How to Measure/Calculate Radiation Dose in Patients?

Loose, R.; Wucherer, Michael

doi:10.1007/s00270-021-02772-x

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Nevertheless, for patients a limit on cumulative dose of radiological procedures is not recommended. However, the radiation dose of a single radiological procedure must be warranted within reasonable thresholds [20,21]. As shown in figure 3, the more vessels were treated in one session, the higher the calculated DRLs.…”

Section: Discussionmentioning

confidence: 99%

Radiation exposure in the intra-arterial nimodipine therapy of subarachnoid hemorrhage related cerebral vasospasm

Opitz¹,

Zensen²,

Bos³

et al. 2022

J. Radiol. Prot.

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The selective intra-arterial nimodipine application for the treatment of cerebral vasospasm (CVS) in patients after spontaneous subarachnoid hemorrhage (sSAH) is widely employed. The purpose of this study is to examine the radiation exposure and to determine local diagnostic reference levels (DRLs) of intra-arterial nimodipine therapy. In a retrospective study design, DRLs and achievable dose (AD) were assessed for all patients undergoing (I) selective intra-arterial nimodipine application or (II) additional mechanical angioplasty for CVS treatment. Interventional procedures were differentiated according to the type of procedure and the number of probed vessels. Altogether 494 neurointerventional procedures of 121 patients with CVS due to sSAH could be included. The radiation exposure indices were distributed as follows: (I) DRL 74.3 Gy·cm2, AD 59.8 Gy·cm2; (II) DRL 128.3 Gy·cm2, AD 94.5 Gy·cm2. Kruskal–Wallis test confirmed significant dose difference considering the number of probed vessels (p< 0.001). The mean cumulative dose per patient was 254.9 Gy·cm2 (interquartile range 88.6–315.6 Gy·cm2). The DRLs of intra-arterial nimodipine therapy are substantially lower compared with DRLs proposed for other therapeutic interventions, such as thrombectomy or aneurysm coiling. However, repeated therapy sessions are often required, bearing the potential risk of a cumulatively higher radiation exposure.

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Section: Discussionmentioning

confidence: 99%

Radiation exposure in the intra-arterial nimodipine therapy of subarachnoid hemorrhage related cerebral vasospasm

Opitz¹,

Zensen²,

Bos³

et al. 2022

J. Radiol. Prot.

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“…This approach has been encouraged for several years in Europe in accordance with the European Directive 2013/59/EURATOM (EU-BSS) [13]. The European Society of Interventional Radiology is also involved in this process [14][15][16][17][18][19]. Beyond the simple optimisation of acquisition parameters, this study underlines the major role of medical physics experts in interventional radiology, their relationship with interventional radiologists, and the importance of educating radiology technologists.…”

Section: Discussionmentioning

confidence: 99%

“…The image quality of the guided acquisitions was considered insufficient for 23% of the patients by the operator. The radiology technologists had to increase the settings by 16 mA [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] during this phase to obtain the expected resolution (figure 4). For the control phase, the required parameters were used for only 48% of the procedures.…”

Section: Dosimetry Datamentioning

confidence: 99%

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

Golin¹,

Izaaryene²,

Dassa³

et al. 2022

J. Radiol. Prot.

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Purpose To evaluate safetey and efficacy of an ultra low dose (ULD) protocol implementation during lung radiofrequency ablations. Methods All patients who underwent a lung RFA were consecutively and retrospectively included between November 2017 and January 2021. 30 patiens were treated with a historical standard protocol (SP), 31 with an ULD protocol. Patient characteristics, dose indicators, technical efficacy (minimal margin MM, recurrence during the follow up) and complications (pneumothorax, alveolar hemorrhage, hemoptysis) were recorded. Results 61 patients were included (median age, 65 [54. 73], 33 women). There was no significant difference in the characteristics of the patients according to the type of protocol, except for the type of anesthesia. Even if the number of helical acquisitions had not significantly changed, all the dose indicators significantly decreased by 1.5-fold to 3-fold. The median dose-length-product and effective dose were respectively 465mGy.cm [315; 554] and 6.5mSv [4.4; 7.8] in the SP group versus 178 mGy.cm [154; 267] and 2.5mSv [2.2; 3.7] in the ULD group, (p<.001). The ULD group presented a lower intra-operator variability and a better inter-operator alignment. The MM were not significantly different in the 2 groups (4.6mm versus 5mm, p=.16). One local recurrence was observed in each group, at 8 months for the SP and at one year for the ULD group (p=1). No significant difference was found in the complications rates. Conclusion Implmenting an ultra-low dose protocol during lung RFA may allow with the same efficacy, a reduction of dose indicators, intra- and inter-operator alignments, without increasing complications rates.

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“…The following data of patients undergoing TAVI procedures were recorded: demographics including age, sex, and BMI; dosimetry measurement (number of exposure images); air kerma-area product value (P KA , in Gy/cm 2 ); cumulative air kerma at the patient entrance reference point (K a,r , in Gy); and total fluoroscopy time (in min) obtained from the examination dose report in the structured radiation report, which is saved in the equipment upon process completion. 14 Aortic stenosis is the most prevalent form of valvular heart disease worldwide and its prevalence continues to increase. 1 As a treatment approach for aortic stenosis, transcatheter aortic valve implantation (TAVI) plays an important role in patients at high risk for surgical aortic valve replacement.…”

Section: Data Collectionmentioning

confidence: 99%

Translation and Codons

Mushtaq¹

2023

JAMS

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Background: The trend in the use of fluoroscopic-guided transcatheter aortic valve implantation (TAVI) is increasing because the procedure is less invasive than surgical procedure. However, high radiation doses have been reported with the procedure. Moreover, the amount of radiation received by patients undergoing TAVI has never before been registered in Thailand. Objectives: This study aimed to investigate the radiation dose and the effects of sex and body mass index (BMI) on the radiation dose received by patients undergoing TAVI at Chulabhorn Hospital. Materials and methods: Data were collected on the radiation dose received by patients undergoing the TAVI procedure during the first 26 months after the operation at the Cardiology Center, Chulabhorn Hospital. We recorded patient demographic data including age, sex, and BMI and the following measures of radiation dose from the procedure: the number of exposure images, air kerma-area product (PKA), cumulative air kerma at the patient entrance reference point (Ka,r), and total fluoroscopy time. Results: In total, 68 patients (35 male and 33 female) underwent TAVI, with median exposure images, PKA, Ka,r, and total fluoroscopy time of 1,067 images, 166.14 Gy/cm2, 1,171.50 mGy, and 31.90 minutes, respectively. The patient’s sex did not affect total fluoroscopy time or the radiation dose received. Patients with BMI ≥30.0 kg/m2 had the highest median values of PKA, Ka,r, and total fluoroscopy time. Moreover, patients with BMI ≥18.5-24.9 kg/m2 received higher doses of radiation than patients with BMI ≥25.0-29.9 kg/m2; the result corresponded with longer total fluoroscopy time in the lower BMI category. Conclusion: The amount of radiation that patients received during TAVI was appropriate for diagnosis and treatment. However, to ensure patient safety, operators should consider reducing the duration of radiation during the procedure. Data from this study are a starting point for the recording of radiation doses received by patients undergoing TAVI and can be used as a future dose reference.

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How to Measure/Calculate Radiation Dose in Patients?

Cited by 5 publications

References 16 publications

Radiation exposure in the intra-arterial nimodipine therapy of subarachnoid hemorrhage related cerebral vasospasm

Radiation exposure in the intra-arterial nimodipine therapy of subarachnoid hemorrhage related cerebral vasospasm

An ultra-low-dose protocol for computed tomography-guided lung radiofrequency ablations

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