Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting

Matsui, Yusuke; Hiraki, Takao; Gobara, Hideo; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Kawabata, Takahiro; Yamauchi, Takatsugu; Yamaguchi, Takuya; Kanazawa, Susumu

doi:10.1007/s00270-016-1308-3

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…By manipulating the needle in real-time, subpleural and small lesions are easily approached using this technique. Although CTF may be associated with increased radiation exposure to the operator, if standard radiological prevention measures are used, CTF radiation exposure to the operator does not significantly differ from CCT [57,58].…”

Section: Ct Protocolmentioning

confidence: 97%

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

et al. 2021

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Image-guided percutaneous lung ablation has proven to be a valid treatment alternative in patients with early-stage non-small cell lung carcinoma or oligometastatic lung disease. Available ablative modalities include radiofrequency ablation, microwave ablation, and cryoablation. Currently, there are no sufficiently representative studies to determine significant differences between the results of these techniques. However, a common feature among them is their excellent tolerance with very few complications. For optimal treatment, radiologists must carefully select the patients to be treated, perform a refined ablative technique, and have a detailed knowledge of the radiological features following lung ablation. Although no randomized studies comparing image-guided percutaneous lung ablation with surgery or stereotactic radiation therapy are available, the current literature demonstrates equivalent survival rates. This review will discuss image-guided percutaneous lung ablation features, including available modalities, approved indications, possible complications, published results, and future applications.

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Section: Ct Protocolmentioning

confidence: 97%

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

et al. 2021

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“…A radiofrequency wave causes ionic stirring and an increase in temperature in the tumor, resulting in immediate cell death by coagulation and necrosis, and delayed cell death by apoptosis [2]. The doses received by operators are within the recommended standards and do not represent a limit to the practice of RFA [3], according to recently published guidelines [4]. The first pulmonary RFA procedure was described in 2000 [5], and multiple studies have shown low rates of complications [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

Habert

Bisceglie

Bartoli

et al. 2021

International Journal of Hyperthermia

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Purpose: Radiofrequency ablation (RFA) is a safe and effective minimally invasive treatment for pulmonary tumors. Patterns on chest computed tomography (CT) after RFA are classified into five types; however, the follow-up has not been fully described. The objectives of this study were to describe (1) the CT pattern 3 years after RFA and (2) its evolution over 7 years. Materials and methods: Lesions treated with RFA between 2009 and 2017 and with !3 years of follow-up CT data were included. Lesions with local recurrences were excluded from the study. The morphology of the ablation zone was classified as nodular, fibrotic, atelectatic, cavitary, and disappeared. Other initial anatomical parameters were recorded. Kruskal-Wallis or Chi-square tests were used to compare the groups. Results: One hundred lung RFA scars were included, and a retrospective longitudinal study was performed. Three years after RFA, nodular, fibrotic, atelectatic, and cavitary scars, and disappearance were observed in 49%, 36%, 5%, 3%, and 6% of the scars, respectively. Evolution over 7 years showed that the fibrosis, atelectasis, and disappearance remained stable over time, whereas 28% of nodular scars evolved into fibrotic scars. Additionally, 45% of cavitary scars evolved into nodular scars. Pleural contact was associated with disappearance, and the use of a 20-mm needle was associated with atelectasis. Conclusion: Follow-up after RFA showed that fibrosis, disappearance, and atelectasis remained stable over time. Nodular scars could evolve into fibrotic scars, and cavitary scars could evolve into nodular scars.

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“…Although there are reports of high radiation exposure of interventional radiologists (interventionalists), when CT fluoroscopy guidance is used [7][8][9][10] , they specifically refer to CT-guided biopsy or drainage procedures. To our knowledge, there are only two articles investigating radiation exposure of interventionalists due to CT fluoroscopy-guided PCA [11][12] . Stewart et al reported that the estimated interventionalists' radiation exposure was 0.0503 mGy/min during CT fluoroscopy-guided renal PCA [11].…”

Section: Introductionmentioning

confidence: 99%

“…Stewart et al reported that the estimated interventionalists' radiation exposure was 0.0503 mGy/min during CT fluoroscopy-guided renal PCA [11]. Matsui et al compared the direct interventionalists' radiation dose between CT fluoroscopy-guided renal PCA and lung RFA measured by electric dosimeters (for the effective dose) and thermoluminescent dosimeter rings (for the equivalent dose on the finger skin) [12]. However, there is no published study directly measuring radiation dose on multiple sites (such as the eye, hand, neck, chest and abdomen) to evaluate interventionalists' radiation exposure during CT fluoroscopy-guided PCA.…”

Section: Introductionmentioning

confidence: 99%

“…The number of PCA needles and the application of hydro-or pneumo-dissection varied according to the target lesions. Thus, the distributions of radiation exposure of interventionalists at each evaluation site were extendedly compared with those of a previous study [12]. Second, RPLDs were used for measuring ESD in this study; however, in the previous study, thermoluminescent dosimeters, optically stimulated luminescence dosimeters, and electronic dosimeters were used [12].…”

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confidence: 99%

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Radiation Exposure of Interventional Radiologists during Computed Tomography Fluoroscopy-Guided Percutaneous Cryoablation

Seki

Miyazaki

Fukushima

et al. 2020

Interventional Radiology

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The principal aim of this study was to evaluate radiation exposure of interventionalists during computed tomography (CT) fluoroscopy-guided percutaneous cryoablation (PCA) using radiophotoluminescent glass dosimeters (RPLDs). The radioprotective effects of safety glasses and lead apron were also evaluated.Materials and Methods: Radiation exposure of interventionalists during 46 CT fluoroscopy-guided PCA procedures was evaluated. Entrance surface dose (ESD) was measured using RPLDs on multiple sites: five sites, representing eye lens exposure; five sites, representing body exposure; and four sites, representing skin exposure. The ESD values on multiple sites were compared between different PCA procedures (renal, liver, and bone).Results: The mean ESD on the X-ray-side hand exhibited the highest value (358.8 μGy). Regarding evaluation sites representing exposure to the eye lens, the highest ESD inside the radiation protective glasses was detected on the X-ray-side cheek (167.1 μGy). Most ESD values among multiple sites (10/14) were linearly correlated with CT fluoroscopy time. Among them, the ESD values measured during renal and liver PCA were relatively higher than those measured during bone PCA, especially on the chest area outside the lead apron, and on the X-ray tube-side elbow and hand during renal and bone PCA. Radioprotective effects of safety glasses and lead apron ranged from 44.6 to 50.6% and from 30.2 to 79.6%, respectively, on each evaluation site. Conclusion:The site with the highest radiation exposure on interventionalists during CT fluoroscopyguided PCA was the X-ray tube-side hand. Radiation exposure of interventionalists was at acceptable levels and consistent with the recommended dose limits.

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Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting

Abstract: Radiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

Cited by 17 publications

References 25 publications

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

Image-guided percutaneous ablation for the treatment of lung malignancies: current state of the art

Description of morphological evolution of lung tumors treated by percutaneous radiofrequency ablation: long term follow-up of 100 lesions with chest CT

Radiation Exposure of Interventional Radiologists during Computed Tomography Fluoroscopy-Guided Percutaneous Cryoablation

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