Effective-dose estimation in interventional radiological procedures
Tóm tắt
Interventional radiology is based on minimally invasive procedures that allow diagnosis and percutaneous treatment of diseases in almost all organ systems. Such procedures have many benefits, but they also contribute significantly to collective radiation dose. In this regard, effective dose (E) is a convenient quantity to estimate patients’ stochastic radiation risk. However, E cannot be accurately evaluated immediately. In the present study, we aimed to estimate the E value in 15 selected interventional procedures. The estimation was based on dose area product (DAP) measurements and used case-specific conversion coefficients. The E values ranged from 3.3 to 69.9 mSv, depending on the kind of procedure. This wide range was mainly due to the broad variation in DAP values, which in turn depend on the details of how the procedures are performed. This suggests that to ensure valid comparative studies and universal reference levels, all interventional procedures should be well classified.
Tài liệu tham khảo
McParland BJ. A study of patient radiation doses in interventional radiological procedures. Br J Radiol. 1998;71:175–85.
Miller DL, Balter S, Wagner LK, Cardella J, Clark TWI, Neithamer CD, Schwartzberg MS, Swan TL, Towbin RB, Rholl KS, Sacks D. Quality improvement guidelines for recording patient radiation dose in the medical record. J VascIntervRadiol. 2004;15:423–9.
Balter S, Hopewell JW, Miller DL, Wagner LK, Zelefsky MJ. Fluoroscopically guided interventional procedures: a review of radiation effects on patients’ skin and hair. Radiology. 2010;254(2):326–41.
Falco MD, Masala S, Stefanini M, Fiori R, Gandini R, Bagalà P, Morosetti D, Calabria E, Tonnetti A, Verona-Rinati G, Santoni R, Simonetti G. Patient skin dose measurements using a cable free system MOSFETs based in fluoroscopically guided percutaneous vertebroplasty, percutaneous disc decompression, radiofrequency medial branch neurolysis, and endovascular critical limb ischemia. J. Appl. Clin. Med Phys. 2015;16(1):298–310.
Söderman M, Mauti M, Boon S, Omar A, Marteinsdóttir M, Andersson T, Holmin S, Hoornaert B. Radiation dose in neuroangiography using image noise reduction technology: a population study based on 614 patients. Neuroradiology. 2013;55:1365–72.
Euratom BSS. Council Directive 2013/59 EURATOM of 5 December 2013 Laying Down the Basic Safety Standards for the Protection of the Health of Workers and the General Public against the Dangers Arising from Ionizing Radiation, and Repealing Directives 89/618/Euratom. 2013.
International Commission on Radiological Protection. Recommendations of the International Commission on Radiological Protection. ICRP Publication 103. Ann. ICRP. 2007;37:1–332.
Schultz FW, Zoetelief J. Dose conversion coefficients for interventional procedures. RadiatProtDosim. 2005;117:225–30.
Bor D, Sancak T, Olgar T, Elcim Y, Adanali A, Sanlidilek U, Akyar S. Comparison of effective doses obtained from dose-area product and air kerma measurements in interventional radiology. Br J Radiol. 2004;77:315–22.
Compagnone G, Giampalma E, Domenichelli S, Renzulli M, Golfieri R. Calculation of conversion factors for effective dose for various interventional radiology procedures. Med Phys. 2012;39(5):2491–8.
Fitousi NT, Efstathopoulos EP, Delis HB, Kottou S, Kelekis AD, Panayiotakis GS. Patient and staff dosimetry in vertebroplasty. Spine. 2006;31(23):E884–9.
Von Wrangel A, Cederblad A, Rodriguez-Catarino M. Fluoroscopically guided percutaneous vertebroplasty: assessment of radiation doses and implementation of procedural routines to reduce operator exposure. Acta Radiol. 2009;50:490–6.
Molyvda-Athanasopoulou E, Karlatira M, Gotzamani-Psarrakou A, Koulouris C, Siountas A. Radiation exposure to patients and radiologists during interventional procedures. RadiatProtDosim. 2011;147(1–2):86–9.
Tappero C, Barbero S, Costantino S, Bergui M, Ropolo R, Bradac G, Gandini G. Patient and operator exposure during percutaneous vertebroplasty. Radiol Med. 2009;114:595–607.
Smans K, Struelens L, Hoornaert MT, Bleeser F, Buls N, Bosmans H. A study of the correlation between dose area product and effective dose in vascular radiology. RadiatProtDosim. 2008;130:300–8.
Hart D, Jones DG, Wall BF. Estimation of effective dose in diagnostic radiology from entrance surface dose and dose-area product measurements. National Radiological Protection Board, Chilton. Technical Report NRPB-R262. (1994).
Balter S, Miller DL, Vano E, Ortiz Lopez P, Bernardi G, Cotelo E, Faulkner K, Nowotny R, Padovani R, Ramirez AA. pilot study exploring the possibility of establishing guidance levels inx-ray directed interventional procedures. Med Phys. 2008;35:673–80.
Faulkner K, Busch HP, Cooney P, Malone JF, Marshall NW, Rawlings DJ. An international intercomparison of dose-area product meters. RadiatProtDosim. 1002;43:131–4.
International Commission on Radiation Units and Measurements. Patient dosimetry for X rays used in medical imaging. ICRU Report 74. J. ICRU. 2005;5(2):1–113.
International Electrotechnical Commission. Area exposure product meter. IEC Report 580, Geneva (1977).
Wall BF. Quality control of dose-area product meters. Technical and Physical Parameters for Quality Assurance in Medical Radiology, BIR Report 18, 140-142. Moores BM, Stieve FE, Eriskat H, Schibilla H (BIR, London, 1989).
International Atomic Energy Agency. Dosimetry in diagnostic radiology: An international code of practice. Technical Reports Series 457. IAEA, Vienna (2007).
Vano E, Sanchez R, Fernandez JM, Gallego JJ, Verdu JF, Gonzalez de Garay M, Azpiazu A, Segarra A, Hernandez MT, Canis M, et al. Patient dose reference levels for interventional radiology: a national approach. CardiovascInterventRadiol. 2009;32:19–24.
Miller DL, Kwon D, Bonavia GH. reference levels for patient radiation dose in interventional radiology: proposed initial values for U.S. practice. Radiology. 2009;253(3):753–64.
Topaltzikis T, Rountas C, Moisidou R, Fezoulidis I, Kappas C, Theodorou K. Radiation dose to patients and staff during angiography of the lower limbs. Derivation of local dose reference levels. Phys. Medica. 2009;25:25–30.
Miller DL, Balter S, Cole PE, Lu HT, Schueler BA, Geisinger M, Berenstein A, Albert R, Georgia JD, Noonan PT, et al. Radiation doses in interventional radiology procedures: the RAD-IR study part i: overall measures of dose. J VascIntervRadiol. 2003;14:711–27.
Padovani R, Quai E. Patient Dosimetry approaches in interventional Cardiology and literature dose data review. RadiatProtDosim. 2005;117(1–3):217–21.
Perisinakis K, Damilakis J, Theocharopoulos N, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N. Patient exposure and associated radiation risks from fluoroscopically guided vertebroplasty or kyphoplasty. Radiology. 2004;232(3):701–7.
Sapiin B, Ng KH, Abdullah BJJ. Radiation Dose to Patients Undergoing Interventional Radiological Procedures in Selected Hospitals in Malaysia: Retrospective Study. J.H.K. CollRadiol. 2004; 7:129–136.
Struelens L, Vanhavere F, Bosmans H, Van Loon R. Effective doses in angiography and interventional radiology: calculation of conversion coefficients for angiography of the lower limbs. Br J Radiol. 2005;78:135–42.
Hidajat N, Wust P, Felix R, Schroder RJ. Radiation exposure to patient and staff in epatic chemoembolization: risk estimation of cancer and deterministic effects. CardiovascInterventRadiol. 2006;29:791–6.
Hart, D. and Wall, B. F. Radiation Exposure of the UK Population from Medical and Dental X-ray Examinations. National Radiological Protection Board, Chilton. NRPB –W4. (2002).
Ector J, Dragusin O, Adriaenssens B, Huybrechts W, Willems R, Ector H, et al. Obesity is a major determinant of radiation dose in patients undergoing pulmonary vein isolation for atrial fibrillation. J Am Coll Card. 2007;50(3):234–42.