Radiation Doses in Patient Eye Lenses during Interventional Neuroradiology Procedures

Sánchez, R. Madrigal; Vañó, Eliseo; Fernández, J.; Rosati, Santiago; López-Ibor, L.

doi:10.3174/ajnr.a4549

Cited by 25 publications

(12 citation statements)

References 14 publications

(16 reference statements)

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“…However, in the case of CT, most recent studies suggest that dose reduction strategies are more effective than eye shielding (e.g., [ 31 ]). Due to the level of eye dose for some fluoroscopically guided cerebral interventional procedures [ 32 , 33 ], the consultation of a Medical Physics Expert is advised on a case-by-case basis.…”

Section: Recommendationsmentioning

confidence: 99%

European consensus on patient contact shielding

et al. 2021

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Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff.

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Section: Recommendationsmentioning

confidence: 99%

European consensus on patient contact shielding

et al. 2021

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“…Tissues at risk are the skin, hair and during neurointerventions the lenses of the eyes [17,20,21]. Stochastic effects are related to effective dose, for example, to the ovaries during pelvic embolization or the thyroid during interventions in the head and neck region.…”

Section: Potentially High Dose Proceduresmentioning

confidence: 99%

“…The critical organ is the lens of the left eye of the patient. In these interventions, dosimeters positioned close to the left eye may be used to estimate the eye lens dose [20]. P KA of the lateral plane can be used for risk assessment.…”

Section: Eye Lens Dosementioning

confidence: 99%

“…P KA of the lateral plane can be used for risk assessment. According to Sanchez et al, the trigger level suggesting follow-up for potential lens injuries in the left eye is P KA > 300 Gy cm 2 (lateral plane) in neurointerventions [ 20 ]. In this study, there was a likelihood of 47% that the lens dose of the left eye was at or above the threshold dose of 500 mGy.…”

Section: Trigger Levels Substantial Radiation Doses Alert Levels Smentioning

confidence: 99%

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Unintended and Accidental Exposures, Significant Dose Events and Trigger Levels in Interventional Radiology

Jaschke

Bartal²,

Martin

et al. 2020

Cardiovasc Intervent Radiol

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Over recent years, an increasing number of fluoroscopically guided interventions (FGIs) have been performed by radiologists and non-radiologists. Also, the number of complex interventional procedures has increased. In the late nineties, first reports of skin injuries appeared in the literature. The medical community responded through increased awareness for radiation protection and public authorities by recommendations and legislation, for example, the European Basic Safety Standards (EU-BSS) which were published in 2014, or the international Basic Safety Standards (BSS). Implementation of the EU-BSS requires concerted action from interventionalists, radiographers, medical physics experts and competent national authorities. Interventionalists should play an important role in this project since implementation of the EU-BSS will affect their daily practice. This paper discusses some important issues of the EU-BSS such as unintended and accidental radiation exposures of patients, the meaning of significant dose events and how to deal with patients who were exposed to a substantial radiation dose with the risk of tissue injuries. In addition, this paper provides practical advice on how to implement alert and trigger levels in daily practice of FGIs in order to increase patient safety.

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“…In diagnostic and interventional radiology, the two terms (notifications and alerts) and sometimes other terms such as "threshold value" or "significant dose events" are used to inform about a high (or potentially high) skin dose for the patient or for unintended exposures. Sometimes, other patient organs with a risk of radiation injury, such as the lenses of the eyes and the cerebrovascular or cardiovascular systems, may be also considered [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

et al. 2022

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The terms “notifications” and “alerts” for medical exposures are used by several national and international organisations. Recommendations for CT scanners have been published by the American Association of Physicists in Medicine. Some interventional radiology societies as well as national authorities have also published dose notifications for fluoroscopy-guided interventional procedures. Notifications and alerts may also be useful for optimisation and to avoid unintended and accidental exposures. The main interest in using these values for high-dose procedures (CT and interventional) is to optimise imaging procedures, reducing the probability of stochastic effects and avoiding tissue reactions. Alerts in X-ray systems may be considered before procedures (as in CT), during procedures (in some interventional radiology systems), and after procedures, when the patient radiation dose results are known and processed. This review summarises the different uses of notifications and alerts to help in optimisation for CT and for fluoroscopy-guided interventional procedures as well as in the analysis of unintended and accidental medical exposures. The paper also includes cautions in setting the alert values and discusses the benefits of using patient dose management systems for the alerts, their registry and follow-up, and the differences between notifications, alerts, and trigger levels for individual procedures and the terms used for the collective approach, such as diagnostic reference levels. Key Points • Notifications and alerts on patient dose values for computed tomography (CT) and fluoroscopy-guided interventional procedures (FGIP) allow to improve radiation safety and contribute to the avoidance of radiation injuries and unintended and accidental exposures. • Alerts may be established before the imaging procedures (as in CT) or during and after the procedures as for FGIP. • Dose management systems should include notifications and alerts and their registry for the hospital quality programmes.

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Radiation Doses in Patient Eye Lenses during Interventional Neuroradiology Procedures

Cited by 25 publications

References 14 publications

European consensus on patient contact shielding

European consensus on patient contact shielding

Unintended and Accidental Exposures, Significant Dose Events and Trigger Levels in Interventional Radiology

Notifications and alerts in patient dose values for computed tomography and fluoroscopy-guided interventional procedures

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