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European Radiology

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01-12-2013 | Computed Tomography

Radiation dose to procedural personnel and patients from an X-ray volume imaging system

Authors: Jijo Paul, Emmanuel C. Mbalisike, Thomas J. Vogl

Published in: European Radiology | Issue 12/2013

Abstract

Objective

To evaluate the radiation dose received by procedural personnel and patients from an X-ray volume imaging (XVI) system during interventional procedures.

Methods

Forty patients were examined using catheter angiography (group A), digital subtraction angiography (group B) and cone-beam CT (CBCT, group C). Doses to procedural personnel (using thermo-luminescent dosimeters, TLDs) and patients were estimated. Image quality and lesion delineation were assessed using objective and subjective methods. Shapiro–Wilk, two-sided Student’s t and Wilcoxon matched-pairs tests were used to test statistical significance.

Results

Doses (milligrays) measured in the hands and left knee of the interventionist were higher than those in an assistant physician (P < 0.05). Doses (dose–area product and skin entry dose) were lower in group A and higher in C compared with other groups; moreover, comparison among the groups were significant (all P = 0.0001). Subjective and objective lesion delineation showed significant results (all P < 0.05) among the tumour types considered. Image quality estimation showed the opposite results for objective and subjective analysis.

Conclusion

More doses were obtained for hands of the procedural personnel compared to other anatomical regions measured. Catheter angiography showed lower dose compared with other imaging groups examined. Lesion delineation was clearly possible using CBCT. Objective and subjective analysis showed the opposite results regarding image quality because of higher noise levels and artefacts.

Key Points

• Interventional radiological procedures inevitably impart relatively high radiation doses

• Little is known about the doses imparted by cone-beam CT (CBCT)-guided procedures.

• During interventional radiological procedures the hands of personnel receive high doses.

• Catheter angiography delivered lower doses compared with CBCT and digital subtraction angiography (DSA).

• Nevertheless the use of CBCT to delineate lesions is advantageous for patients.

Vogl TJ, Zangos S, Eichler K, Yakoub D, Nabil M (2007) Colorectal liver metastases: regional chemotherapy via transarterial chemoembolization (TACE) and hepatic chemoperfusion—an update. Eur Radiol 17:1025–1034PubMedCrossRef

Vogl TJ, Gruber T, Balzer JO, Eichler K, Hammerstingl R, Zangos S (2009) Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology 250:281–289PubMedCrossRef

Vogl TJ, Jost A, Nour-Eldin NA, Mack MG, Zangos S, Naguib NNN (2012) Repeated transarterial chemoembolization using different chemotherapeutic drug combinations followed by MR-guided laser-induced thermotherapy in patients with liver metastasis of colorectal carcinoma. Br J Cancer 106:1274–1279PubMedCrossRef

Paul J, Jacobi V, Farhang M, Bazrafshan B, Vogl TJ, Mbalisike EC (2012) Radiation dose and image quality of X-ray volume imaging systems: cone beam CT, digital subtraction angiography and digital fluoroscopy. Eur Radiol. doi:10.1007/s00330-012-2737-2

Wong KM, Tan BS, Taneja M et al (2011) Cone beam computed tomography for vascular interventional radiology procedures: early experience. Ann Acad Med 40:308–314

Jeon UB, Lee JW, Choo KS et al (2009) Iodized oil uptake assessment with cone-beam CT in chemoembolization of small hepatocellular carcinomas. World J Gastroenterol 15:5833–5837PubMedCrossRef

Meng B, Lee H, Fahimian BP (2013) Single-scan patient-specific scatter correction in computed tomography using peripheral detection of scatter and compressed sensing scatter retrieval. Med Phys 40. doi:10.1118/1.4769421

Schulz B, Heidenreich R, Heidenreich M et al (2012) Radiation exposure to operating staff during rotational flat-panel angiography and C-arm cone beam computed tomography applications. Eur J Radiol 81:4138–4142PubMedCrossRef

Paul J, Vogl TJ, Mbalisike E (2012) Radiation dose and image quality evaluation relative to different contrast media using cone-bean CT. Imaging Med 4:505–513CrossRef

10.

Lee H, Xing L, Lee R, Fahimian BP (2012) Scatter correction in cone-beam CT via a half beam blocker technique allowing simultaneous acquisition of scatter and image information. Med Phys 39:2386–2395PubMedCrossRef

11.

Rührnschopf EP, Klingenbeck K (2011) A general framework and review of scatter correction methods in cone beam CT. Part 2: scatter estimation approaches. Med Phys 38:5186–5199CrossRef

12.

Siewerdsen JH, Jaffray DA (2000) Optimization of X-ray imaging geometry (with specific application to flat panel cone-beam CT). Med Phys 27:1903–1914PubMedCrossRef

13.

Ding GX, Duggan DM, Coffey CW (2007) Characteristics of kilovoltage X-ray beams used for cone-beam CT in radiation therapy. Phys Med Biol 52:1595–1615PubMedCrossRef

14.

Daly MJ, Siewerdsen JH, Moseley DJ, Jaffray DA, Irish JC (2006) Intraoperative cone-beam CT for guidance of head and neck surgery: assessment of dose and image quality using a C-arm prototype. Med Phys 33:3767–3780

15.

Suzuki S, Furui S, Yamaguchi I et al (2009) Effective dose during abdominal three dimensional imaging with a flat-panel detector angiography system. Radiology 250:545–550PubMedCrossRef

16.

Sakamoto H, Aikawa Y, Ikegawa H, Sano Y, Araki T (2004) Consideration of the newly standardized interventional reference point. Nihon Hoshasen Gijutsu Gakkai Zasshi 60:520–527PubMed

17.

Morimoto M, Numata K, Kondo M et al (2010) C-arm cone-beam CT for hepatic tumor ablation under real time 3D imaging. AJR Am J Roentgenol 194:W452–W454PubMedCrossRef

18.

Tans JTJ, Hoogland PH, Jonkman EJ (1985) Role of venous digital subtraction angiography of the carotid bifurcation in the evaluation of patients with reversible ischemic attacks or stroke. Stroke 3:435–440CrossRef

19.

Stewart FA, Akleyev AV, Hauer-Jensen M et al (2012) ICRP publication 118: ICRP statement on tissue reactions and early and late effects of radiation in normal tissues and organs–threshold doses for tissue reactions in a radiation protection context. Ann ICRP 41:1–322PubMedCrossRef

Title: Radiation dose to procedural personnel and patients from an X-ray volume imaging system
Authors: Jijo Paul
Emmanuel C. Mbalisike
Thomas J. Vogl
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2013
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-013-2939-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Radiation dose to procedural personnel and patients from an X-ray volume imaging system

Abstract

Objective

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

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