940 Disease Site and Processing Engine Affect Radiation Exposure Dose During Ercp

Hayashi, Shiro; Higaki, Yu; Tomita, Ryo; Shimakoshi, Hiromi; Shimoda, Akiyoshi; Osugi, Naoto; Sugimoto, Aya; Takahashi, Kei; Mukai, Kaori; Nakamatsu, Dai; Matsubara, Tokuhiro; Yamamoto, Masashi; Nakajima, Sachiko; Nishida, Tsutomu; Fukui, Koji; Inada, Masami

doi:10.1016/j.gie.2018.04.1348

Cited by 2 publications

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“…Clinical factors related to ERCP and interventional EUS have been retrospectively collected at two sites (Toyonaka Municipal Hospital and Kindai University) 20 22–24. We used those published data to develop plans for the design or implementation of this study and to determine the research question or the outcome measures.…”

Section: Methods and Analysismentioning

confidence: 99%

Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study)

et al. 2020

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IntroductionRecently, the use of various endoscopic procedures under X-ray fluoroscopic guidance, such as endoscopic retrograde cholangiopancreatography (ERCP), interventional endoscopic ultrasonography (EUS), enteral endoscopy and stenting, has been rapidly increasing because of the minimally invasive nature of these procedures compared with that of surgical intervention. With the spread of CT and fluoroscopic interventions, including endoscopic procedures under X-ray guidance, high levels of radiation exposure (RE) from medical imaging have led to major concerns throughout society. However, information about RE related to these image-guided procedures in gastrointestinal endoscopy is scarce, and the RE reference levels have not been established. The aim of this study is to prospectively collect the actual RE dose and to help establish diagnostic reference levels (DRLs) in the field of gastroenterology in Japan.Methods and analysisThis is a multicentre, prospective observational study that is being conducted to collect the actual RE from treatments and diagnostic procedures, including ERCP, interventional EUS, balloon-assisted enteroscopy, enteral metallic stent placement and enteral tube placement. We will measure the total fluoroscopy time (min), the total dose–area product (Gycm2) and air-kerma (mGy) of those procedures. Because we are collecting the actual RE data and identifying the influential factors through a prospective, nationwide design, this study will provide guidance regarding the DRLs of ERCP, interventional EUS, balloon-assisted enteroscopy, enteral metallic stent placement and enteral tube placement.Ethics and disseminationApproval was obtained from the Institutional Review Board of Toyonaka Municipal Hospital (25 April 2019). The need for informed consent will be waived via the opt-out method of each hospital website.Trial registration numberThe UMIN Clinical Trials Registry, UMIN000036525.

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Section: Methods and Analysismentioning

confidence: 99%

Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study)

et al. 2020

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“…Procedural variations, including variations in procedure time, fluoroscopy time and radiation dose, can result in a wide range of values[36], and a single DRL has not yet been established for ERCP because each DRL is designated for an individual CT location, such as the head, spine, chest or abdomen. Therefore, a sufficient amount of data and an applicable, simple classification scheme are necessary to set the DRL for ERCP.…”

Section: Understanding the Drl And Managing Radiation Exposure Duringmentioning

confidence: 99%

“…We also previously reported a simple classification based on disease site (common bile duct stones, proximal malignant biliary obstruction, distal malignant biliary obstruction and other). Consequently, different classifications result in clearly divided outcomes and may be helpful for accurately determining DRLs[36].…”

Section: Image-guided Procedures: How Should Their Complexity Be Apprmentioning

confidence: 99%

“…Recently, some image-enhancing technologies, centre volume and local DRL guidelines have also been shown to influence the total radiation dose delivered to patients[36,55-58]. The simplest and most effective ways to reduce the total radiation dose are: (1) using a low frame rate; (2) using low magnification and (3) employing a short fluoroscopy time.…”

Section: Factors Influencing the Radiation Dosementioning

confidence: 99%

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Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography

Hayashi¹,

Takenaka²,

Hosono³

et al. 2018

WJCC

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Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently used image-guided procedures in gastrointestinal endoscopy. Post-ERCP pancreatitis is an important concern, and prophylaxis, cannulation and other related technical procedures have been well documented by endoscopists. In addition, medical radiation exposure is of great concern in the general population because of its rapidly increasing frequency and its potential carcinogenic effects. International organizations and radiological societies have established diagnostic reference levels, which guide proper radiation use and serve as global standards for all procedures that use ionizing radiation. However, data on gastrointestinal fluoroscopic procedures are still lacking because the demand for these procedures has recently increased. In this review, we present the current status of quality indicators for ERCP and the methods for measuring radiation exposure in the clinical setting as the next quality indicator for ERCP. To reduce radiation exposure, knowledge of its adverse effects and the procedures for proper measurement and protection are essential. Additionally, further studies on the factors that affect radiation exposure, exposure management and diagnostic reference levels are necessary. Then, we can discuss how to manage medical radiation use in these complex fluoroscopic procedures. This knowledge will help us to protect not only patients but also endoscopists and medical staff in the fluoroscopy unit.

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940 Disease Site and Processing Engine Affect Radiation Exposure Dose During Ercp

Cited by 2 publications

References 0 publications

Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study)

Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study)

Radiation exposure during image-guided endoscopic procedures: The next quality indicator for endoscopic retrograde cholangiopancreatography

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