scholarly journals Observations and Considerations on Patient X-ray Exposure in the Electrophysiology Lab

2013 ◽  
Vol 2 (2) ◽  
pp. 141 ◽  
Author(s):  
Xianxian Jiang ◽  
Lukas RC Dekker ◽  
◽  
Keyword(s):  
Catheter Ablation ◽  
Dose Rate ◽  
Pulmonary Vein ◽  
Fluoroscopy Time ◽  
Radiation Dose Rate ◽  
X Ray ◽  
Dose Area Product ◽  
Air Kerma ◽  
Area Product ◽  
Patient Radiation Exposure

To assess patient radiation during catheter ablation procedures and operator differences. From 84 patients (51 males, age 63 ± 10 years) undergoing complex catheter ablation by three experienced operators we collected: body mass index (BMI), procedure type and time, fluoroscopy time, dose area product (DAP), air kerma and X-ray system setting (cine, collimation and angiographic imaging angle). A new factor, fluoroscopy DAP–fluoroscopy time ratio, was introduced to compare operator differences. The results show the average procedure time was 179 (± 57) minutes (min), fluoroscopy time was 31 (± 21) min, DAP was 26.4 (± 19.6) Gy.cm2and air kerma was 0.26 (± 0.19) Gy. Procedure types were: pulmonary vein isolation (PVI) (52 %), redo PVI (11 %), pulmonary vein ablation catheter (PVAC) (14 %), ventricular tachycardia (VT) (8 %) and others (15 %). Inter-operator difference was observed in fluoroscopy and cine usage. Fluoroscopy DAP-time ratios showed a similar level of patient radiation dose rate by operator A and B (correlation: 0.89), and a significantly higher dose rate by operator C (correlation: 0.20, p<0.001; 0.26, p<0.01, to operator A and B). In conclusion, operators should be aware of patient radiation exposure levels and the influencing factors. Inter- and intra-operator differences can be measured and bench marked for improvement in X-ray efficiency and patient radiation reduction.

scholarly journals Measurement of the radiation level dose to patient from fluoroscopy device during cardiac catheterization

2020 ◽  
Vol 2 (1) ◽  
pp. 35-41
Author(s):  
Luma Naji Joudha
Keyword(s):  
Dose Rate ◽  
Cardiac Catheterization ◽  
Exposure Dose ◽  
Radiation Doses ◽  
X Ray ◽  
Dose Area Product ◽  
Dose Rates ◽  
Wide Range ◽  
Area Product ◽  
Permissible Dose

Fluoroscopy is a type of medical imaging that shows a continuous X-ray image on a screen, it is used in a wide range of examination and procedures for diagnosis such as in cardiac catheterization. Fluoroscopy can result in relatively high radiation doses, especially for complex interventional procedures that it needed to monitor radiation to reduce exposure. The purpose of this study is to determine the radiation doses for patients during cardiac catheterization exam and compare it with the permissible dose limits. The main parameters which are studied in this work are the time of exposure dose rate, x-ray techniques (milliamper. second), tube voltage (kilovolt) and Dose Area Product (DAP). Twenty-seven patients were included and  absorbed doses were measured and distributed according to Fluoroscopy (Fluo) time, mAs and Dose Area Product (DPA). It was found that the absorbed dose received by the patients has a  linear relationship with the Fluoroscopy time, mAs and DAP. Exposure dose rates were measured and compared with the maximum permissible dose (100 mGy/min), the estimated patient dose rate varied from (12-81.6) mGy/min) for 24 patients as a permissible dose in the safe side, and 3 patients exposed to higher values of the exposure dose rates ) over permissible dose) range (107.4-108) mGy/min

Establishment of dosimetric references in terms of dose-area product for small sizes MV X-ray beams

2015 ◽  
Vol 31 ◽  
pp. e52-e53 ◽  
Author(s):  
M. Le Roy ◽  
S. Dufreneix ◽  
J. Daures ◽  
F. Delaunay ◽  
J. Gouriou ◽  
...  
Keyword(s):  
X Ray ◽  
Dose Area Product ◽  
Area Product

scholarly journals Clinical apparatus for the reduction of dose area product for patients undergoing x-ray catheterization

2015 ◽  
Vol 42 (1) ◽  
pp. 521-530 ◽  
Author(s):  
Normand Robert ◽  
Kristina N. Watt ◽  
Sophie Rochette ◽  
Lionel Desponds ◽  
Régis Vaillant ◽  
...  
Keyword(s):  
X Ray ◽  
Dose Area Product ◽  
Area Product

scholarly journals Measurement of Area of Surplus X-ray Radiation by Dose-area Product Meter at Image Intensifier in Angiography X-ray Units

2006 ◽  
Vol 62 (7) ◽  
pp. 990-996 ◽  
Author(s):  
Shigenobu Seguchi ◽  
Takaya Saijou ◽  
Tatsuji Nagao ◽  
Yoshinobu Ishikawa ◽  
Shouta Mizuno ◽  
...  
Keyword(s):  
Image Intensifier ◽  
X Ray ◽  
Dose Area Product ◽  
Area Product

scholarly journals An Approach for Online Determining the Entrance Surface Air Kerma (ESAK) in Digital Radiology

2021 ◽  
Author(s):  
Ibrahim Idris Suliman
Keyword(s):  
Interventional Radiology ◽  
Digital Imaging ◽  
Digital Information ◽  
Patient Exposure ◽  
Digital Radiology ◽  
X Ray ◽  
Air Kerma ◽  
Dicom Header ◽  
Area Product ◽  
Entrance Surface Air Kerma

Abstract An online method is proposed to determine the entrance surface air kerma (ESAK) in digital radiology from console-displayed kerma area product (PKA) data. ESAK values were calculated from X-ray tube outputs and patient exposure factors across five X-ray examinations. The corresponding PKAvalues were taken from the Digital Imaging and Communications in Medicine (DICOM) header. Using linear regression between ESAK and values, the slope and intercept coefficients for each type of X-ray equipment and procedure were determined. The coefficient to determine ESAK from ranged from 59% for a posteroanterior chest to 88% for anteroposterior lumbar spine view X-ray procedures. The results demonstrated the possibility of online estimates of ESAK from a console that displayed using readily available digital information in radiology. The results may have important implications in interventional radiology, where ESAK values are crucial for preventing skin injuries due to prolonged fluoroscopy times.

scholarly journals Radiation Dose and Fluoroscopy Time of Endovascular Treatment in Patients with Intracranial Lateral Dural Arteriovenous Fistulae

2020 ◽  
Author(s):  
Robert Forbrig ◽  
Robert Stahl ◽  
Lucas L. Geyer ◽  
Yigit Ozpeynirci ◽  
Thomas Liebig ◽  
...  
Keyword(s):  
Low Dose ◽  
Endovascular Embolization ◽  
Fluoroscopy Time ◽  
Low Grade ◽  
Endovascular Technique ◽  
Dose Area Product ◽  
Single Center Study ◽  
Life Threatening ◽  
Area Product ◽  
Dosimetry Data

Abstract Purpose Intracranial lateral dural arteriovenous fistula (LDAVF) represents a specific subtype of cerebrovascular fistulae, harboring a potentially life-threatening risk of brain hemorrhage. Fluoroscopically guided endovascular embolization is the therapeutic gold standard. We provide detailed dosimetry data to suggest novel diagnostic reference levels (DRL). Methods Retrospective single-center study of LDAVFs treated between January 2014 and December 2019. Regarding dosimetry, the dose area product (DAP) and fluoroscopy time were analyzed for the following variables: Cognard scale grade, endovascular technique, angiographic outcome, and digital subtraction angiography (DSA) protocol. Results A total of 70 patients (19 female, median age 65 years) were included. Total median values for DAP and fluoroscopy time were 325 Gy cm2 (25%/75% percentile: 245/414 Gy cm2) and 110 min (68/142min), respectively. Neither median DAP nor fluoroscopy time were significantly different when comparing low-grade with high-grade LDAVF (Cognard I + IIa versus IIb–V; p > 0.05, each). Transvenous coil embolization yielded the lowest dosimetry values, with significantly lower median values when compared to a combined transarterial/transvenous technique (DAP 290 Gy cm2 versus 388 Gy cm2, p = 0.031; fluoroscopy time 85 min versus 170 min, p = 0.016). A significant positive correlation was found between number of arterial feeders treated by liquid embolization and both DAP (rs = 0.367; p = 0.010) and fluoroscopy time (rs = 0.295; p = 0.040). Complete LDAVF occlusion was associated with transvenous coiling (p = 0.001). A low-dose DSA protocol yielded a 20% reduction of DAP (p = 0.021). Conclusion This LDAVF study suggests several local DRLs which varied substantially dependent on the endovascular technique and DSA protocol.

scholarly journals SPOT REGION OF INTEREST IMAGING: A NOVEL FUNCTIONALITY AIMED AT X-RAY DOSE REDUCTION IN NEUROINTERVENTIONAL PROCEDURES

2020 ◽  
Vol 188 (3) ◽  
pp. 322-331
Author(s):  
Ljubisa Borota ◽  
Andreas Patz
Keyword(s):  
Dose Reduction ◽  
Region Of Interest ◽  
Skin Dose ◽  
X Ray ◽  
Dose Area Product ◽  
Dose Saving ◽  
Area Product ◽  
Anatomical Area ◽  
Neurointerventional Procedures ◽  
Peak Skin Dose

Abstract Aim of the study: The aim of this study was to describe a new functionality aimed at X-ray dose reduction, referred to as spot region of interest (Spot ROI) and to compare it with existing dose-saving functionalities, spot fluoroscopy (Spot F), and conventional collimation (CC). Material and methods: Dose area product, air kerma, and peak skin dose were measured for Spot ROI, Spot F, and CC in three different fields of view (FOVs) 20 × 20 cm, 15 × 15 cm, and 11 × 11 cm using an anthropomorphic head phantom RS-230T. The exposure sequence was 5 min of pulsed fluoroscopy (7.5 pulses per s) followed by 7× digital subtraction angiography (DSA) runs with 30 frames per DSA acquisition (3 fps × 10 s). The collimation in Spot F and CC was adjusted such that the size of the anatomical area exposed was as large as the Spot ROI area in each FOV. Results: The results for all FOVs were the following: for the fluoroscopy, all measured parameters for Spot ROI and Spot F were lower than corresponding values for CC. For DSA and DSA plus fluoroscopy, all measured parameters for Spot ROI were lower than corresponding parameters for Spot F and CC. Conclusion: Spot ROI is a promising dose-saving technology that can be applied in fluoroscopy and acquisition. The biggest benefit of Spot ROI is its ability to keep the entire FOV information always visible.

Use of weight-based vs age-based groupings in the study of typical values of air kerma area product (PKA) for paediatric radiographs of chest and abdomen

2021 ◽  
pp. 20210331
Author(s):  
Ioannis Delakis ◽  
Charlotte Kelly
Keyword(s):  
Age Groups ◽  
Equivalent Weight ◽  
Late Adolescent ◽  
Weight Group ◽  
X Ray ◽  
Air Kerma ◽  
Chest X Ray ◽  
The Difference ◽  
Area Product ◽  
Weight Groups

Objective: To compare age groupings versus weight groupings in the calculation of typical air kerma area product (PKA) values in paediatric X-ray exams of chest and abdomen in our hospital. Methods: Data were analysed from 687 abdominal and 1374 chest X-ray examinations. The PKA of exams was extracted with Radimetrics, and patient weights were collected from electronic records. Data were organised in different age groups and typical PKA values were estimated. The process was repeated by organising data in different weight groups. Results: Typical PKA values for the four younger age groups (<1m, 1m - < 4y, 4y - < 10y and 10y - < 14y) were comparable to typical values for their equivalent weight groups (<5 kg, 5–15 kg, 15–30 kg and 30–50 kg, respectively). However, typical PKA values at the late adolescent age group (14y - < 18y) were much lower than its equivalent weight group (>50 kg). Conclusions: Age and weight groupings were found at our site to be interchangeable for the calculation of typical paediatric PKA values. The only exception was the late adolescent group, whose weight distribution can account for the difference in typical PKA results within its equivalent weight group. Advances in knowledge: In calculating typical PKA values for radiological paediatric body examinations, departments must ascertain if using age groups, which is typical practice, is equivalent to using weight groups. Otherwise, results may misrepresent local practice.

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