ERCP procedures as a source of radiation risk to a single gastroenterologist

Staniszewska, Maria Anna; Kujawski, Krzysztof; Kopeć, Renata; Sasak, Krzysztof

doi:10.13075/mp.5893.00519

Cited by 5 publications

(6 citation statements)

References 7 publications

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“…A recent meta‐analysis found that the dose to the lens of the eye was even higher, 18 µSv/procedure for fixed effect analysis and 139 µSv/procedure for random effect analysis. 12 Based on our results and those found in the literature, 11 , 12 , 13 , 14 , 15 approaching or exceeding the annual dose constraint for the lens of the eye may be possible. Thus, the authors recommend that staff within 1m of the patient utilize radioprotective eyewear.…”

Section: Discussionsupporting

confidence: 73%

Radiation exposure to staff during fluoroscopic endoscopic procedures

2023

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Objectives Fluoroscopically guided procedures utilize ionizing radiation to assist in the diagnosis and treatment of the patient. The use of ionizing radiation is not without risk to the operator and other staff members present during endoscopic procedures. This study simulates radiation exposure during endoscopic retrograde cholangiopancreatography procedures under different shielded conditions and provides practical radiation safety recommendations, through easy‐to‐use visual guides. Methods We obtained radiation exposure measurements at varying locations with different shielding setups surrounding a mobile C‐arm fluoroscopic unit while imaging a patient equivalent phantom at different heights. Heat maps were generated for the various conditions to provide visual guides for radiation protection. Results Different heat maps detailing various shielding methods have been generated to assist in determining the dose rate at varying locations surrounding the patient. The use of appropriate radiation protection could decrease the staff dose by up to 98%. Conclusion Although minor per procedure, the magnitude of radiation exposure will accumulate over the staff's working life. As such, it is recommended that precautions be taken during fluoroscopically guided endoscopy procedures to ensure radiation is kept as low as reasonably achievable.

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Section: Discussionsupporting

confidence: 73%

Radiation exposure to staff during fluoroscopic endoscopic procedures

2023

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“…It is well known that frame rate directly correlates with RD and that half pulsed imaging reduces the RD [ 24 ] [ 25 ]. NS1 utilizes half pulsed imaging, and this effect of RD reduction seems to be natural, as described in other reports [ 26 ] [ 27 ]. However, the important point is that NS1 contains some novel technologies that maintain image quality even in a half-frame rate [ 28 ] (S1 video).…”

Section: Discussionmentioning

confidence: 81%

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

et al. 2018

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IntroductionVarious endoscopic procedures under fluoroscopic guidance are being rapidly adopted, and radiation exposure is considered to be increasing. However, there is little concern about this issue in gastroenterology practice. This study aims to evaluate the actual radiation exposure dose (RD) during endoscopic retrograde cholangiopancreatography (ERCP) and the factors affecting the RD.MethodsIn this retrospective, single-center cohort study of 1157 consecutive patients who underwent ERCP between October 2012 and February 2017, we analyzed the influences of patient characteristics, procedure time (min), total fluoroscopy time (min), type of processing engine, experience of the endoscopist, and type of disease on the total RD (mGy).ResultsThe median procedure times were 28 min for common bile duct stones (CBDS), 25 min for distal malignant biliary obstruction (MBO), and 30 min for proximal MBO. Similarly, the median fluoroscopy times were 10.3, 8.8, and 13.4 min, and the median RDs were 167, 123, and 242 mGy, respectively. Proximal MBO required significantly longer procedure time and fluoroscopy time and resulted in greater RD than distal MBO (P = 0.0006, <0.0001, <0.0001) and CBDS (P = 0.015, <0.0001, <0.0001). Multiple linear regression showed that distal MBO and a novel processing engine negatively correlate with RD (P = 0.04, <0.0001) and that proximal MBO positively correlates with RD (P = 0.0001).DiscussionProcedure time and fluoroscopy time were significantly longer for proximal MBO than for CBDS and distal MBO. The type of disease and processing engine significantly influenced the RD during ERCP.

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“…The estimated risk associated with exposure to ionizing radiation is based on evaluation of the effective dose (E), starting from the equivalent dose (H) received during X-ray-guided procedures. Concerning endoscopic procedures, risks have been widely studied, with special focus on the potential risk of radiation-induced cancer 1 2 3 4 5 6 7 8 9 .…”

Section: Introductionmentioning

confidence: 99%

Endoscopist’s occupational dose evaluation related to correct wearing of dosimeter during X-ray-guided procedures

et al. 2019

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Background Since endoscopists performing procedures in the endoscopy suite can change their position by turning their back, side or front toward the X-ray source, this study aimed to establish whether dosimeter position affects the correct evaluation of an endoscopist’s personal radiation exposure during X-ray-guided procedures. Materials and methods Between January and February 2018, two dosimeters specularly placed outside the lead apron (anterior one on the chest and posterior one on the back) measured endoscopists’ personal dose equivalent (Hp) during 62 X-ray-guided procedures on adult and pediatric patients. Procedures were divided into three groups considering the position taken by the endoscopist with respect to the radiation source. For each group, the difference between mean Hp from the anterior and posterior dosimeters was calculated. Results A statistically significant difference in mean Hp was recorded for the endoscopists’ frontal and back positions (P = 0.014, and P < 0.00001, respectively). No significant difference was found in mean Hp for the side position (P = 0.489). Conclusions The position of personal dosimeters affects the correct evaluation of endoscopists’ radiation exposure during X-ray-guided procedures when frontal and back positions were recorded. To correctly evaluate radiation doses, the whole-body dosimeter should be worn according to the position of the endoscopist with respect to the radiation source; otherwise, it results in an incorrect personal dose evaluation, which may lead to substantial underestimation of staff exposure.

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ERCP procedures as a source of radiation risk to a single gastroenterologist

Cited by 5 publications

References 7 publications

Radiation exposure to staff during fluoroscopic endoscopic procedures

Radiation exposure to staff during fluoroscopic endoscopic procedures

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

Endoscopist’s occupational dose evaluation related to correct wearing of dosimeter during X-ray-guided procedures

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