Report of IRPA task group on the impact of the eye lens dose limits

Cantone, M.C.; Ginjaume, M.; Miljanić, Saveta; Martin, C J; Akahane, Keiichi; Mpete, Louisa; Michelin, Severino; Flannery, Cynthia M.; Dauer, Lawrence T.; Balter, Stephen

doi:10.1088/1361-6498/aa604b

Cited by 28 publications

(38 citation statements)

References 9 publications

(5 reference statements)

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“…(118) ICRU (1992) recommended the use of the operational quantity, personal dose equivalent H p (3), for dosimetry of the lens of the eye. However, while H p (3) is well suited to assess dose to the lens of the eye, calibration of dosimeters in H p (3) is not available in many countries (Cantone et al, 2017). In Publications 103 (ICRP, 2007a, Annex B) and 116 (ICRP, 2010b), it is recommended that the operational quantity H p (0.07) is adequate for monitoring the lens of the eye for photon exposures.…”

Section: Recommended Option For the Assessment Of Effective Dosementioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

170

123

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In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

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Section: Recommended Option For the Assessment Of Effective Dosementioning

confidence: 99%

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

López¹,

Dauer²,

Loose³

et al. 2018

Ann ICRP

170

123

View full text Add to dashboard Cite

show abstract

“…8 In addition, guidelines for protective devices according to exposure levels were provided. 9 As the lens dosage cannot be measured directly, ICRP recommends that the most accurate method is the measurement of H p (3), which is the individual dose at a depth of 3 mm, corresponding to the most radiosensitive region. 10 Dosimeters specifically designed to measure H p (3) should be located as close to the eye as possible.…”

Section: Introductionmentioning

confidence: 99%

Contact lens‐type ocular in vivo dosimeter for radiotherapy

et al. 2019

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Purpose This study aimed to (a) develop a contact lens‐type ocular in vivo dosimeter (CLOD) that can be worn directly on the eye and (b) assess its dosimetric characteristics and biological stability for radiation therapy. Methods The molder of a soft contact lens was directly used to create the dosimeter, which included a radiation‐sensitive component — an active layer similar to a radiochromic film — to measure the delivered dose. A flatbed scanner with a reflection mode was used to measure the change in optical density due to irradiation. The sensitivity, energy, dose rate, and angular dependence were tested, and the uncertainty in determining the dose was calculated using error propagation analysis. Sequential biological stability tests, specifically, cytotoxicity and ocular irritation tests, were conducted to ensure the safe application of the CLOD to patients. Results The dosimeter demonstrated high sensitivity in the low dose region, and the sensitivity linearly decreased with the dose. The responses obtained for the 10 and 15 MV photon beams were 1.7% and 1.9% higher compared to the 6 MV photon beam. A strong dose rate dependence was not obtained for the CLOD. Angular dependence was observed from 90° to 180° with a difference in response from 1% to 2%. The total uncertainty in error propagation analysis decreased as a function of the dose in the red channel. For a dose range of 0 to 50 cGy, the total uncertainties for 5, 10, and 50 cGy were 14.2%, 8.9%, and 5%, respectively. Quantitative evaluation using the MTT (3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide) method presented no cytotoxicity. Further, no corneal opacity, iris reaction, or conjunctival inflammation was observed. Conclusions The CLOD is the first dosimeter that can be worn close to the eye. The results of cytotoxicity and irritation tests indicate that it is a stable medical device. The evaluation of dose characteristics in open field conditions shows that the CLOD can be applied to an in vivo dosimeter in radiotherapy.

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“…When considering the use of a particular intraoperative imaging modality in spine surgery, radiation exposure to the patient and operating room staff is a concern 11 . The International Commission on Radiological Protection recommends less than 5 Rem per year of the total body exposure and 50 Rem per year of the extremity exposure 12 . Radiation to the surgeon and OR staff is highly variable and dependent on several factors including surgeon and fluoroscopy technician experience.…”

Section: Discussionmentioning

confidence: 99%

Fluoroscopy time analysis of a prospective, multi‐centre study comparing robotic‐ and fluoroscopic‐guided placement of percutaneous pedicle screw instrumentation for short segment minimally invasive lumbar fusion surgery

Jamshidi

Massel

Liounakos

et al. 2020

Robotics Computer Surgery

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Background As minimally invasive spine surgery becomes more widespread, concerns regarding radiation exposure to surgeons and patients alike have become a growing concern. Robotic guidance has been developed as a way to increase the accuracy of instrumentation while decreasing radiation burden. Methods A retrospective analysis of a large, multi‐centre, prospective study comparing robotic‐guided (RG) to fluoroscopic‐guided (FG) (Multi‐centre, Partially Randomized, Controlled Trial of MIS Robotic vs. Freehand in Short Adult Degenerative Spinal Fusion Surgeries) was performed to evaluate for differences in radiation exposure between study groups. Results RG was associated with 78.3% (p < 0.001) and 79.8% (p < 0.001) reduction in total and per screw fluoroscopy times, respectively, as compared to FG. RG was also associated with a 50.8% (p < 0.001) reduction in total operative fluoroscopy time. Conclusions RG was associated with significantly lower fluoroscopy times compared to FG. This suggests that utilization of robotic navigation systems may result in decreased operative radiation exposure, which is a growing concern for surgeons performing minimally invasive spine surgery.

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Report of IRPA task group on the impact of the eye lens dose limits

Cited by 28 publications

References 9 publications

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures

Contact lens‐type ocular in vivo dosimeter for radiotherapy

Fluoroscopy time analysis of a prospective, multi‐centre study comparing robotic‐ and fluoroscopic‐guided placement of percutaneous pedicle screw instrumentation for short segment minimally invasive lumbar fusion surgery

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