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Metaxas V, Dimitroukas C, Efthymiou F, Delis H, Gatzounis G, Tzortzidis F, Zampakis P, Theofanopoulos A, Constantoyannis C, Panayiotakis G. Assessment of organ doses, peak skin doses and effective doses in patients undergoing anterior cervical discectomy and fusion utilising VirtualDose-IR software. RADIATION PROTECTION DOSIMETRY 2024; 200:164-174. [PMID: 38016804 PMCID: PMC10875322 DOI: 10.1093/rpd/ncad286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 10/09/2023] [Accepted: 11/03/2023] [Indexed: 11/30/2023]
Abstract
In this study, the effect of patient- and procedure-related parameters on organ doses (ODs), peak skin dose (PSD) and effective dose (E) during anterior cervical discectomy and fusion (ACDF) was evaluated. Patient- and procedure-related parameters, as well as fluoroscopy time, kerma-area product (KAP), cumulative air-kerma (Kair) and incident Kair, were analysed for 50 ACDF procedures performed with a mobile C-arm. These parameters were inserted in VirtualDose-IR software implementing sex-specific and body mass index (BMI)-adjustable anthropomorphic phantoms to calculate OD, PSD and E. The BMI, gender and type of implants did not significantly affect KAP, incident Kair, PSD and E. However, the type of fusion significantly affected the E. The single fusions in C5/C6 resulted in significantly higher KAP, incident Kair and E than C4/C5 levels, while those performed in C6/C7 resulted in significantly higher E and PSD than C4/C5 levels. The thyroid, oesophagus and salivary glands received the largest doses in all groups studied. The BMI did not significantly affect ODs. The salivary glands absorbed significantly higher doses in males than females, while the extrathoracic region's dose significantly increased for multi- than single-level fusions. The fusions in C6/C7 resulted in significantly higher oesophagus and thyroid doses than C3/C4 and C4/C5 levels, as well as fusions performed in C5/C6 compared with C4/C5 levels. The data presented here could be used by the neurosurgeons as a comparator for future studies in optimising radiation protection during ACDF procedures in the operating theatre by keeping the ODs, PSD and E as low as reasonably practicable.
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Affiliation(s)
- Vasileios Metaxas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Christos Dimitroukas
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
| | - Fotios Efthymiou
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Harry Delis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
| | - George Gatzounis
- Department of Neurosurgery, University Hospital of Patras, 26504 Patras, Greece
- Department of Neurosurgery, School of Medicine, University of Patras, 26504 Patras, Greece
| | - Fotios Tzortzidis
- Department of Neurosurgery, University Hospital of Patras, 26504 Patras, Greece
| | - Petros Zampakis
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece
- Department of Radiology, School of Medicine, University of Patras, 26504 Patras, Greece
| | | | - Constantine Constantoyannis
- Department of Neurosurgery, University Hospital of Patras, 26504 Patras, Greece
- Department of Neurosurgery, School of Medicine, University of Patras, 26504 Patras, Greece
| | - George Panayiotakis
- Department of Medical Physics, School of Medicine, University of Patras, 26504 Patras, Greece
- Department of Medical Physics, University Hospital of Patras, 26504 Patras, Greece
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