Skin Injuries from Fluoroscopically Guided Procedures

Koenig, Titus R.; Mettler, Fred A.; Wagner, Louis K.

doi:10.2214/ajr.177.1.1770013

Cited by 341 publications

(110 citation statements)

References 37 publications

(52 reference statements)

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…Radiation, electrical and thermal burns all exhibit erythema, dry or moist desquamation, ulceration, and necrosis [2, 8, 9]. However, a defining characteristic of severe radiation burns is the occurrence of unpredictable cycles of inflammation that extend the initial damage, increasing the affected area of superficial epidermis and deeper tissues, as is delayed tissue necrosis and repair failure [2, 10].…”

Section: Introductionmentioning

confidence: 99%

Accelerated senescence in skin in a murine model of radiation-induced multi-organ injury

McCart

Thangapazham

Lombardini

et al. 2017

Journal of Radiation Research

View full text Add to dashboard Cite

Accidental high-dose radiation exposures can lead to multi-organ injuries, including radiation dermatitis. The types of cellular damage leading to radiation dermatitis are not completely understood. To identify the cellular mechanisms that underlie radiation-induced skin injury in vivo, we evaluated the time-course of cellular effects of radiation (14, 16 or 17 Gy X-rays; 0.5 Gy/min) in the skin of C57BL/6 mice. Irradiation of 14 Gy induced mild inflammation, observed histologically, but no visible hair loss or erythema. However, 16 or 17 Gy radiation induced dry desquamation, erythema and mild ulceration, detectable within 14 days post-irradiation. Histological evaluation revealed inflammation with mast cell infiltration within 14 days. Fibrosis occurred 80 days following 17 Gy irradiation, with collagen deposition, admixed with neutrophilic dermatitis, and necrotic debris. We found that in cultures of normal human keratinocytes, exposure to 17.9 Gy irradiation caused the upregulation of p21/waf1, a marker of senescence. Using western blot analysis of 17.9 Gy–irradiated mice skin samples, we also detected a marker of accelerated senescence (p21/waf1) 7 days post-irradiation, and a marker of cellular apoptosis (activated caspase-3) at 30 days, both preceding histological evidence of inflammatory infiltrates. Immunohistochemistry revealed reduced epithelial stem cells from hair follicles 14–30 days post-irradiation. Furthermore, p21/waf1 expression was increased in the region of the hair follicle stem cells at 14 days post 17 Gy irradiation. These data indicate that radiation induces accelerated cellular senescence in the region of the stem cell population of the skin.

show abstract

Section: Introductionmentioning

confidence: 99%

Accelerated senescence in skin in a murine model of radiation-induced multi-organ injury

McCart

Thangapazham

Lombardini

et al. 2017

Journal of Radiation Research

View full text Add to dashboard Cite

show abstract

“…Some fluoroscopical procedures are associated with a risk of radiation injury to the skin. The majority of instances reported in the literature or to the United States Food and Drug Administration (FDA) result from cardiac radiofrequency ablation or coronary angioplasty [3,6]. Some reported skin injuries were associated with transjugular intrahepatic portosystemic shunt (TIPS) creation, renal angioplasty, multiple hepatic/biliary procedures, or embolization [1,3,[6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Radiation Exposure of Medical Staff in Interventional Radiology

Kara

Akkurt

2016

Acta Phys. Pol. A

View full text Add to dashboard Cite

The aim of this study was to assess the radiation dose received by doctors, nurses, X-ray technician medical staff during cardiac catheterization in a representative sample of the staff in our angiography department. Radiation from X-ray machines can cause serious side effects. Radiation exposure of angiography staff (doctors, nurses, medical staff and X-ray technicians) has been recognized as a necessary hazard in angiography department. The purpose of our work is to determine angiography staff radiation doses during interventional radiology, to identify procedures associated with higher radiation doses, and to determine the effects of various parameters on staff doses. This study was performed at Suleyman Demirel University Medical Faculty Hospital. The procedure of study was performed in an interventional radiology department. We have recorded radiation doses data during all related imaging procedures performed as a part of department activity. The distances from the X-ray tube were 0 cm (doctor), 60 cm (nurse), 120 cm (medical staff) and 180 cm (X-ray technician). It is important to understand the radiation effects on medical staff in interventional radiology procedures. Determinants of radiation risk include not only radiation dose levels but also medical staff number, ages, gender and their position. These factors can increase or decrease the risk of exposure.

show abstract

“…Even today, there are case reports of injuries (such as radiation‐induced erythema) caused by the radiation from IVR X‐ray systems 13 , 14 , 15 . Therefore, the management of radiation doses in IVR is important 16 , 17 , 18 , 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

A cross‐sectional study of the radiation dose and image quality of X‐ray equipment used in IVR

Inaba

Chida

Kobayashi

et al. 2016

J Applied Clin Med Phys

View full text Add to dashboard Cite

There are case reports of injuries caused by the radiation from interventional radiology (IVR) X‐ray systems. Therefore, the management of radiation doses in IVR is important. However, no detailed report has evaluated image quality for a large number of IVR X‐ray systems. As a result, it is unclear whether the image quality of the X‐ray equipment currently used in IVR procedures is optimal. We compared the entrance surface doses and image quality of multiple IVR X‐ray systems. This study was conducted in 2014 at 13 medical facilities using 18 IVR X‐ray systems. We evaluated image quality and simultaneously measured the radiation dose. Entrance surface doses for fluoroscopy (duration, 1 min) and cineradiography (duration, 10 s) are measured using a 20‐cm‐thick acrylic plate and skin dose monitor. The image quality (such as spatial resolution and low‐contrast detectability) of both fluoroscopy and cineradiography was evaluated using a QC phantom. For fluoroscopy, the average entrance surface dose using the 20‐cm‐thick acrylic plate was 13.9 (range 2.1–28.2) mGy/min. For cineradiography, the average entrance surface dose was 24.6 (range 5.1–49.3) mGy/10 s. We found positive correlations between radiation doses and image quality scores, in general, especially for fluoroscopy. The differences in surface dose among the 18 IVR X‐ray systems were high (max/min, 9.7‐fold for cineradiography; 13.4‐fold for fluoroscopy). The differences in image quality scores (spatial resolution, low‐contrast detectability, and dynamic range) were also very large. In general, there tended to be a correlation between radiation dose and image quality. Periodical measurements of the radiation dose and image quality of the X‐ray equipment used for cineradiography and fluoroscopy in IVR are necessary. The need to minimize patient exposure requires that the dose be reduced to the minimum level that will generate an image with an acceptable degree of noise.PACS number(s): 87.57.C, 87.57.uq, 87.59.B, 87.59.bf, 87.59.C, 87.59.cf, 87.59.Dj

show abstract

Skin Injuries from Fluoroscopically Guided Procedures

Cited by 341 publications

References 37 publications

Accelerated senescence in skin in a murine model of radiation-induced multi-organ injury

Accelerated senescence in skin in a murine model of radiation-induced multi-organ injury

Radiation Exposure of Medical Staff in Interventional Radiology

A cross‐sectional study of the radiation dose and image quality of X‐ray equipment used in IVR

Contact Info

Product

Resources

About