Skip to main content
Top
Published in: Journal of Gastroenterology 6/2024

04-05-2024 | Endoscopic Retrograde Cholangiopancreatography | Review

Managing radiation safety and protection in gastroenterology in Japan: insights from the REX-GI study

Authors: Tsutomu Nishida, Shiro Hayashi, Mamoru Takenaka, Makoto Hosono

Published in: Journal of Gastroenterology | Issue 6/2024

Login to get access

Abstract

Fluoroscopy-guided gastrointestinal procedures, including gastrointestinal stenting, balloon-assisted endoscopy (BAE), endoscopic retrograde cholangiopancreatography (ERCP), and endoscopic ultrasound (EUS), are essential for diagnosis and treatment in gastroenterology. Such procedures involve radiation exposure that necessitates strict safety measures to protect patients, doctors, and medical staff. The April 2020 update to Japan’s Ionizing Radiation Injury Prevention Regulations for occupational exposure reduced the lens exposure dose limit to approximately one-seventh of its previous level. This change highlights the need for improved safety protocols. Without adaptation, the sustainability of fluoroscopy-based endoscopic techniques could be at risk due to the potential to exceed these new limits. This review examines the current state of medical radiation exposure in the field of gastroenterology in Japan and discusses the findings of the REX-GI study.
Literature
1.
go back to reference Vano E, Miller DL, Martin CJ, et al. ICRP publication 135: diagnostic reference levels in medical imaging. Ann ICRP. 2017;46:1–144.CrossRefPubMed Vano E, Miller DL, Martin CJ, et al. ICRP publication 135: diagnostic reference levels in medical imaging. Ann ICRP. 2017;46:1–144.CrossRefPubMed
2.
go back to reference Nishida T, Hayashi S, Takenaka M, et al. Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study). BMJ Open. 2020;10:e033604.CrossRefPubMedPubMedCentral Nishida T, Hayashi S, Takenaka M, et al. Multicentre prospective observational study protocol for radiation exposure from gastrointestinal fluoroscopic procedures (REX-GI study). BMJ Open. 2020;10:e033604.CrossRefPubMedPubMedCentral
3.
go back to reference Hayashi S, Takenaka M, Hosono M, et al. Diagnostic reference levels for fluoroscopy-guided gastrointestinal procedures in Japan from the REX-GI study: a nationwide multicentre prospective observational study. Lancet Reg Health West Pac. 2022;20:100376.PubMedPubMedCentral Hayashi S, Takenaka M, Hosono M, et al. Diagnostic reference levels for fluoroscopy-guided gastrointestinal procedures in Japan from the REX-GI study: a nationwide multicentre prospective observational study. Lancet Reg Health West Pac. 2022;20:100376.PubMedPubMedCentral
4.
go back to reference Ikezawa K, Hayashi S, Takenaka M, et al. Occupational radiation exposure to the lens of the eyes and its protection during endoscopic retrograde cholangiopancreatography. Sci Rep. 2023;13:7824.CrossRefPubMedPubMedCentral Ikezawa K, Hayashi S, Takenaka M, et al. Occupational radiation exposure to the lens of the eyes and its protection during endoscopic retrograde cholangiopancreatography. Sci Rep. 2023;13:7824.CrossRefPubMedPubMedCentral
5.
go back to reference Nagaike K, Hayashi S, Yakushijin T, et al. Radiation dose and factors related to exceeding the diagnostic reference level in 496 transnasal ileus tube placement procedures from the REX-GI study. Br J Radiol. 2023;96:20230086.CrossRefPubMed Nagaike K, Hayashi S, Yakushijin T, et al. Radiation dose and factors related to exceeding the diagnostic reference level in 496 transnasal ileus tube placement procedures from the REX-GI study. Br J Radiol. 2023;96:20230086.CrossRefPubMed
6.
go back to reference Tokura J, Yoshio T, Hayashi S, et al. Medical radiation exposure during gastrointestinal enteral metallic stent placement: post hoc analysis of the REX-GI study. JGH Open. 2023;7:869–74.CrossRefPubMedPubMedCentral Tokura J, Yoshio T, Hayashi S, et al. Medical radiation exposure during gastrointestinal enteral metallic stent placement: post hoc analysis of the REX-GI study. JGH Open. 2023;7:869–74.CrossRefPubMedPubMedCentral
7.
go back to reference Hayashi S, Takenaka M, Kogure H, et al. A follow-up questionnaire survey 2022 on radiation protection among 464 medical staff from 34 endoscopy-fluoroscopy departments in Japan. DEN Open. 2023;3:e227.CrossRefPubMedPubMedCentral Hayashi S, Takenaka M, Kogure H, et al. A follow-up questionnaire survey 2022 on radiation protection among 464 medical staff from 34 endoscopy-fluoroscopy departments in Japan. DEN Open. 2023;3:e227.CrossRefPubMedPubMedCentral
8.
go back to reference Hayashi S, Takenaka M, Kogure H, et al. A questionnaire survey on radiation protection among 282 medical staff from 26 endoscopy-fluoroscopy departments in Japan. DEN Open. 2021;1:e5.CrossRefPubMedPubMedCentral Hayashi S, Takenaka M, Kogure H, et al. A questionnaire survey on radiation protection among 282 medical staff from 26 endoscopy-fluoroscopy departments in Japan. DEN Open. 2021;1:e5.CrossRefPubMedPubMedCentral
9.
go back to reference Vañó E, Rosenstein M, Liniecki J, et al. ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Ann ICRP. 2009;39:7–68.CrossRefPubMed Vañó E, Rosenstein M, Liniecki J, et al. ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. Ann ICRP. 2009;39:7–68.CrossRefPubMed
10.
go back to reference Committee AT, Pedrosa MC, Farraye FA, et al. Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics. Gastrointest Endosc. 2010;72:227–35.CrossRef Committee AT, Pedrosa MC, Farraye FA, et al. Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics. Gastrointest Endosc. 2010;72:227–35.CrossRef
11.
go back to reference Dumonceau JM, Garcia-Fernandez FJ, Verdun FR, et al. Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy. 2012;44:408–21.CrossRefPubMed Dumonceau JM, Garcia-Fernandez FJ, Verdun FR, et al. Radiation protection in digestive endoscopy: European Society of Digestive Endoscopy (ESGE) guideline. Endoscopy. 2012;44:408–21.CrossRefPubMed
12.
go back to reference Son BK, Lee KT, Kim JS, et al. Lack of radiation protection for endoscopists performing endoscopic retrograde cholangiopancreatography. Korean J Gastroenterol. 2011;58:93–9.CrossRefPubMed Son BK, Lee KT, Kim JS, et al. Lack of radiation protection for endoscopists performing endoscopic retrograde cholangiopancreatography. Korean J Gastroenterol. 2011;58:93–9.CrossRefPubMed
13.
go back to reference Ciraj-Bjelac O, Rehani MM, Sim KH, et al. Risk for radiation-induced cataract for staff in interventional cardiology: is there reason for concern? Catheter Cardiovasc Interv. 2010;76:826–34.CrossRefPubMed Ciraj-Bjelac O, Rehani MM, Sim KH, et al. Risk for radiation-induced cataract for staff in interventional cardiology: is there reason for concern? Catheter Cardiovasc Interv. 2010;76:826–34.CrossRefPubMed
14.
go back to reference Vano E, Kleiman NJ, Duran A, et al. Radiation cataract risk in interventional cardiology personnel. Radiat Res. 2010;174:490–5.CrossRefPubMed Vano E, Kleiman NJ, Duran A, et al. Radiation cataract risk in interventional cardiology personnel. Radiat Res. 2010;174:490–5.CrossRefPubMed
16.
go back to reference Takenaka M, Hosono M, Hayashi S, et al. How should radiation exposure be handled in fluoroscopy-guided endoscopic procedures in the field of gastroenterology? Dig Endosc. 2021;34:890–900.CrossRef Takenaka M, Hosono M, Hayashi S, et al. How should radiation exposure be handled in fluoroscopy-guided endoscopic procedures in the field of gastroenterology? Dig Endosc. 2021;34:890–900.CrossRef
17.
go back to reference Kozuma K, Chikamori T, Hashimoto J, et al. JCS 2021 Guideline on radiation safety in cardiology. Circ J. 2022;86:1148–203.CrossRefPubMed Kozuma K, Chikamori T, Hashimoto J, et al. JCS 2021 Guideline on radiation safety in cardiology. Circ J. 2022;86:1148–203.CrossRefPubMed
18.
go back to reference Hayashi S, Nishida T, Matsubara T, et al. Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography. PLoS ONE. 2018;13:e0207539.CrossRefPubMed Hayashi S, Nishida T, Matsubara T, et al. Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography. PLoS ONE. 2018;13:e0207539.CrossRefPubMed
19.
go back to reference Hayashi S, Nishida T, Kuriki S, et al. Radiation exposure dose of fluoroscopy-guided gastrointestinal procedures: a single-center retrospective study. Endosc Int Open. 2020;8:E1872–7.CrossRefPubMedPubMedCentral Hayashi S, Nishida T, Kuriki S, et al. Radiation exposure dose of fluoroscopy-guided gastrointestinal procedures: a single-center retrospective study. Endosc Int Open. 2020;8:E1872–7.CrossRefPubMedPubMedCentral
20.
go back to reference Hayashi S, Nishida T, Osugi N, et al. Time trend of the radiation exposure dose in endoscopic retrograde cholangiopancreatography over an 8-year period: a single-center retrospective study. Am J Gastroenterol. 2021;116:100–5.CrossRefPubMed Hayashi S, Nishida T, Osugi N, et al. Time trend of the radiation exposure dose in endoscopic retrograde cholangiopancreatography over an 8-year period: a single-center retrospective study. Am J Gastroenterol. 2021;116:100–5.CrossRefPubMed
23.
go back to reference Hayashi S, Takenaka M, Hosono M, et al. Radiation exposure during image-guided endoscopic procedures: the next quality indicator for endoscopic retrograde cholangiopancreatography. World J Clin Cases. 2018;6:1087–93.CrossRefPubMedPubMedCentral Hayashi S, Takenaka M, Hosono M, et al. Radiation exposure during image-guided endoscopic procedures: the next quality indicator for endoscopic retrograde cholangiopancreatography. World J Clin Cases. 2018;6:1087–93.CrossRefPubMedPubMedCentral
Metadata
Title
Managing radiation safety and protection in gastroenterology in Japan: insights from the REX-GI study
Authors
Tsutomu Nishida
Shiro Hayashi
Mamoru Takenaka
Makoto Hosono
Publication date
04-05-2024
Publisher
Springer Nature Singapore
Published in
Journal of Gastroenterology / Issue 6/2024
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-024-02106-x

Other articles of this Issue 6/2024

Journal of Gastroenterology 6/2024 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Webinar | 06-02-2024 | 20:00 (CET)

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by: Viatris

Developed by: Springer Healthcare