Patient and staff doses for some complex x-ray examinations

Abstract

The aim of this study was to measure patient and staff doses simultaneously for some complex x-ray examinations. Measurements of dose-area product (DAP) and entrance skin dose (ESD) were carried out in a sample of 107 adult patients who underwent different x-ray examinations such as double contrast barium enema (DCBE), single contrast barium enema (SCBE), barium swallow, endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC), and various orthopaedic surgical procedures. Dose measurements were made separately for each projection, and DAP, thermoluminescent dosimetry (TLD), film dosimetry and tube output measurement techniques were used. Staff doses were measured simultaneously with patient doses for these examinations, with the exception of barium procedures. The measured mean DAP values were found to be 8.33, 90.24, 79.96 Gy cm(2) for barium swallow, SCBE and DCBE procedures with the fluoroscopy times of 3.1, 4.43 and 5.86 min, respectively. The calculated mean DAP was 26.33 Gy cm(2) for diagnostic and 89.76 Gy cm(2) therapeutic ERCP examinations with the average fluoroscopy times of 1.9 and 5.06 min respectively. Similarly, the calculated mean DAP was 97.53 Gy cm(2) with a corresponding fluoroscopy time of 6.1 min for PTC studies. The calculated mean entrance skin dose (ESD) was 172 mGy for the orthopaedic surgical studies. Maximum skin doses were measured as 324, 891, 1218, 750, 819 and 1397 mGy for barium swallow, SCBE, DCBE, ERCP, PTC and orthopaedic surgical procedures, respectively. The high number of radiographs taken during barium enema examinations, and the high x-ray outputs of the fluoroscopic units used in ERCP, were the main reasons for high doses, and some corrective actions were immediately taken.

Radio induced cancer risk during ERCP: Is it a real clinical problem?

“…In our multiple linear regression model we found that the conduct of therapy, especially the placement of biliary stent, implied a higher DAP. This has already been reported in many previous studies (2)(3)(4)8) showing that therapeutic ERCP could be six times higher. In fact, in most studies regarding radiation dose, authors differentiate between diagnosis and therapeutic ERCP, treating them as two different techniques.…”

“…In this sense, the most described is therapeutic indication that could increase the dose area product (DAP) three to four times (2,3). Therapeutic options are becoming more com-…”

Patient and Staff Radiation Exposure during Endoscopic Retrograde Cholangio-Pancreatography: Eight Years of Dose Monitoring

“…Few studies that evaluate radiation exposure to staff during ERCP are found in the recent literature [11,[19][20][21][22][23]. These studies confirm that the radiation exposure to personnel undertaking ERCP is not negligible and radiation protection measures should be taken.…”

The Impact of Endoscopic Retrograde Cholangiopancreatography Education on Radiation Exposure to Experienced Endoscopist: “Trainee Effect”

“…Such studies have either been on various interventional radiology procedures including ERCP [9,11,16,21], relatively old studies focusing on protective measures [13,32], or phantom studies [18,22]. Such studies were undertaken at different periods and with different fluoroscopy devices (fixed X-ray source situated either under or above the patient bed vs. C-arm devices).…”

“…Over the past 20 years, only a handful of studies have tackled the issue of radiation exposure in staff performing ERCP [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] in which ERCP was either evaluated as a part of several interventional radiological procedures or as a simulation study [9,11,16,18,21,22]. However, the year of publication, fluoroscopy equipment used, protective methods used against radiation exposure, and the body parts that were tested for exposure showed significant variations between studies.…”