Strahlenexposition in der interventionellen Radiologie am Beispiel der Chemoembolisation des hepatozellulären Karzinoms und der Laserangioplastie der Beckenarterien

Hidajat, N.; Vogl, Th.; Biamino, Giancarlo; Michel, Laura L.; Wust, Peter; Panzer, W.; Zankl, M.; Félix, R.

doi:10.1055/s-2007-1015649

Cited by 9 publications

(3 citation statements)

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“…16 Some interventions are technically more complex due to individual anatomy (e.g., pelvic leg angiographies) resulting in increased radiation exposure, whereas chemoembolizations usually have shorter intervention times. 17,18 In addition, some patients were treated repeatedly using the same intervention protocol, and the anatomy was frequently known to the radiologist from previous examinations. Nevertheless, all techniques showed a significant reduction in radiation exposure when using live-screen dosimetry.…”

Section: Discussionmentioning

confidence: 99%

Reduction of radiation dose using real‐time visual feedback dosimetry during angiographic interventions

Koch

Conrades

Gruenewald

et al. 2022

J Applied Clin Med Phys

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This prospective study sought to evaluate potential savings of radiation dose to medical staff using real‐time dosimetry coupled with visual radiation dose feedback during angiographic interventions. For this purpose, we analyzed a total of 214 angiographic examinations that consisted of chemoembolizations and several other types of therapeutic interventions. The Unfors RaySafe i2 dosimeter was worn by the interventionalist at chest height over the lead protection. A total of 110 interventions were performed with real‐time radiation dosimetry allowing the interventionalist to react upon higher x‐ray exposure and 104 examinations served as the comparative group without real‐time radiation monitoring. By using the real‐time display during interventions, the overall mean operator radiation dose decreased from 3.67 (IQR, 0.95–23.01) to 2.36 μSv (IQR, 0.52–12.66) (−36%; p = 0.032) at simultaneously reduced operator exposure time by 4.5 min ( p = 0.071). Dividing interventions into chemoembolizations and other types of therapeutic interventions, radiation dose decreased from 1.31 (IQR, 0.46‐3.62) to 0.95 μSv (IQR, 0.53‐3.11) and from 24.39 (IQR, 12.14‐63.0) to 10.37 μSv (IQR, 0.85‐36.84), respectively, using live‐screen dosimetry ( p ≤ 0.005). Radiation dose reductions were also observed for the participating assistants, indicating that they could also benefit from real‐time visual feedback dosimetry during interventions (−30%; p = 0.039). Integration of real‐time dosimetry into clinical processes might be useful in reducing occupational radiation exposure time during angiographic interventions. The real‐time visual feedback raised the awareness of interventionalists and their assistants to the potential danger of prolonged radiation exposure leading to the adoption of radiation‐sparing practices. Therefore, it might create a safer environment for the medical staff by keeping the applied radiation exposure as low as possible.

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Section: Discussionmentioning

confidence: 99%

Reduction of radiation dose using real‐time visual feedback dosimetry during angiographic interventions

Koch

Conrades

Gruenewald

et al. 2022

J Applied Clin Med Phys

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“…In einer älteren Studie mit einer zwar auf fünf sehr limitierten Patientenzahl [4] konnten wir bereits zeigen, dass die Teilkör-perdosis der Augenlinse als eine im Hinblick auf die Einhaltung der Dosisgrenzwerte potenziell limitierende Größe für den Radiologen angesehen werden kann. Nach den Erkenntnissen dieser Arbeit erwies sich allerdings die aus den Werten der Teilkör-perdosis des roten Knochenmarks und des Muskels abgeleitete maximale Anwendungszahl von 86 bzw.…”

Section: Technik Und Medizinphysikunclassified

“…Es ist bekannt, dass dabei hohe Strahlenexpositionen auftreten, die beim Patienten oftmals Hautrötungen verursachen können [2,3]. Überschreitungen des für die Augenlinse des Radiologen von der internationalen Strahlenschutzkommission empfohlenen und in die deutsche Strahlenschutzgesetzgebung übernommenen Grenzwertes sind zu befürchten [4,5]. Da die Mehrzahl der Patienten schon bei der Erstdiagnose nicht resektabel sind und größere Tumoren aufweisen und da die TACE in der Regel repetitiv durchgeführt wird [6,7], kann in großen Zentren eine große Anzahl an TACE erwartet werden.…”

Section: Introductionunclassified

Die Strahlendosis des Radiologen und des Assistenten bei der transarteriellen hepatischen Chemoembolisation - Vergleich mit den Dosisgrenzwerten

Hidajat¹,

Wust²,

Felix³

et al. 2006

Rofo Fortschr Geb Rontgenstr N

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Practice of ALARA in the pediatric interventional suite

2006

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As interventional procedures have become progressively more sophisticated and lengthy, the potential for high patient radiation dose has increased. Staff exposure arises from patient scatter, so steps to minimize patient dose will in turn reduce operator and staff dose. The practice of ALARA in an interventional radiology (IR) suite, therefore, requires careful attention to technical detail in order to reduce patient dose. The choice of imaging modality should minimize radiation when and where possible. In this paper practical steps are outlined to reduce patient dose. Further details are included that specifically reduce operator exposure. Challenges unique to pediatric intervention are reviewed. Reference is made to experience from modern pediatric interventional suites. Given the potential for high exposures, the practice of ALARA is a team responsibility. Various measures are outlined for consideration when implementing a quality assurance (QA) program for an IR service.

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Strahlenexposition in der interventionellen Radiologie am Beispiel der Chemoembolisation des hepatozellulären Karzinoms und der Laserangioplastie der Beckenarterien

Cited by 9 publications

References 0 publications

Reduction of radiation dose using real‐time visual feedback dosimetry during angiographic interventions

Reduction of radiation dose using real‐time visual feedback dosimetry during angiographic interventions

Die Strahlendosis des Radiologen und des Assistenten bei der transarteriellen hepatischen Chemoembolisation - Vergleich mit den Dosisgrenzwerten

Practice of ALARA in the pediatric interventional suite

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