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O'Rourke M, Moore N, Young R, Svetlic S, Bucknall H, McEntee MF, England A. An investigation into the knowledge, attitudes, and practice of radiation protection in interventional radiology and cardiac catheter-laboratories. J Med Imaging Radiat Sci 2024; 55:101440. [PMID: 38908031 DOI: 10.1016/j.jmir.2024.101440] [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: 01/18/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND According to current literature, there is a lack of information regarding the radiation protection (RP) practices of interventional radiology (IR) and cardiology catheter laboratory (CCL) staff. This study aims to determine the RP practices of staff within IR and CCLs internationally and to suggest areas for improvement. METHODS A cross-sectional study in the form of an online questionnaire was developed. Participation was advertised via online platforms and through email. Participants were included if they were healthcare professionals currently working in IR and CCLs internationally. Questionnaire design included Section 1 demographic data, Section 2 assessed RP training and protocols, Section 3 surveyed the use of different types of RP lead shields, both personal and co-worker use and Section 4 assessed other methods of minimising radiation dose within practice. Questions were a mix of open and closed ended, descriptive statistics were used for closed questions and thematic analysis was employed for open ended responses. RESULTS A total of 178 responses to the questionnaire were recorded with 130 (73 %) suitable for analysis. Most respondents were female (n = 94, 72 %) and were radiographers (n = 97, 75 %). Only 68 (53 %) had received training, the majority receiving this in-house (n = 54, 79 %). 118 (98 %) of respondents had departmental protocols in place for RP. Radiology managers (n = 106, 82 %) were most likely to contribute to such protocols. Multiple methods of dose minimisation exist, these include low-dose fluoroscopy, staff rotation, radiation dose audits and minimal time in the controlled areas. Respondents reported that lead apron shields were wore personally by 99 % of respondents and by co-workers in 95 % of cases. CONCLUSION The practices of RP by IR and CCL staff in this survey was variable and can be improved. The unavailability of basic radiation protection tools and RP specific training courses/modules were some of the reasons for sub-optimal self-protection against ionising radiation reported by respondents.
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Affiliation(s)
- Megan O'Rourke
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Niamh Moore
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Rena Young
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland
| | - Silvia Svetlic
- Department of Radiology, San Raffaelle Hospital, Milan, Italy
| | - Helen Bucknall
- Department of Radiology, St. George's Hospital, London, UK
| | - Mark F McEntee
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland; Faculty of Medicine, University of Sydney, Sydney, Australia; School of Health Sciences, University of Southern Denmark, Denmark
| | - Andrew England
- Discipline of Medical Imaging & Radiation Therapy, University College Cork, Cork, Ireland.
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Mansour A, Gamal NM, Tohamy A, Abdeltawab A. A multicentre survey of knowledge and implementation of radiation protection techniques in cardiac cath-lab medical personnel. Egypt Heart J 2024; 76:69. [PMID: 38829551 PMCID: PMC11147976 DOI: 10.1186/s43044-024-00492-4] [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: 12/22/2023] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Awareness of radiation hazards and methods to reduce radiation dose is a sine qua non for all staff working in the cath-lab for their own safety and their patient's safety. RESULTS There were large variations in the implementation of radiation protection techniques with overall inadequate radiation risk knowledge. Some members of the cath-lab team are at higher risk of radiation-induced side effects, including the fellows, nurses, technicians, and anaesthesiologists because they spent longer time in the cath-lab and/or their position in relation to the source of radiation. About 10% of the participants have reported different health problems potentially induced by radiation exposure. CONCLUSIONS There is lack of radiation risks knowledge with inadequate radiation protection practice among cath-lab team. Some members such as fellows, nurse, technicians, and cardiac anaesthesiologist are at higher risks. They represent the forgotten members of the Cath-Lab team.
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Affiliation(s)
- Amr Mansour
- Cardiology Department, Ain Shams University Hospital, 62 Hegaz St, Abbassia, Heliopolis, Cairo, Egypt
| | - Noha M Gamal
- Cardiology Department, Assiut University, Asyut, Egypt
| | - Ali Tohamy
- Cardiology Department, Assiut University, Asyut, Egypt
| | - Adham Abdeltawab
- Cardiology Department, Ain Shams University Hospital, 62 Hegaz St, Abbassia, Heliopolis, Cairo, Egypt.
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Wickramasinghe SU, Ramanathan V, Sarasanandarajah S, De Zoyza M, Paranamana R. Occupational dose measurement in interventional cardiology practice. RADIATION PROTECTION DOSIMETRY 2024; 200:629-639. [PMID: 38555495 DOI: 10.1093/rpd/ncae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 04/02/2024]
Abstract
Ensuring the safety of healthcare workers in interventional cardiology necessitates effective monitoring of occupational radiation exposure. This study aims to assess the accuracy of the over-apron single dosimetric approach compared with double dosimetric methods and explore the relationship between under-apron and over-apron doses. This investigation showed that the prescribed annual dose constraint of 20 mSv year-1 was not exceeded by the maximum annual occupational doses determined by dosimetric algorithms, which were 0.13 ± 0.02, 0.15 ± 0.02 and 0.27 ± 0.04 mSv, respectively. The study demonstrated excellent statistically significant correlations among single and double dosimetric algorithms and between direct under-apron and over-apron doses. Consequently, single dosimetric algorithms could effectively estimate doses for double dosimetric algorithms, highlighting the limited added value of under-apron measurements. These findings significantly impact the practice of interventional cardiology in Sri Lanka, playing a crucial role in enhancing radiation protection measures.
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Affiliation(s)
| | - Vijitha Ramanathan
- Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Sivananthan Sarasanandarajah
- Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
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Soucy B, Lee D, Moreau-Bourbonnais A, Filiatrault M, Denis I, Chang MC, Boudier-Revéret M. Influence of resident involvement on fluoroscopy time and ionizing radiation exposure in fluoroscopy-guided spinal procedures. PM R 2024; 16:260-267. [PMID: 37639553 DOI: 10.1002/pmrj.13066] [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: 12/18/2022] [Revised: 07/05/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Fluoroscopic guidance has become the standard for a variety of medical procedures. Mastering these techniques requires practice, which may entail additional radiation for patients and providers. Despite their widespread use, the literature examining factors influencing radiation exposure in fluoroscopically guided pain procedures is scarce. OBJECTIVE To evaluate the influence of resident involvement on radiation exposure during fluoroscopy-guided spinal interventions. DESIGN Single-center, observational study. SETTING Outpatient physiatry clinic in a teaching hospital. PATIENTS All patients who received cervical or lumbar facet block(s) (FBs), transforaminal epidural steroid injection(s) (TFESIs) without digital subtraction, or a caudal epidural (CE) during the study period were included. INTERVENTIONS Resident involvement in the procedures: absent, observing, or participating. MAIN OUTCOME MEASURES Machine-indicated fluoroscopy time (seconds) and radiation dose (milligrays [mGy]). RESULTS Two hundred ninety six procedures were included: 188 FBs (58 cervical, 130 lumbar), 48 CEs, and 60 TFESIs. For lumbar FBs, fluoroscopy time and radiation dose increased significantly when residents performed them (meantime = 24.5 s, confidence interval [CI] = 20.4-28.7; meandose = 3.53 mGy, CI = 2.57-4.49) compared to when they observed (meantime = 9.9 s, CI = 8.1-11.7; meandose = 1.28 mGy, CI = 0.98-1.59) (mean difference: time = 14.63 s, CI = 9.31-19.94; dose = 2.25 mGy, CI = 1.17-3.33) and were absent during the procedure (meantime = 12.9 s, CI = 11.1-14.6; meandose = 1.65 mGy, CI = 1.40-1.89) (mean difference: time = 11.67 s, CI = 7.35-15.98; dose = 1.88 mGy, CI = 1.01-2.76). In the case of TFESIs, time, but not dose, increased significantly when residents observed (meantime = 39.1 s, CI = 30.7-47.6; meandose = 6.73 mGy, CI = 3.39-10.07) compared to when they were absent (meantime = 27.1 s, CI = 22.4-31.8; meandose = 4.41 mGy, CI = 3.06-5.76 (mean difference: time = 11.99 s, CI = 1.37-22.61; dose = 2.32 mGy, CI = -1.20-5.84). Finally, resident involvement did not significantly affect the outcomes for CEs (ptime = .032, pdose = .74) and cervical FBs (ptime = .64, pdose = .68). CONCLUSION Resident participation affected lumbar FBs the most, with an increase in both fluoroscopy time and radiation dose.
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Affiliation(s)
- Béatrice Soucy
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Dillon Lee
- Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Amélie Moreau-Bourbonnais
- Department of Physical Medicine and Rehabilitation, CISSS des Laurentides, Saint-Jérôme, Québec, Canada
| | - Marc Filiatrault
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Isabelle Denis
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, South Korea
| | - Mathieu Boudier-Revéret
- Department of Physical Medicine and Rehabilitation, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada
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Wickramasinghe SU, Ramanathan V, Sarasanandarajah S. Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka. Radiol Phys Technol 2024; 17:258-268. [PMID: 38240885 DOI: 10.1007/s12194-023-00774-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/06/2023] [Accepted: 12/27/2023] [Indexed: 03/01/2024]
Abstract
Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.
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Affiliation(s)
- Sachini Udara Wickramasinghe
- Department of Radiography and Radiotherapy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka.
| | - Vijitha Ramanathan
- Department of Radiography and Radiotherapy, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Sivananthan Sarasanandarajah
- Department of Physical Sciences, Peter MacCallum Cancer Institute, Melbourne, Australia
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
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6
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Rahman MN, Javed M, Adnan G, Khan M, Nizar Z, Shah I. Differing radiation exposure in scrub technicians and rotating staff in Cardiac catheterization laboratory: occupation matters. Egypt Heart J 2024; 76:18. [PMID: 38334828 PMCID: PMC10858000 DOI: 10.1186/s43044-024-00448-8] [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: 05/19/2023] [Accepted: 01/28/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Radiation exposure is a significant hazard associated with invasive Cardiology, with most studies based on primary operator exposure. This prospective, observational study aimed to find out over lead radiation exposure as effective dose acquired by non-physician staff comprising scrub technicians and rotating staff in the cath laboratory. Effective dose (ED) measured per procedure via Raysafe i2®dosimeter badges worn by both rotating staff and scrub technicians over lead aprons along with dose area product (DAP), fluoroscopy time (FT) and procedure time (PT) in minutes was collected prospectively over forty-six invasive Cardiology procedures. RESULTS This study shows that rotating staff acquire higher ED in comparison with their scrub technician colleagues in diagnostic, interventional and electrophysiology cases. However, a statistically significant difference in radiation exposure of both staff groups was demonstrated in diagnostic and interventional Cardiology procedures, with p values of 0.04 and 0.01, respectively. CONCLUSIONS These findings highlight occupational role and mobility around fluoroscopic sources as major factors in radiation exposure, which should be addressed within current radiation protection practices.
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Affiliation(s)
- Muhammad Nasir Rahman
- 1Department of Medicine, Section of Cardiology, Aga Khan University Hospital, National Stadium Road, Karachi, Pakistan.
| | - Maleeha Javed
- Aga Khan University Hospital, National Stadium road, Karachi, Sindh, Pakistan
| | - Ghufran Adnan
- Wazirabad Institute of Cardiology, Wazirabad, Pakistan
| | - Maria Khan
- Wazirabad Institute of Cardiology, Wazirabad, Pakistan
| | - Zeenat Nizar
- Section of Cardiology, Department of Medicine, Aga Khan University Hospital, National Stadium Road, Karachi, Pakistan
| | - Izat Shah
- Section of Cardiology, Department of Medicine, Aga Khan University Hospital, National Stadium Road, Karachi, Pakistan
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Sattar Y, Sengodan PM, Cheema MS, Javed N, Ashraf S, Fakhra S, Alharbi A, Syed M, Alam M, Elgendy IY, Haleem A, Kawsara A, Alraies MC, Daggubati R. Lead Cap Use in Interventional Cardiology: Time to Protect Our Head in the Cardiac Catheterisation Laboratory? Interv Cardiol 2023; 18:e18. [PMID: 37435603 PMCID: PMC10331561 DOI: 10.15420/icr.2023.10] [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: 02/22/2023] [Accepted: 03/27/2023] [Indexed: 07/13/2023] Open
Abstract
Background: Radiation exposure is an occupational hazard for interventional cardiologists and cardiac catheterisation laboratory staff that can manifest with serious long-term health consequences. Personal protective equipment, including lead jackets and glasses, is common, but the use of radiation protective lead caps is inconsistent. Methods: A systematic review qualitative assessment of five observational studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines protocol was performed. Results: It was concluded that lead caps significantly reduce radiation exposure to the head, even when a ceiling-mounted lead shield was present. Conclusion: Although newer protective systems are being studied and introduced, tools, such as lead caps, need to be strongly considered and employed in the catheterisation laboratory as mainstay personal protective equipment.
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Affiliation(s)
- Yasar Sattar
- Department of Cardiology, West Virginia UniversityMorgantown, WV, US
| | | | - Mustafa Sajjad Cheema
- Department of Medicine, CMH Lahore Medical College and Institute of DentistryLahore, Punjab, Pakistan
| | - Nismat Javed
- Department of Internal Medicine, BronxCare Health SystemNew York, NY, US
| | - Shoaib Ashraf
- Department of Cardiology, Hackensack University Medical CentreNJ, US
| | - Sadaf Fakhra
- Department of Internal Medicine, University of Nevada, Kirk Kerkorian School of MedicineLas Vegas, NV, US
| | - Anas Alharbi
- Department of Cardiology, West Virginia UniversityMorgantown, WV, US
| | - Moinuddin Syed
- Department of Cardiology, Boston UniversityBoston, MA, US
| | - Mahboob Alam
- Department of Cardiology, Baylor College of MedicineHouston, TX, US
| | - Islam Y Elgendy
- Division of Cardiovascular Medicine, Gill Heart Institute, University of KentuckyLexington, KT, US
| | - Affan Haleem
- Department of Cardiology, West Virginia UniversityMorgantown, WV, US
| | - Akram Kawsara
- Department of Cardiology, West Virginia UniversityMorgantown, WV, US
| | - M Chadi Alraies
- Detroit Medical Centre, Wayne State UniversityDetroit, MI, US
| | - Ramesh Daggubati
- Department of Cardiology, West Virginia UniversityMorgantown, WV, US
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Anim-Sampong S, Antwi WK, Adomako JB, Botwe BO, Sarkodie BD, Brakohiapa EK. Patient radiation dose during diagnostic and interventional cardiology procedures: A study in a tertiary hospital. J Med Imaging Radiat Sci 2023; 54:298-305. [PMID: 36746713 DOI: 10.1016/j.jmir.2022.12.010] [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: 07/25/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Fluoroscopy-guided diagnostic and interventional cardiology (IC) procedures help to identify and treat several problems associated with the heart. However, these procedures expose patients, cardiologists, radiographers, and nurses to radiation doses. Due to the risk that ionizing radiation poses, concerns have been raised and studies are continually being done to ensure that optimization is achieved during such procedures. This study assessed patient radiation dose during diagnostic and interventional cardiology procedures as well as right heart studies at a tertiary hospital in Ghana to formulate the facility's diagnostic reference levels (DRLs) for optimization purposes. As this study was the first of its kind in Ghana, it was a vital step towards dose optimization within the local department, as well as contributing to future DRLs in Ghana. METHODS The study collected dose (air kerma, and kerma area product (KAP) and procedural data, and assessed any correlation between parameters such as fluoroscopy time and KAP, and between body mass index (BMI) and KAP. The DRL values were determined as the 75th percentile level for the dose distribution for the various IC procedures including percutaneous coronary interventions (PCI), coronary angiography (CA), and right heart catheterization (RHC). Data were analyzed using SPSS version 23. RESULTS CA was the most frequently performed IC procedure (77.3%), while RHC was the least recorded (3.3%). The highest mean KAP was observed during the PCI procedure. The proposed diagnostic reference levels (DRLs) were 162.0 Gy.cm2 (PCI), 69.4 Gy.cm2 (CA), 39.8 Gy.cm2 (RHC) and 159.9 Gy.cm2 (CA+PCI). Patients who presented for the CA+PCI and RHC procedures received the highest and lowest mean KAP of 159.9 Gy.cm2 and 39.8 Gy.cm2 of radiation respectively. CONCLUSION This study, therefore, concludes that there is a need for dose optimization of radiation exposures for IC procedures at the cardiothoracic center in Ghana.
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Affiliation(s)
- Samuel Anim-Sampong
- Department. of Radiography, University of Ghana School of Biomedical and Allied Health Sciences, P.O. Box KB 143, Korle Bu, Accra, Ghana
| | - William Kwadwo Antwi
- Department. of Radiography, University of Ghana School of Biomedical and Allied Health Sciences, P.O. Box KB 143, Korle Bu, Accra, Ghana.
| | - John Bright Adomako
- Department. of Radiography, University of Ghana School of Biomedical and Allied Health Sciences, P.O. Box KB 143, Korle Bu, Accra, Ghana
| | - Benard Ohene Botwe
- Department. of Radiography, University of Ghana School of Biomedical and Allied Health Sciences, P.O. Box KB 143, Korle Bu, Accra, Ghana; Department of Midwifery and Radiography Division School of Health & Psychological Sciences, City, University of London, Northampton Square, London EC1V 0HB, UK
| | - Benjamin Dabo Sarkodie
- Department of Radiology, University of Ghana School of Medical and Dental Science, Accra, Ghana
| | - Edmund K Brakohiapa
- Department of Radiology, University of Ghana School of Medical and Dental Science, Accra, Ghana
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Azman MN, Abualroos NJ, Yaacob KA, Zainon R. Feasibility of nanomaterial tungsten carbide as lead-free nanomaterial-based radiation shielding. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110492] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Lyu C, Guo S, Zhou W, Yan Y, Yang C, Wang Y, Meng F. A Deep-Learning-Based Guidewire Compliant Control Method for the Endovascular Surgery Robot. MICROMACHINES 2022; 13:mi13122237. [PMID: 36557535 PMCID: PMC9788084 DOI: 10.3390/mi13122237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 05/14/2023]
Abstract
Endovascular surgery is a high-risk operation with limited vision and intractable guidewires. At present, endovascular surgery robot (ESR) systems based on force feedback liberates surgeons' operation skills, but it lacks the ability to combine force perception with vision. In this study, a deep learning-based guidewire-compliant control method (GCCM) is proposed, which guides the robot to avoid surgical risks and improve the efficiency of guidewire operation. First, a deep learning-based model called GCCM-net is built to identify whether the guidewire tip collides with the vascular wall in real time. The experimental results in a vascular phantom show that the best accuracy of GCCM-net is 94.86 ± 0.31%. Second, a real-time operational risk classification method named GCCM-strategy is proposed. When the surgical risks occur, the GCCM-strategy uses the result of GCCM-net as damping and decreases the robot's running speed through virtual resistance. Compared with force sensors, the robot with GCCM-strategy can alleviate the problem of force position asynchrony caused by the long and soft guidewires in real-time. Experiments run by five guidewire operators show that the GCCM-strategy can reduce the average operating force by 44.0% and shorten the average operating time by 24.6%; therefore the combination of vision and force based on deep learning plays a positive role in improving the operation efficiency in ESR.
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Affiliation(s)
- Chuqiao Lyu
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Shuxiang Guo
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
- Correspondence: ; Tel.: +86-186-0020-0326
| | - Wei Zhou
- Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
| | - Yonggan Yan
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Chenguang Yang
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Yue Wang
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Fanxu Meng
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
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11
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Kellens PJ, De Hauwere A, Gossye T, Peire S, Tournicourt I, Strubbe L, De Pooter J, Bacher K. Integrity of personal radiation protective equipment (PRPE): a 4-year longitudinal follow-up study. Insights Imaging 2022; 13:183. [PMID: 36471171 PMCID: PMC9723036 DOI: 10.1186/s13244-022-01323-3] [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: 08/09/2022] [Accepted: 11/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Personal radiation protective equipment (PRPE) such as lead aprons minimises radiation exposure of operators using X-ray systems. However, PRPE might be prone to cracks in the attenuating layer resulting in inadequate radiation protection. This study aims to investigate the prevalence, qualification and quantification of PRPE integrity during a longitudinal follow-up study. METHODS All PRPE of a large, general hospital was evaluated yearly in the period 2018-2021. The equipment was inspected on a tele-operated X-ray table, and tears were qualified and quantified using an X-ray opaque ruler. Rejection criteria of Lambert & McKeon, with an extra rejection criterion of 15 mm2 for individual tears, were applied to accept or reject further use of the PRPE. RESULTS Over the 4-year follow-up period, a total of 1011 pieces of PRPE were evaluated. In total, 47.3% of the PRPE showed tears of which 31% exceeded the mentioned rejection criteria. Remarkably, of the 287 newly registered pieces of PRPE, 6.0% showed tears in the first year of use of which 88.2% needed to be rejected. Also, 48% of the repaired PRPE was rejected again in the consecutive year. CONCLUSIONS PRPE is prone to cracks. Up to 50% of PRPE showed tears and cracks resulting in 31% rejections. Newly purchased PRPE is not guaranteed to remain free of cracks and tears in the first year of use. Repair does not guarantee a long-term solution for prolonging the lifespan. Regular X-ray-based integrity analysis of PRPE is needed to ensure adequate radioprotection for operators using X-ray systems.
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Affiliation(s)
- Pieter-Jan Kellens
- grid.5342.00000 0001 2069 7798Medical Physics, Ghent University, Proeftuinstraat 86, 9000 Ghent, Belgium
| | - An De Hauwere
- grid.5342.00000 0001 2069 7798Medical Physics, Ghent University, Proeftuinstraat 86, 9000 Ghent, Belgium
| | - Tim Gossye
- grid.5342.00000 0001 2069 7798Medical Physics, Ghent University, Proeftuinstraat 86, 9000 Ghent, Belgium
| | - Sven Peire
- grid.420036.30000 0004 0626 3792AZ Sint-Jan Brugge - Oostende AV, Brugge, Belgium
| | - Ingrid Tournicourt
- grid.420036.30000 0004 0626 3792AZ Sint-Jan Brugge - Oostende AV, Brugge, Belgium
| | - Luc Strubbe
- grid.420036.30000 0004 0626 3792AZ Sint-Jan Brugge - Oostende AV, Brugge, Belgium
| | - Jan De Pooter
- grid.410566.00000 0004 0626 3303Heart Centre, University Hospital Ghent, Ghent, Belgium
| | - Klaus Bacher
- grid.5342.00000 0001 2069 7798Medical Physics, Ghent University, Proeftuinstraat 86, 9000 Ghent, Belgium
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Baker A, Narayanan S, Tsai JP, Tjoumakaris SI, Haranhalli N, Fraser JF, Hetts SW. Society of NeuroInterventional Surgery: position statement on pregnancy and parental leave for physicians practicing neurointerventional surgery. J Neurointerv Surg 2022; 15:5-7. [DOI: 10.1136/jnis-2022-019613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022]
Abstract
BackgroundThe aim of this article is to outline a position statement on pregnancy and parental leave for physicians practicing neurointerventional surgery.MethodsWe performed a structured literature review regarding parental leave policies in neurointerventional surgery and related fields. The recommendations resulted from discussion among the authors, and additional input from the Women in NeuroIntervention Committee, the full Society of NeuroInterventional Surgery (SNIS) Standards and Guidelines Committee, and the SNIS Board of Directors.ResultsSome aspects of workplace safety during pregnancy are regulated by the US Nuclear Regulatory Commission. Other aspects of the workplace and reasonable job accommodations are legally governed by the Family and Medical Leave Act of 1993, the Affordable Care Act of 2010 and the Fair Labor Standards Act of 1938, Americans with Disabilities Act of 1990, Title IX of the Education Amendments of 1972, Title VII of the Civil Rights Act of 1964 as well as rights and protections put forth by the Occupational Safety and Health Administration as part of the United States Department of Labor. Family friendly policies have been associated not only with improved job satisfaction but also with improved parental and infant outcomes. Secondary effects of such accommodations are to increase the number of women within the specialty.ConclusionsSNIS supports a physician’s ambition to have a family as well as start, develop, and maintain a career in neurointerventional surgery. Legal and regulatory mandates and family friendly workplace policies should be considered when institutions and individual practitioners approach the issue of childbearing in the context of a career in neurointerventional surgery.
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Loyaga-Rendon RY, Lee S, Dickinson MG, Grayburn R, Gonzalez M, Jani M, Fermin D, Vanoosterhout S, Parker JL, McNamara DA, Madder RD. Physician Radiation Exposure During Endomyocardial Biopsy and Right Heart Catheterization. J Card Fail 2022; 29:473-478. [PMID: 36195201 DOI: 10.1016/j.cardfail.2022.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cardiologists performing coronary angiography (CA) and percutaneous coronary intervention (PCI) are at risk of health problems related to chronic occupational radiation exposure. Unlike during CA and PCI, physician radiation exposure during right heart catheterization (RHC) and endomyocardial biopsy (EMB) has not been adequately studied. The objective of this study was to assess physicians' radiation doses during RHC with and without EMB and compare them to those of CA and PCI. METHODS Procedural head-level physician radiation doses were collected by real-time dosimeters. Radiation-dose metrics (fluoroscopy time, air kerma [AK] and dose area product [DAP]), and physician-level radiation doses were compared among RHC, RHC with EMB, CA, and PCI. RESULTS Included in the study were 351 cardiac catheterization procedures. Of these, 36 (10.3%) were RHC, 42 (12%) RHC with EMB, 156 (44.4%) CA, and 117 (33.3%) PCI. RHC with EMB and CA had similar fluoroscopy time. AK and DAP were progressively higher for RHC, RHC with EMB, CA, and PCI. Head-level physician radiation doses were similar for RHC with EMB vs CA (P = 0.07). When physicians' radiation doses were normalized to DAP, RHC and RHC with EMB had the highest doses. CONCLUSION Physicians' head-level radiation doses during RHC with EMB were similar to those of CA. After normalizing to DAP, RHC and RHC with EMB were associated with significantly higher physician radiation doses than CA or PCI. These observations suggest that additional protective measures should be undertaken to decrease physicians' radiation exposure during RHC and, in particular, RHC with EMB.
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Affiliation(s)
- Renzo Y Loyaga-Rendon
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health.
| | - Sangjin Lee
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - Michael G Dickinson
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - Ryan Grayburn
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - Matthew Gonzalez
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - Milena Jani
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - David Fermin
- Advanced Heart Failure Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | | | | | - David A McNamara
- Advanced Cardiac Imaging Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health
| | - Ryan D Madder
- Interventional Cardiology Section, Frederick Meijer Heart & Vascular Institute, Spectrum Health, Grand Rapids, Michigan
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Shi HM, Sun ZC, Ju FH. Understanding the harm of low‑dose computed tomography radiation to the body (Review). Exp Ther Med 2022; 24:534. [PMID: 35911849 DOI: 10.3892/etm.2022.11461] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/24/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hai-Min Shi
- Department of Gynecology and Obstetrics Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China
| | - Zhi-Chao Sun
- Department of Medical Imaging, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310006, P.R. China
| | - Fang-He Ju
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Zhejiang 310006, P.R. China
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Affiliation(s)
- D G Buys
- Department of Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa.
| | - S C Brown
- Department of Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa
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