The number of examinations using interventional radiology (IVR) has increased recently. Because of the more advanced and more complex procedures for IVR, longer treatment time is required. Therefore, it is important to determine exposure doses. We measured operator exposure dose during IVR using a thermoluminescence dosimeter. The results revealed the dose equivalent to the operator's hands and fingers to be higher than that of other parts, although the effective dose for the operator was low. Moreover, we looked into the factors that affected exposure dose to the operator's fingers, and examined ways to reduce the dose. In regard to the exposed dose to the operator's fingers, dose reduction was possible as a result of a geometric arrangement of the fluoroscopic unit, the radiation field size, using a radiation protective device and deliberation to exposure dose reduction of the operator. It is possible to carry out IVR more safely using the method of exposure dose reduction to the operator's fingers.
Most contrast agents used in digital subtraction angiography (DSA) are non-ionic iodinated contrast agents, which can cause severe side effects in patients with contraindications for iodine or allergic reactions to iodine. Therefore, DSA examinations using carbon dioxide gas or examinations done by magnetic resonance imaging (MRI) and ultrasound (US) were carried out in these patients. However, none of these examinations provided images as clear as those of DSA with an iodinated contrast agent. We experienced DSA examination using a gadolinium contrast agent in a patient contraindicated for iodine. The patient had undergone MRI examination with a gadolinium contrast agent previously without side effects. The characteristics of gadolinium and the iodinated contrast agent were compared, and the DSA images obtained clinically using these media were also evaluated. The signal-to-noise (SN) ratio of the gadolinium contrast agent was the highest at tube voltages of 70 to 80 kilovolts and improved slightly when the image intensifier (I.I.) entrance dose was greater than 300 microR (77.4 nC/kg). The dilution ratios of five iodinated contrast agents showed the same S/N value as the undiluted gadolinium contrast agent. Clinically, the images obtained showed a slight decrease in contrast but provided the data necessary to make a diagnosis and made it possible to obtain IVR without any side effects. DSA examinations using a gadolinium contrast agent have some benefit with low risk and are thought to be useful for patients contraindicated for iodine.
二 ed Aug . 2 , 2000 ; CDde Nos . 621 、 814 ゆ mommwwwwwwww ー pm . ww and measured entrance dc)ses , the deviation was about 10 % in phan − tom studies and 20 % in the clinical setting . Using our equation , calculation of entrance skin dose is pos − sible from area exposure product and is useful forpatient dose control in the clinical setting .
Because of the more advanced and more complex procedures in interventional radiology (IVR), longer treatment times have become necessary. Therefore, it is important to determine the exposure doses received by operators and patients. Operator doses arising from the use of X-rays are mainly due to scattered radiation. The purpose of this study was to assess the feasibility of estimating operator dose by dose area product (DAP), which shows the total X-ray output from the collimator. DAP showed a strong correlation with the space dose from the fundamental examination. In clinical practice, we measured the exposure doses of the neck, left shoulder, left hand, and right finger using a thermoluminescence dosimeter (TLD). These then were compared with the DAP. The results indicated that the dose equivalents (H70 microm) of the neck and left shoulder were strongly correlated with DAP (r=0.85, 0.86), whereas the H70 microm of the left hand and right finger were less closely correlated (r=0.40, 0.48). In comparison with the fluoroscopic time, the dose equivalents showed a better correlation with DAP in all the evaluated parts. The effective doses for the operator were strongly correlated with DAP (r=0.87). When measurements are not available, dose equivalents and operator effective doses can be estimated by the DAP, as indicated by the strong correlations recognized in this study.
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