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Mitrovic M, Ciraj-Bjelac O, Jovanovic Z, Krstic N, Nikezic D, Krstic D, Zivkovic M, Lazarevic-Macanovic M. Voxel model of a rabbit: assessment of absorbed doses in organs after CT examination performed by two different protocols. Radiat Environ Biophys 2021; 60:631-638. [PMID: 34487228 DOI: 10.1007/s00411-021-00941-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 08/21/2021] [Indexed: 06/13/2023]
Abstract
The objective of this work was to assess absorbed doses in organs and tissues of a rabbit, following computed tomography (CT) examinations, using a dedicated 3D voxel model. Absorbed doses in relevant organs were calculated using the MCNP5 Monte Carlo software. Calculations were perfomed for two standard CT protocols, using tube voltages of 110 kVp and 130 kVp. Absorbed doses were calculated in 11 organs and tissues, i.e., skin, bones, brain, muscles, heart, lungs, liver, spleen, kidney, testicles, and fat tissue. The doses ranged from 15.3 to 28.3 mGy, and from 40.2 to 74.3 mGy, in the two investigated protocols. The organs that received the highest dose were bones and kidneys. In contrast, brain and spleen were organs that received the smallest doses. Doses in organs which are stretched along the body did not change significantly with distance. On the other hand, doses in organs which are localized in the body showed maximums and minimums. Using the voxel model, it is possible to calculate the dose distribution in the rabbit's body after CT scans, and study the potential biological effects of CT doses in certain organs. The voxel model presented in this work can be used to calculated doses in all radiation experiments in which rabbits are used as experimental animals.
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Affiliation(s)
- M Mitrovic
- Department of Radiology and Radiation Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia
| | - O Ciraj-Bjelac
- Radiation Protection Department, Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Z Jovanovic
- Faculty of Science, University of Kragujevac, Kragujevac, Serbia
| | - N Krstic
- Department of Radiology and Radiation Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia
| | - D Nikezic
- State University of Novi Pazar, Novi Pazar, Serbia.
| | - D Krstic
- Faculty of Science, University of Kragujevac, Kragujevac, Serbia
| | - M Zivkovic
- Faculty of Science, University of Kragujevac, Kragujevac, Serbia
| | - M Lazarevic-Macanovic
- Department of Radiology and Radiation Hygiene, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia
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2
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O'Connor U, Carinou E, Clairand I, Ciraj-Bjelac O, De Monte F, Domienik-Andrzejewska J, Ferrari P, Ginjaume M, Hršak H, Hupe O, Knežević Ž, Sans Merce M, Sarmento S, Siiskonen T, Vanhavere F. Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals. Phys Med 2021; 87:131-135. [PMID: 34153572 DOI: 10.1016/j.ejmp.2021.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 05/04/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022] Open
Abstract
Occupational radiation doses from interventional procedures have the potential to be relatively high. The requirement to optimise these doses encourages the use of electronic or active personal dosimeters (APDs) which are now increasingly used in hospitals. They are typically used in tandem with a routine passive dosimetry monitoring programme, with APDs used for real-time readings, for training purposes and when new imaging technology is introduced. However, there are limitations when using APDs. A survey in hospitals to identify issues related to the use of APDs was recently completed, along with an extensive series of APD tests by the EURADOS Working Group 12 on Dosimetry for Medical Imaging. The aim of this review paper is to summarise the state of the art regarding the use of APDs. We also used the results of our survey and our tests to develop a set of recommendations for the use of APDs in the clinical interventional radiology/cardiology settings, and draw attention to some of the current challenges.
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Affiliation(s)
| | - E Carinou
- Greek Atomic Energy Commission, EEAE, Agia Paraskevi, Attiki, Greece
| | - I Clairand
- IRSN, Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | - O Ciraj-Bjelac
- Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - F De Monte
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - P Ferrari
- ENEA. IRP-Radiation Protection Institute, Bologna, Italy
| | - M Ginjaume
- UPC, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - H Hršak
- University Hospital Centre Zagreb, Croatia
| | - O Hupe
- Physikalisch-Technische Bundesanstalt (PTB), 38116 Braunschweig, Germany
| | - Ž Knežević
- Ruđer Bošković Institute RBI, Zagreb, Croatia
| | - M Sans Merce
- CHUV, University Hospital of Lausanne, Lausanne, Switzerland; HUG, University Hospital of Geneva, Geneva, Switzerland
| | - S Sarmento
- IPO Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | | | - F Vanhavere
- SCK-CEN, Belgian Nuclear Research Centre, Mol, Belgium
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3
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Rafajlovic S, Ciraj-Bjelac O, Bozovic P. Towards National Diagnostic Reference Levels for Mammography in Serbia. Radiat Prot Dosimetry 2020; 191:ncaa173. [PMID: 33230542 DOI: 10.1093/rpd/ncaa173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/18/2020] [Accepted: 10/03/2020] [Indexed: 06/11/2023]
Abstract
The objective of this work is to investigate the possibility to set a national diagnostic reference levels (nDRLs) for diagnostic and screening mammography in Serbia based on local practice and available resources. This study included all types of mammography systems that are currently used in Serbia, namely screen-film mammography (SFM), computed radiography (CR) and full-field digital mammography (FFDM). The nDRLs are provided in terms of mean glandular dose (MGD) for different breast thicknesses simulated by polymethyl methacrylate (PMMA) phantom. For each breast thickness, MGD was calculated for the X-ray tube output, using clinically used exposure parameters. DRLs were chosen as the 75th percentile of MGD distribution for 20-, 40-, 45-, 60- and 70-mm phantom thicknesses. For SFM units proposed nDRL values are 0.7, 2.1, 2.7, 4.6 and 6.8 mGy; for CR units proposed nDRL values are 0.7, 1.8, 2.4, 4.5 and 5.6 mGy; and corresponding values for FFDM units are 0.8, 1.7, 2, 2. and 3.2 mGy for 20-, 40-, 45-, 60- and 70-mm PMMA thickness, respectively.
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Affiliation(s)
- S Rafajlovic
- University of Belgrade, School of Electrical Engineering, Bulevar kralja Aleksandra Str. 73, 11000 Belgrade, Serbia
| | - O Ciraj-Bjelac
- University of Belgrade, School of Electrical Engineering, Bulevar kralja Aleksandra Str. 73, 11000 Belgrade, Serbia
- University of Belgrade, Vinca Institute of Nuclear Sciences, M. P. Alasa Str., Vinca, PO Box 522, 11001 Belgrade, Serbia
| | - P Bozovic
- University of Belgrade, School of Electrical Engineering, Bulevar kralja Aleksandra Str. 73, 11000 Belgrade, Serbia
- University of Belgrade, Vinca Institute of Nuclear Sciences, M. P. Alasa Str., Vinca, PO Box 522, 11001 Belgrade, Serbia
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4
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Krajinović M, Dobrić M, Ciraj-Bjelac O. SKIN DOSE MAPPING IN INTERVENTIONAL CARDIOLOGY: A PRACTICAL SOLUTION. Radiat Prot Dosimetry 2020; 188:508-515. [PMID: 32614065 DOI: 10.1093/rpd/ncaa002] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/25/2019] [Accepted: 01/06/2020] [Indexed: 06/11/2023]
Abstract
Numerous cases of radiation-induced tissue reactions following interventional cardiology (IC) procedures have been reported, resulting in the need for an optimized and personalized dosimetry. At present, there are many fluoroscopy units without Digital Imaging and Communications in Medicine (DICOM) Radiation Dose Structured Report globally installed. Many of these have not been updated yet, and may never be, therefore, the main objectives of this paper are to develop an offline skin dose mapping application, which uses DICOM headers for the peak skin dose (PSD) assessment and to compare the PSD assessment results to XR-RV3 Gafchromic film for common IC procedures. The mean deviation between the measured and the calculated PSD was 8.7 ± 26.3%. Simulated skin dose map showed good matching with XR-RV3 Gafchromic film. The skin dose mapping application presented in this paper is an elegant solution and a suitable alternative to XR-RV3 Gafchromic film.
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Affiliation(s)
- M Krajinović
- School of Electrical Engineering, University of Belgrade, Studentski trg 1, 11000 Belgrade, Serbia
- Vinča Institute of Nuclear Sciences, University of Belgrade, Studentski trg 1, 11000 Belgrade, Serbia
| | - M Dobrić
- Clinic for Cardiology, Clinical Center of Serbia, Belgrade 11000, Serbia
| | - O Ciraj-Bjelac
- School of Electrical Engineering, University of Belgrade, Studentski trg 1, 11000 Belgrade, Serbia
- Vinča Institute of Nuclear Sciences, University of Belgrade, Studentski trg 1, 11000 Belgrade, Serbia
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5
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Vanhavere F, Carinou E, Clairand I, Ciraj-Bjelac O, De Monte F, Domienik-Andrzejewska J, Ferrari P, Ginjaume M, Hršak H, Hupe O, Knezevic Z, O'Connor U, Merce MS, Sarmento S, Savary A, Siskoonen T. THE USE OF ACTIVE PERSONAL DOSEMETERS IN INTERVENTIONAL WORKPLACES IN HOSPITALS: COMPARISON BETWEEN ACTIVE AND PASSIVE DOSEMETERS WORN SIMULTANEOUSLY BY MEDICAL STAFF. Radiat Prot Dosimetry 2020; 188:22-29. [PMID: 31832653 DOI: 10.1093/rpd/ncz253] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 05/11/2019] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
Medical staff in interventional procedures are among the professionals with the highest occupational doses. Active personal dosemeters (APDs) can help in optimizing the exposure during interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field and because of the pulsed nature of the radiation. Many parameters like the type of interventional procedure, personal habits and working techniques, protection tools used and X-ray field characteristics influence the occupational exposure and the scattered radiation around the patient. In this paper, we compare the results from three types of APDs with a passive personal dosimetry system while being used in real clinical environment by the interventional staff. The results show that there is a large spread in the ratios of the passive and active devices.
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Affiliation(s)
- F Vanhavere
- SCK-CEN, Belgian Nuclear Research Centre, Mol, Belgium
| | - E Carinou
- Greek Atomic Energy Commission, EEAE, Agia Paraskevi, Attiki, Greece
| | - I Clairand
- IRSN, Institute for Radiological Protection and Nuclear Safery, Fontenay-Aux-Roses, France
| | - O Ciraj-Bjelac
- Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - F De Monte
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | | | - P Ferrari
- ENEA. IRP-Radiation Protection Institute, Bologna, Italy
| | - M Ginjaume
- UPC, Universitat Politècnica de Catalunya, Barcelona, Spain
| | | | - O Hupe
- Physikalisch-Technische Bundesanstalt (PTB), 38116 Braunschweig, Germany
| | - Z Knezevic
- Ruder Boskovic Institute RBI, Zagreb, Croatia
| | | | - M Sans Merce
- CHUV, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - S Sarmento
- Porto Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
| | - A Savary
- IRSN, Institute for Radiological Protection and Nuclear Safery, Fontenay-Aux-Roses, France
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Struelens L, Covens P, Benadjaoud M, Auvinen A, Gianicolo E, Wegener A, Domienik J, Carinou E, Dragusin O, Teles P, Widmark A, Ciraj-Bjelac O, Andreassi MG, Padovani R. 69. The European epidemiological study (EURALOC) on radiation-induced lens opacities among interventional cardiologists. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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7
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Siiskonen T, Ciraj-Bjelac O, Dabin J, Diklic A, Domienik-Andrzejewska J, Farah J, Fernandez J, Gallagher A, Hourdakis C, Jurkovic S, Järvinen H, Järvinen J, Knežević Ž, Koukorava C, Maccia C, Majer M, Malchair F, Riccardi L, Rizk C, Sanchez R, Sandborg M, Merce MS, Segota D, Sierpowska J, Simantirakis G, Sukupova L, Thrapsanioti Z, Vano E. Establishing the European diagnostic reference levels for interventional cardiology. Phys Med 2018; 54:42-48. [DOI: 10.1016/j.ejmp.2018.09.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/19/2018] [Accepted: 09/23/2018] [Indexed: 11/29/2022] Open
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8
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Struelens L, Dabin J, Carinou E, Askounis P, Ciraj-Bjelac O, Domienik-Andrzejewska J, Berus D, Padovani R, Farah J, Covens P. Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses. Radiat Res 2018; 189:399-408. [DOI: 10.1667/rr14970.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- L. Struelens
- Radiation Protection Dosimetry and Calibration Group, Belgian Nuclear Research Centre (SCK•CEN), Belgium
| | - J. Dabin
- Radiation Protection Dosimetry and Calibration Group, Belgian Nuclear Research Centre (SCK•CEN), Belgium
| | - E. Carinou
- Dosimetry and Calibration Department, Greek Atomic Energy Commission (EEAE), Agia Paraskevi, Greece
| | - P. Askounis
- Dosimetry and Calibration Department, Greek Atomic Energy Commission (EEAE), Agia Paraskevi, Greece
| | - O. Ciraj-Bjelac
- Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - J. Domienik-Andrzejewska
- Radiation Protection Department, Nofer Institute of Occupational Medicine (NIOM), 91-348 Lodz, Poland
| | - D. Berus
- Department of Radiation Protection, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - R. Padovani
- Department of Medical Physics, Abdus Salam International Centre for Theoretical Physics (ICTP), 34151 Trieste, Italy
| | | | - P. Covens
- Department of Radiation Protection, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
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9
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Kaljevic J, Ciraj-Bjelac O, Stankovic J, Arandjic D, Bozovic P, Antic V. OCCUPATIONAL DOSE ASSESSMENT IN INTERVENTIONAL CARDIOLOGY IN SERBIA. Radiat Prot Dosimetry 2016; 170:279-283. [PMID: 26464526 DOI: 10.1093/rpd/ncv439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this work is to assess the occupational dose in interventional cardiology in a large hospital in Belgrade, Serbia. A double-dosimetry method was applied for the estimation of whole-body dose, using thermoluminescent dosemeters, calibrated in terms of the personal dose equivalent Hp(10). Besides the double-dosimetry method, eye dose was also estimated by means of measuring ambient dose equivalent, H*(10), and doses per procedure were reported. Doses were assessed for 13 physicians, 6 nurses and 10 radiographers, for 2 consequent years. The maximum annual effective dose assessed was 4.3, 2.1 and 1.3 mSv for physicians, nurses and radiographers, respectively. The maximum doses recorded by the dosemeter worn at the collar level (over the apron) were 16.8, 11.9 and 4.5 mSv, respectively. This value was used for the eye lens dose assessment. Estimated doses are in accordance with or higher than annual dose limits for the occupational exposure.
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Affiliation(s)
- J Kaljevic
- Vinca Institute of Nuclear Sciences, University of Belgrade, M. P. Alasa 12-14, Belgrade 11001, Serbia
| | - O Ciraj-Bjelac
- Vinca Institute of Nuclear Sciences, University of Belgrade, M. P. Alasa 12-14, Belgrade 11001, Serbia School of Electrical Engineering, University of Belgrade, Bulevar Kralja Aleksandra 73, Belgrade 11120, Serbia
| | - J Stankovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, M. P. Alasa 12-14, Belgrade 11001, Serbia School of Electrical Engineering, University of Belgrade, Bulevar Kralja Aleksandra 73, Belgrade 11120, Serbia
| | - D Arandjic
- Vinca Institute of Nuclear Sciences, University of Belgrade, M. P. Alasa 12-14, Belgrade 11001, Serbia School of Electrical Engineering, University of Belgrade, Bulevar Kralja Aleksandra 73, Belgrade 11120, Serbia
| | - P Bozovic
- Vinca Institute of Nuclear Sciences, University of Belgrade, M. P. Alasa 12-14, Belgrade 11001, Serbia School of Electrical Engineering, University of Belgrade, Bulevar Kralja Aleksandra 73, Belgrade 11120, Serbia
| | - V Antic
- Center for Nuclear Medicine, University Clinical Centre of Serbia, Pasterova 2, Belgrade 11000, Serbia
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10
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Dabin J, Negri A, Farah J, Ciraj-Bjelac O, Clairand I, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Novák L, Siiskonen T, Vanhavere F, Trianni A, Knežević Ž. Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. Phys Med 2015; 31:1112-1117. [DOI: 10.1016/j.ejmp.2015.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 10/22/2022] Open
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11
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Farah J, Trianni A, Ciraj-Bjelac O, Clairand I, De Angelis C, Delle Canne S, Hadid L, Huet C, Jarvinen H, Negri A, Novák L, Pinto M, Siiskonen T, Waryn MJ, Knežević Ž. Characterization of XR-RV3 GafChromic®
films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. Med Phys 2015; 42:4211-26. [DOI: 10.1118/1.4922132] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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12
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Farah J, Trianni A, Carinou E, Ciraj-Bjelac O, Clairand I, Dabin J, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Negri A, Novák L, Siiskonen T, Vanhavere F, Knežević Ž. Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. Radiat Prot Dosimetry 2015; 164:138-142. [PMID: 25316909 DOI: 10.1093/rpd/ncu314] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of >3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.
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Affiliation(s)
- J Farah
- Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France
| | - A Trianni
- Udine University Hospital (AOUD), Ple S. Maria della Misericordia, 15, Udine 33100, Italy
| | - E Carinou
- Greek Atomic Energy Commission (GAEC), PO Box 60092, Ag. Paraskevi, Athens 15310, Greece
| | - O Ciraj-Bjelac
- VINCA Institute of Nuclear Sciences (VINCA), PO Box 522, Belgrade 11001, Serbia
| | - I Clairand
- Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France
| | - J Dabin
- Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium
| | - C De Angelis
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome 00161, Italy
| | - J Domienik
- Nofer Institute of Occupational Medicine (NIOM), 8 Sw. Teresy, Str., Łódź 91-348, Poland
| | - H Jarvinen
- Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland
| | - R Kopec
- Institute of Nuclear Physics (IFJ PAN), ul Radzikowskiego 152, Kraków PL-31-342, Poland
| | - M Majer
- Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia
| | - F Malchair
- Centre Hospitalier Universitaire de Liège (CHUL), Avenue de l'Hôpital, Liège 4000, Belgium
| | - A Negri
- Istituto Oncologico Veneto (IOV), Via Gattamelata 64, Padova 35124, Italy
| | - L Novák
- National Radiation Protection Institute (NRPI), Bartoškova 28, Prague 4 140 00, Czech Republic
| | - T Siiskonen
- Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland
| | - F Vanhavere
- Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium
| | - Ž Knežević
- Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia
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13
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Ciraj-Bjelac O, Rehani MM. Eye dosimetry in interventional radiology and cardiology: current challenges and practical considerations. Radiat Prot Dosimetry 2014; 162:329-337. [PMID: 24262928 DOI: 10.1093/rpd/nct291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Interventional radiology and cardiology are areas with high potential for risk to eye lens. Accurate assessment of eye dose is one of the most important aspects of correlating doses with observed lens opacities among workers in interventional suites and ascertaining compliance with regulatory limits. The purpose of this paper is to review current approaches and opportunities in eye dosimetry and assess challenges in particular in accuracy and practicality. The possible approaches include practical dosimetry using passive dosemeters or active dosemeters with obvious advantage of active dosimetry. When neither of these is available, other approaches are based on either retrospective dose assessment using scatter radiation dose levels or correlations between patient dose indices and eye doses to the operators. In spite of all uncertainties and variations, estimation of eye dose from patient dose can be accepted as a compromise. Future challenges include development of practical methods for regular monitoring of individual eye doses and development of better techniques to estimate eye dose from measurements at some reference points.
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Affiliation(s)
- O Ciraj-Bjelac
- Vinca Institute of Nuclear Science, University of Belgrade, M.P. Alasa 12, Vinca, Belgrade, Serbia
| | - M M Rehani
- International Atomic Energy Agency (formerly) and European Society of Radiology (ESR), Vienna, Austria
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14
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Antic V, Ciraj-Bjelac O, Stankovic J, Arandjic D, Todorovic N, Lucic S. Radiation exposure to nuclear medicine staff involved in PET/CT practice in Serbia. Radiat Prot Dosimetry 2014; 162:577-585. [PMID: 24464817 DOI: 10.1093/rpd/ncu001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this work is to evaluate the radiation exposure to nuclear medicine (NM) staff in the two positron emission tomography-computed tomography centres in Serbia and to investigate the possibilities for dose reduction. Dose levels in terms of Hp(10) for whole body and Hp(0.07) for hands of NM staff were assessed using thermoluminescence and electronic personal dosemeters. The assessed doses per procedure in terms of Hp(10) were 4.2-7 and 5-6 μSv, in two centres, respectively, whereas the extremity doses in terms of Hp(0.07) in one of the centres was 34-126 μSv procedure(-1). The whole-body doses per unit activity were 17-19 and 21-26 μSv GBq(-1) in two centres, respectively, and the normalised finger dose in one centre was 170-680 μSv GBq(-1). The maximal estimated annual whole-body doses in two centres were 3.4 and 2.0 mSv, while the corresponding extremity dose in the later one was 45 mSv. Improvements as introduction of automatic dispensing system and injection and optimisation of working practice resulted in dose reduction ranging from 12 up to 67 %.
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Affiliation(s)
- V Antic
- Center for Nuclear Medicine, University Clinical Centre of Serbia, Belgrade, Serbia
| | - O Ciraj-Bjelac
- Radiation Protection Laboratory, Vinca Institute of Nuclear Science, University of Belgrade, PO Box 522, Belgrade 11001, Serbia
| | - J Stankovic
- Radiation Protection Laboratory, Vinca Institute of Nuclear Science, University of Belgrade, PO Box 522, Belgrade 11001, Serbia
| | - D Arandjic
- Radiation Protection Laboratory, Vinca Institute of Nuclear Science, University of Belgrade, PO Box 522, Belgrade 11001, Serbia
| | - N Todorovic
- Faculty of Science, Department of Physics, University of Novi Sad, Novi Sad, Serbia
| | - S Lucic
- Oncology Institute of Vojvodina, Sremska Kamenica, Novi Sad, Serbia
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15
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Arandjic D, Bonutti F, Biasizzo E, Ciraj-Bjelac O, Floreani M, Giustizieri M, Iaiza F, Inkoom S, Tommasini G, Padovani R. Radiation doses in cerebral perfusion computed tomography: patient and phantom study. Radiat Prot Dosimetry 2013; 154:459-464. [PMID: 23060430 DOI: 10.1093/rpd/ncs260] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to investigate radiation doses in cerebral perfusion computed tomography (CT) examination. As a part of routine patient monitoring, data were collected on patients in terms of the skin dose and CT dose index (CTDIvol) and dose-length product (DLP) values. For the estimation of the dose to the lens a phantom study was performed. Dose values for skin and lens were below the threshold for deterministic effects. The results were also compared with already published data. For better comparison, the effective dose was also estimated. The values collected on patients were in the ranges 230-680 mGy for CTDI and 2120-2740 mGy cm for DLP, while the skin dose and estimated effective dose were 340-800 mGy and 4.9-6.3 mSv, respectively. These values measured in the phantom study were similar, while the doses estimated to the lens were 53 and 51 mGy for the right and left lens, respectively.
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Affiliation(s)
- D Arandjic
- Vinca Institute of Nuclear Sciences, Radiation Protection Department, Belgrade, Serbia.
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16
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Antic V, Ciraj-Bjelac O, Rehani M, Aleksandric S, Arandjic D, Ostojic M. Eye lens dosimetry in interventional cardiology: results of staff dose measurements and link to patient dose levels. Radiat Prot Dosimetry 2012; 154:276-284. [PMID: 23152146 DOI: 10.1093/rpd/ncs236] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Workers involved in interventional cardiology procedures receive high eye lens dose if protection is not used. Currently, there is no suitable method for routine use for the measurement of eye dose. Since most angiography machines are equipped with suitable patient dosemeters, deriving factors linking staff eye doses to the patient doses can be helpful. In this study the patient kerma-area product, cumulative dose at an interventional reference point and eye dose in terms of Hp(3) of the cardiologists, nurses and radiographers for interventional cardiology procedures have been measured. Correlations between the patient dose and the staff eye dose were obtained. The mean eye dose was 121 µSv for the first operator, 33 µSv for the second operator/nurse and 12 µSv for radiographer. Normalised eye lens doses per unit kerma-area product were 0.94 µSv Gy⁻¹ cm⁻² for the first operator, 0.33 µSv Gy⁻¹ cm⁻² for the second operator/nurse and 0.16 µSv Gy⁻¹ cm⁻² for radiographers. Statistical analysis indicated that there is a weak but significant (p < 0.01) correlation between the eye dose and the kerma-area product for all three staff categories. These values are based on a local practice and may provide useful reference for other studies for validation and for wider utilisation in assessing the eye dose using patient dose values.
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Affiliation(s)
- V Antic
- Center for Nuclear Medicine, University Clinical Centre of Serbia, Belgrade, Serbia
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17
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Ciraj-Bjelac O, Rehani M, Minamoto A, Sim KH, Liew HB, Vano E. Radiation-induced eye lens changes and risk for cataract in interventional cardiology. Cardiology 2012; 123:168-71. [PMID: 23128776 DOI: 10.1159/000342458] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Accepted: 08/01/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent studies have reported a significant increase in eye lens opacities among staff in the cardiac catheterization laboratory but indicated further studies are needed to confirm the findings. OBJECTIVE To evaluate the prevalence of opacities in eyes of cardiologists, radiographers and nurses working in interventional cardiology. METHODS The eyes of 52 staff in interventional cardiology facilities and 34 age- and sex-matched unexposed controls were screened in a cardiology conference held in Kuala Lumpur by dilated slit-lamp examination, and posterior lens changes were graded. Individual cumulative lens X-ray exposures were calculated from responses to a questionnaire in terms of workload and working practice. RESULTS The prevalence of posterior lens opacities among interventional cardiologists was 53%, while in nurses and radiographers it was 45%. Corresponding relative risks were 2.6 (95% CI: 1.2-5.4) and 2.2 (95% CI: 0.98-4.9), for interventional cardiologists and support staff, respectively. CONCLUSIONS This study confirms a statistically significant increase in radiation-associated posterior lens changes in the eyes of interventional cardiology staff.
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Affiliation(s)
- O Ciraj-Bjelac
- Vinca Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
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18
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Rehani MM, Ciraj-Bjelac O, Vañó E, Miller DL, Walsh S, Giordano BD, Persliden J. ICRP Publication 117. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. Ann ICRP 2012; 40:1-102. [PMID: 22732420 DOI: 10.1016/j.icrp.2012.03.001] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An increasing number of medical specialists are using fluoroscopy outside imaging departments, but there has been general neglect of radiological protection coverage of fluoroscopy machines used outside imaging departments. Lack of radiological protection training of those working with fluoroscopy outside imaging departments can increase the radiation risk to workers and patients. Procedures such as endovascular aneurysm repair, renal angioplasty, iliac angioplasty, ureteric stent placement, therapeutic endoscopic retrograde cholangio-pancreatography,and bile duct stenting and drainage have the potential to impart skin doses exceeding Gy. Although tissue reactions among patients and workers from fluoroscopy procedures have, to date, only been reported in interventional radiology and cardiology,the level of fluoroscopy use outside imaging departments creates potential for such injuries.A brief account of the health effects of ionising radiation and protection principles is presented in Section 2. Section 3 deals with general aspects of the protection of workers and patients that are common to all, whereas specific aspects are covered in Section 4 for vascular surgery, urology, orthopaedic surgery, obstetrics and gynaecology,gastroenterology and hepatobiliary system, and anaesthetics and pain management.Although sentinel lymph node biopsy involves the use of radio-isotopic methods rather than fluoroscopy, performance of this procedure in operating theatres is covered in this report as it is unlikely that this topic will be addressed in another ICRP publication in coming years. Information on radiation dose levels to patients and workers, and dose management is presented for each speciality.
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19
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Krmar M, Baucal M, Bozic N, Jovancevic N, Ciraj-Bjelac O. Neutron dose equivalent measured at the maze door with various openings for the jaws and MLC. Med Phys 2012; 39:1278-81. [PMID: 22380359 DOI: 10.1118/1.3682313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE This study was undertaken to explore the effects of the jaws and the MLC openings on the neutron dose equivalent (DE) at the maze door and neutron flux at the patient plane. METHODS The neutron dose equivalent was measured at the maze entrance door of a 15 MV therapy linear accelerator room. All measurements were performed using various field sizes up to 40 cm × 40 cm. Activation detectors constructed from natural Indium (In) were exposed at Cd envelope to neutrons in order to estimate relative changes of epithermal neutron fluences in the patient plane. RESULTS Our study showed that the dose equivalent at the maze door is at the highest when the jaw are closed and that maximal jaws opening reduces the DE by more than 20%. The neutron dose equivalent at the maze door measured for radiation fields defined by jaws do not differ significantly from the DE measured when MLC determines the same size radiation field. The epithermal capture reaction rate measured using different jaw openings differs by approximately 10%. When an MLC leaf is inserted into a fixed geometry for one opening of the jaws, an increase of the epithermal neutron capture reaction rate in Indium activation detectors was observed. CONCLUSIONS There is no significant difference in the neutron DE when MLC defines radiation field instead of jaws. This leads to the conclusion that the overall number of neutrons remains similar and it does not depend on how primary photon beam was stopped-by the jaws or the MLC. An increase of the fast neutron capture reaction rate when MLC leaves are inserted probably originates from the neutron scattering.
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Affiliation(s)
- M Krmar
- Physics Department, University of Novi Sad, Novi Sad, Serbia.
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20
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Ciraj-Bjelac O, Beganović A, Faj D, Ivanovic S, Videnovic I, Rehani M. Status of radiation protection in interventional cardiology in four East European countries. Radiat Prot Dosimetry 2011; 147:62-67. [PMID: 21725081 DOI: 10.1093/rpd/ncr268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Level of staff and patient radiation protection in interventional cardiology in four counties (Bosnia and Herzegovina, Croatia, Montenegro and Serbia) as a part of International Atomic Energy Agency project (RER/9/093) are presented. Patient doses were assessed in terms of air kerma area product (KAP), peak skin dose (PSD) or air kerma at interventional reference point (K(IRP)). Results were available from nine hospitals: 775 patients for KAP, 157 for PSD and 437 for K(IRP). Eight centres reported KAP >100 Gy cm(2) and five centres reported values >200 Gy cm(2). From patients monitored in terms of PSD, 14 (9 %) had PSD >2 Gy and 6 (3 %) patients from those monitored in terms of K(IRP) had value >5 Gy, indicating risk of skin injury. The results indicate need for optimisation and dose monitoring in complex fluoroscopically guided cardiology interventions.
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Affiliation(s)
- O Ciraj-Bjelac
- Radiation and Environmental Protection Department, Vinca Institute of Nuclear Sciences, MP Alasa 12-14, Vinca, PO Box 522, 11001 Belgrade, Serbia.
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21
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Ciraj-Bjelac O, Arandjic D, Kosutic D. Comparison of different methods for shielding design in computed tomography. Radiat Prot Dosimetry 2011; 147:133-136. [PMID: 21743070 DOI: 10.1093/rpd/ncr287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The purpose of this work is to compare different methods for shielding calculation in computed tomography (CT). The BIR-IPEM (British Institute of Radiology and Institute of Physics in Engineering in Medicine) and NCRP (National Council on Radiation Protection) method were used for shielding thickness calculation. Scattered dose levels and calculated barrier thickness were also compared with those obtained by scatter dose measurements in the vicinity of a dedicated CT unit. Minimal requirement for protective barriers based on BIR-IPEM method ranged between 1.1 and 1.4 mm of lead demonstrating underestimation of up to 20 % and overestimation of up to 30 % when compared with thicknesses based on measured dose levels. For NCRP method, calculated thicknesses were 33 % higher (27-42 %). BIR-IPEM methodology-based results were comparable with values based on scattered dose measurements, while results obtained using NCRP methodology demonstrated an overestimation of the minimal required barrier thickness.
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Affiliation(s)
- O Ciraj-Bjelac
- Radiation and Environmental Department Protection, Vinca Institute of Nuclear Sciences, MP Alasa 12-14, Vinca, PO Box 522, 11001Belgrade, Serbia.
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22
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Krmar M, Baucal M, Jovancevic N, Ciraj-Bjelac O, Ganezer K. SU-E-T-297: Neutron Fluxes at the Patient Plane and Dosages Measured at the Maze Door with Various Openings for the Jaws and MLC. Med Phys 2011. [DOI: 10.1118/1.3612248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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23
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Muhogora WE, Ahmed NA, Alsuwaidi JS, Beganovic A, Ciraj-Bjelac O, Gershan V, Gershkevitsh E, Grupetta E, Kharita MH, Manatrakul N, Maroufi B, Milakovic M, Ohno K, Ben Omrane L, Ptacek J, Schandorf C, Shaaban MS, Toutaoui N, Sakkas D, Wambani JS, Rehani MM. Paediatric CT examinations in 19 developing countries: frequency and radiation dose. Radiat Prot Dosimetry 2010; 140:49-58. [PMID: 20154022 DOI: 10.1093/rpd/ncq015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aims of this study were to investigate the frequency of computed tomography (CT) examinations for paediatric patients below 15 y of age in 128 CT facilities in 28 developing countries of Africa, Asia and Eastern Europe and to assess the magnitude of CT doses. Radiation dose data were available from 101 CT facilities in 19 countries. The dose assessment was performed in terms of weighted CT dose index (CTDI(w)), volume CT index and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. The results show that on average the frequency of paediatric CT examinations was 20, 16 and 5 % of all CT examinations in participating centres in Africa, Asia and Eastern Europe, respectively. Eleven CT facilities in six countries were found to use adult CT exposure parameters for paediatric patients, thus indicating limited awareness and the need for optimisation. CT images were of adequate quality for diagnosis. The CTDI(w) variations ranged up to a factor of 55 (Africa), 16.3 (Asia) and 6.6 (Eastern Europe). The corresponding DLP variations ranged by a factor of 10, 20 and 8, respectively. Generally, the CTDI(w) and DLP values in Japan are lower than the corresponding values in the three regions in this study. The study has indicated a stronger need in many developing countries to justify CT examinations in children and their optimisation. Awareness, training and monitoring of radiation doses is needed as a way forwards.
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Affiliation(s)
- W E Muhogora
- Tanzania Atomic Energy Commission, PO Box 743, Arusha, Tanzania
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Kosutic D, Ciraj-Bjelac O, Arandjic D. Mammography practice in Serbia: evaluation and optimisation of image quality and the technical aspects of the mammographic imaging chain. Radiat Prot Dosimetry 2010; 139:293-297. [PMID: 20207752 DOI: 10.1093/rpd/ncq096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this work was to assess mammography practice in Serbia and its appropriateness for both diagnostic service and potential screening by implementing quality control (QC) protocol in three large teaching hospitals. Corrective actions were suggested, accordingly. In addition to technical aspects of QC, image quality was assessed using image grading before and after the introduction of corrective measures. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Average glandular doses ranged from 1.8 to 2.8 mGy, while reference optical density (OD) ranged from 1.0 to 2.6. Image grading resulted in a very high percentage of images with poor quality (12-70 % for cranio-caudal projection and 8-66 % for medio-lateral oblique projection). Main problems were associated with film processing, viewing conditions and OD control. Following introduction of corrective measures, the image grading results were improved in some hospitals, so the percentage of images without any remarks has been increased.
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Affiliation(s)
- D Kosutic
- Radiation Protection Laboratory, Radiation and Environmental Protection Department, Vinca Institute of Nuclear Sciences, MP Alasa 12-14, Vinca, Belgrade, Serbia
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25
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Muhogora WE, Ahmed NA, Beganovic A, Benider A, Ciraj-Bjelac O, Gershan V, Gershkevitsh E, Grupetta E, Kharita MH, Manatrakul N, Milakovic M, Ohno K, Ben Omrane L, Ptacek J, Schandorf C, Shabaan MS, Stoyanov D, Toutaoui N, Wambani JS, Rehani MM. Patient doses in CT examinations in 18 countries: initial results from International Atomic Energy Agency projects. Radiat Prot Dosimetry 2009; 136:118-126. [PMID: 19687134 DOI: 10.1093/rpd/ncp144] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of this prospective study at 73 facilities in 18 countries in Africa, Asia and Eastern Europe was to investigate if the CT doses to adult patients in developing countries are higher than international standards. The dose assessment was performed in terms of weighted computed tomography dose index (CTDIw) and dose length product (DLP) for chest, chest (high resolution), lumbar spine, abdomen and pelvis CT examinations using standard methods. Except in one case, the mean CTDIw values were below diagnostic reference level (DRL) while for DLP, 17 % of situations were above DRLs. The resulting CT images were of adequate quality for diagnosis. The CTDIw and DLP data presented herein are largely similar to those from two recent national surveys. The study has shown a stronger need to create awareness and training of radiology personnel as well as monitoring of radiation doses in many developing countries so as to conform to the ALARA principle.
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Affiliation(s)
- W E Muhogora
- Tanzania Atomic Energy Commission, PO Box 743, Arusha, Tanzania
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Bosnjak J, Ciraj-Bjelac O, Strbac B. Implementation of quality assurance in diagnostic radiology in Bosnia and Herzegovina (Republic of Srpska). Radiat Prot Dosimetry 2008; 129:249-252. [PMID: 18283063 DOI: 10.1093/rpd/ncn011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Application of a quality control (QC) programme is very important when optimisation of image quality and reduction of patient exposure is desired. QC surveys of diagnostics imaging equipment in Republic of Srpska (entity of Bosnia and Herzegovina) has been systematically performed since 2001. The presented results are mostly related to the QC test results of X-ray tubes and generators for diagnostic radiology units in 92 radiology departments. In addition, results include workplace monitoring and usage of personal protective devices for staff and patients. Presented results showed the improvements in the implementation of the QC programme within the period 2001--2005. Also, more attention is given to appropriate maintenance of imaging equipment, which was one of the main problems in the past. Implementation of a QC programme is a continuous and complex process. To achieve good performance of imaging equipment, additional tests are to be introduced, along with image quality assessment and patient dosimetry. Training is very important in order to achieve these goals.
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Affiliation(s)
- J Bosnjak
- Public Health Institute of Republic of Srpska, Jovana Ducica 1, Banja Luka, Bosnia and Herzegovina.
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