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European Journal of Vascular and... Jul 2015Endovascular procedures, requiring X-ray guidance, are commonly performed in vascular surgery. X-ray exposure is associated with biological risks for both patients and... (Review)
Review
CONTEXT
Endovascular procedures, requiring X-ray guidance, are commonly performed in vascular surgery. X-ray exposure is associated with biological risks for both patients and physicians. Medical X-ray use must follow "as low as reasonably achievable" (ALARA) principles, which aim at using the lowest radiation exposure to achieve a procedure safely. This is underlined by European and international recommendations that also suggest that adequate theoretical and practical training is mandatory during the initial education of physicians. However, the content of this education and professional practices vary widely from one country to another.
OBJECTIVE
This review aims to summarize the basic knowledge required for vascular surgeons on X-ray physics and image production.
METHODS
A panel of endovascular therapists (vascular surgeons and radiologists) and physicists dedicated to X-rays was gathered. International recommendations were summarized. A literature review was performed via MEDLINE to identify studies reporting dosages of common endovascular procedures.
RESULTS
The different mechanisms inducing biological risks, and the associated potential effects on health, are described. Details on dose metrics are provided and a common nomenclature to measure, estimate, and report dose is proposed in order to perform accurate comparisons between publications and practices. Key points of the European and international legislation regarding medical X-ray use are summarized, and radiation protection basics for patients and staff, are detailed. Finally, a literature review is proposed for physicians to evaluate their practice.
CONCLUSIONS
Today's trainees will be highly exposed to radiation throughout their practice. It is thus compulsory that they undergo dedicated radiation education during their initial training, and regular refresher sessions later. In daily practice, focus on dose reduction and monitoring of patient and staff exposure are mandatory.
Topics: Endovascular Procedures; Humans; Occupational Exposure; Radiation Dosage; Radiation Protection; Records; Risk Factors
PubMed: 25818982
DOI: 10.1016/j.ejvs.2015.01.014 -
Italian Journal of Pediatrics Oct 2020In the recent years, clinical progress and better medical assistance for pregnant women, together with the introduction of new complex technologies, has improved the...
BACKGROUND
In the recent years, clinical progress and better medical assistance for pregnant women, together with the introduction of new complex technologies, has improved the survival of preterm infants. However, this result requires frequent radiological investigations mostly represented by thoracic and abdominal radiographs in incubators. This document was elaborated by an expert panel Italian inter-society working group (Radiologists, Paediatricians, Medical Physicists) with the aim to assist healthcare practitioners in taking choices involving radiation exposures of new-born infants and to provide practical recommendations about justification and optimization in Neonatal Intensive Care Units. The adherence to these practice recommendations could ensure a high quality and patient safety. More complex and less common radiological practice, such as CT scan or fluoroscopy have been excluded.
METHODS
The consensus was reached starting from current good practice evidence shared by four scientific societies panel: AIFM (Italian Association of Physics in Medicine), SIN (Italian Neonatology Society), SIP (Italian Paediatric Society), SIRM (Italian Medical Radiology Society) in order to guarantee good standard practices for every professional involved in Neonatal Intensive Care Units (NICU). The report is divided into clinical and physical-dosimetric sections: clinical Indications, good practice in radiological exposures, devices, exposure parameters and modalities, patient positioning and immobilization, Reference Diagnostic Levels, operators and patient's radiation protection. Another important topic was the evaluation of the different incubators in order to understand if the consequences of the technological evolution have had an impact on the increase of the dose to the small patients, and how to choose the best device in terms of radiation protection. At the end the working group faced the problem of setting up the correct communication between clinicians and parents following the most recent indications of the international paediatric societies.
RESULTS
Taking into account the experience and expertise of 10 Italian Centres, the guideline sets out the criteria to ensure a high standard of neonatal care in NICU about procedures, facilities, recommended equipment, quality assurance, radiation protection measures for children and staff members and communication on radiation risk.
CONCLUSIONS
This document will allow a standardization of the approach to the exposures in NICU, although oriented to a flexible methodology.
Topics: Consensus; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Italy; Patient Positioning; Radiation Exposure; Radiation Protection; Societies, Medical
PubMed: 33109231
DOI: 10.1186/s13052-020-00905-5 -
Zeitschrift Fur Medizinische Physik Feb 2024
Topics: Radiation Protection
PubMed: 38262888
DOI: 10.1016/j.zemedi.2024.01.004 -
Journal of Medical Systems Dec 2018A CT system with a tablet as mobile user interface and a wireless remote control for positioning and radiation release has recently been presented. Our aim was to...
A CT system with a tablet as mobile user interface and a wireless remote control for positioning and radiation release has recently been presented. Our aim was to evaluate the effects of a mobile CT examination workflow on the radiographers' performance compared to conventional examinations. A prototype of a radiation protection cabin was installed besides the gantry of a CT system. The CT system was equipped with a simplified user interface on a portable tablet and a mobile remote control. 98 patients with an indication for CT of the chest were randomly assigned to examination using the mobile devices (study group, n = 47) or using the conventional stationary workflow on the console (reference group, n = 51). Three ceiling mounted fisheye cameras were used for motion tracking of the radiographers, two in the examination room and one in the control room. Relative density of detection heat-maps and area counts were assessed using a dedicated software tool to quantify radiographers' movements. Duration of each task of the examination was manually recorded using a stopwatch. In the reference group 25% of the area counts were located inside of the examination room, while it was 48% in the study group. The time spent in the same room with the patient increased from 3:06 min (29%) to 6:01 min (57%) using the mobile workflow (p < 0.05), thereof 0:59 min (9%) were spent in moderate separation with maintained voice and visual contact in the radiation protection cabin. Heat-maps showed an increase of the radiographer's working area, indicating a higher freedom of movement. Total duration of the examination was slightly less in the study group without statistical significance (median time: study 10:36, reference 10:50 min; p = 0.29). A mobile CT examination transfers the radiographers' interaction with the scanner from the control room into the examination room. There, radiographers' freedom of movement is higher, without any tradeoffs regarding the examination duration.
Topics: Computers, Handheld; Humans; Movement; Point-of-Care Systems; Radiation Protection; Task Performance and Analysis; Thorax; Time Factors; Tomography, X-Ray Computed; User-Computer Interface; Workflow
PubMed: 30535865
DOI: 10.1007/s10916-018-1131-2 -
Proceedings of the Japan Academy.... 2012The severe accident that broke out at Fukushima Dai-ichi nuclear power stations on March 11, 2011, caused seemingly infinite damage to the daily life of residents.... (Review)
Review
The severe accident that broke out at Fukushima Dai-ichi nuclear power stations on March 11, 2011, caused seemingly infinite damage to the daily life of residents. Serious and wide-spread contamination of the environment occurred due to radioactive materials discharged from nuclear power stations (NPSs). At the same time, many issues were highlighted concerning countermeasures to severe nuclear accidents. The accident is outlined, and lessons learned are extracted with respect to the safety of NPSs, as well as radiation protection of residents under the emergency involving the accident. The materials of the current paper are those released by governmental agencies, academic societies, interim reports of committees under the government, and others.
Topics: Engineering; Fukushima Nuclear Accident; Humans; Nuclear Power Plants; Radiation Monitoring; Radiation Protection; Radioactive Pollutants; Social Control, Formal
PubMed: 23138450
DOI: 10.2183/pjab.88.471 -
British Medical Journal Nov 1957
Topics: Accidents; Humans; Radiation Protection
PubMed: 13472078
DOI: No ID Found -
Public Health Reports (Washington, D.C.... Jun 1960
Topics: Humans; Radiation Protection; X-Rays
PubMed: 13833642
DOI: No ID Found -
Journal of Applied Clinical Medical... Feb 2020This technical note presents an inexpensive tool and method for determining lead equivalency using digital radiography x-ray equipment.
PURPOSE
This technical note presents an inexpensive tool and method for determining lead equivalency using digital radiography x-ray equipment.
METHODS
A test tool was developed using commercially available lead tape (3M™ Lead Foil Tape 421). The test tool consisted of nine varying lead thick squares arranged in a larger square (0.1, 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, and 1.0 mm). It was imaged on a DR plate with a digital portable x-ray unit across a range of energies (60-120 kVp) and two beam filtrations. Lead equivalency was determined by using the linear relationship between dose to the detector and pixel values in the raw images. The lead equivalency of the tape was validated using known lead thicknesses (physically measured with caliper). Additional lead equivalency measurements were made for protective eyewear, a thyroid shield, and a lead apron.
RESULTS
The test tool and method measured the two known lead thicknesses to be -9.7% to 7.1% different from the actual values across the range of energies under normal x-ray beam conditions and under a 1-mm copper filtered x-ray beam. The additional lead equivalency measurements of radiation protection apparel across energies ranged from -6% to 20% for both beam conditions when compared with the values provided by the manufacturer.
CONCLUSION
This work validates the test tool and methodology as an inexpensive alternative to checking the lead equivalency of radiation protection apparel in a clinical setting. The methodology is equipment independent with a few prerequisites.
Topics: Equipment Design; Filtration; Humans; Image Processing, Computer-Assisted; Lead; Protective Clothing; Radiation Dosage; Radiation Protection; Radiographic Image Enhancement; Radiography; Reproducibility of Results; Scattering, Radiation; X-Rays
PubMed: 31916401
DOI: 10.1002/acm2.12810 -
Scientific Reports Sep 2022In this work, morphological and attenuation parameters of gamma ray protection were studied. Dimethyl polysiloxane (Silicon Rubber) Mixed with micro-size and nano-size...
In this work, morphological and attenuation parameters of gamma ray protection were studied. Dimethyl polysiloxane (Silicon Rubber) Mixed with micro-size and nano-size lead oxide particles at different weight percentage were prepared. The morphological structure of PbO/SR composites was investigated by SEM test, according to SEM images the nano PbO particles are more uniform micro PbO particles. The radiation attenuation test was carried out using 3" × 3" NaI (TI) detector for (Am-241), (Cs-137), (Co-60), (Ba-133), and (Eu-152). The effect on attenuation property of SR-PbO shown that the increase of PbO filler significantly increases the linear attenuation coefficient and improve the other radiation protection parameters especially at low gamma energy. It's found that a significant agreement between the experimental result and theoretical result from Xcom program. In this study it's found matrix filled with nano-PbO have higher gamma shielding ability compared to micro-PbO matrix at the same filler concentration. It can say that SR-nano PbO has a higher radiation protection than SR-micro PbO compositions.
Topics: Cesium Radioisotopes; Dimethylpolysiloxanes; Nanoparticles; Radiation Protection; Rubber; Silicon
PubMed: 36127499
DOI: 10.1038/s41598-022-20103-z -
International Journal of Molecular... Sep 2020Low-temperature treatments (i.e., hypothermia) may be one way of regulating environmental radiation damage in living systems. With this in mind, hibernation under... (Review)
Review
Low-temperature treatments (i.e., hypothermia) may be one way of regulating environmental radiation damage in living systems. With this in mind, hibernation under hypothermic conditions has been proposed as a useful approach for long-term human space flight. However, the underlying mechanisms of hypothermia-induced radioresistance are as yet undetermined, and the conventional risk assessment of radiation exposure during hibernation remains insufficient for estimating the effects of chronic exposure to galactic cosmic rays (GCRs). To promote scientific discussions on the application of hibernation in space travel, this literature review provides an overview of the progress to date in the interdisciplinary research field of radiation biology and hypothermia and addresses possible issues related to hypothermic treatments as countermeasures against GCRs. At present, there are concerns about the potential effects of chronic radiation exposure on neurological disorders, carcinogenesis, ischemia heat failures, and infertility in astronauts; these require further study. These concerns may be resolved by comparing and integrating data gleaned from experimental and epidemiological studies.
Topics: Astronauts; Humans; Hypothermia, Induced; Radiation Injuries; Radiation Protection; Space Flight
PubMed: 32882991
DOI: 10.3390/ijms21176349