi Orita
- Department of Radiology, National Hospital Organization Kyushu Medical Center
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15
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Strocchi S, Chiaravalli A, Veronese I, Novario R. ON-FIELD EVALUATION OF OPERATOR LENS PROTECTIVE DEVICES IN INTERVENTIONAL RADIOLOGY. RADIATION PROTECTION DOSIMETRY 2016; 171:382-388. [PMID: 26410765 DOI: 10.1093/rpd/ncv412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/27/2015] [Accepted: 08/28/2015] [Indexed: 06/05/2023]
Abstract
The recent publication of the Euratom Directive 2013/59, adopting the reduction of eye lens dose limits from 150 to 20 mSv y-1, calls for the development of new tools and methodologies for evaluating the eye lens dose absorbed by the medical staff involved in interventional radiology practices. Moreover, the effectiveness of the protective devices, like leaded glasses, which can be employed for radiation protection purposes, must be tested under typical exposure scenarios. In this work, eye lens dose measurements were carried out on an anthropomorphic phantom simulating a physician bound to perform standard interventional neuroradiology angiographic procedures. The correlation between eye lens doses, in terms of Hp(0.07), and the equivalent dose [again in terms of Hp(0.07)] monthly measured with thermoluminescent dosemeters placed above the lead apron at the chest level was studied, in the presence and in the absence of different types of leaded glasses.
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Affiliation(s)
- S Strocchi
- Medical Physics Department, Varese Hospital, Varese, Italy
| | - A Chiaravalli
- Dipartimento di Fisica, Università degli Studi di Milano, Milano, Italy
| | - I Veronese
- Dipartimento di Fisica, Università degli Studi di Milano, Milano, Italy
| | - R Novario
- Department of Biotechnology and Life Sciences, Medical Physics, University Hospital of Varese, Varese, Italy
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Ciraj-Bjelac O, Carinou E, Ferrari P, Gingaume M, Merce MS, O’Connor U. Occupational Exposure of the Eye Lens in Interventional Procedures: How to Assess and Manage Radiation Dose. J Am Coll Radiol 2016; 13:1347-1353. [DOI: 10.1016/j.jacr.2016.06.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/01/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
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17
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Radiation-Induced Cataractogenesis: A Critical Literature Review for the Interventional Radiologist. Cardiovasc Intervent Radiol 2015; 39:151-60. [DOI: 10.1007/s00270-015-1207-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
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