Effect of Exposure Angulation on the Occupational Radiation Exposure during Cardiac Angiography: Simulation Study

Roh, Younghoon; Kim, Jung-Su; Park, Hyemin; Kim, Jungmin; Ryu, Dongryeol; Chun, Kukjin; Seo, Jong-Kwon; Lee, Bongki; Cho, Byungryul; Yoon, Yongsu

doi:10.3390/ijerph18158097

Cited by 6 publications

(1 citation statement)

References 23 publications

(22 reference statements)

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“…Changes in the angulation of the X-ray tube might also be helpful in such a scenario. However, theoretically this would also lead to an increase in radiation dose [31].…”

Section: Discussionmentioning

confidence: 99%

Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study

Augustin

Detomas

Hartung

et al. 2023

Rofo

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Purpose To assess radiation exposure and diagnostic performance of bilateral inferior petrosal sinus sampling for the distinction of pituitary and ectopic adrenocorticotropin-dependent Cushingʼs syndrome. Materials and Methods Procedural data of bilateral inferior petrosal sinus procedures were retrospectively evaluated. The analysis included the patients’ clinical and demographic data, procedural radiation exposure, and complication rates, sampling results, clinical course of the patients, and calculation of diagnostic performance data. Results The cases of 46 patients diagnosed with adrenocorticotropin-dependent Cushingʼs syndrome were evaluated. Bilateral inferior petrosal sinus sampling was successfully performed in 97.8 % of the cases. The overall median procedure-related fluoroscopy time was 7.8 min. (range 3.2–36.2 min.), and the median procedural dose area product was 11.9 Gy*cm2 (range 2.1–73.7 Gy*cm2). Radiation doses due to digital subtraction angiography series for visualization of the inferior petrosal sinus were 3.6 Gy*cm2 (range 1.0–18.1 Gy*cm2). Radiation doses due to fluoroscopy had a higher impact on the overall radiation exposure and were significantly influenced by the patients’ habitus. The sensitivity, specificity, and positive and negative predictive values were 84 %, 100 %, 100 %, and 72 % before stimulation with corticotropin-releasing hormone, and 97 %, 100 %, 100 %, and 93 % after stimulation. Concordance between magnetic resonance imaging studies and bilateral inferior petrosal sinus sampling results was only found in 35.6 % of the cases. The periprocedural complication rate was 2.2 %, with one patient experiencing vasovagal syncope during catheterization. Conclusion Bilateral inferior petrosal sinus sampling is a safe procedure with high technical success rates und excellent diagnostic performance. The procedure-related radiation exposure shows large variations and depends on the complexity of cannulation as well as the patients’ habitus. Fluoroscopy accounted for the largest proportion of radiation exposure. Acquisition of digital subtraction angiography series for the verification of correct catheter placement appears justified. Key Points: Citation Format

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“…Changes in the angulation of the X-ray tube might also be helpful in such a scenario. However, theoretically this would also lead to an increase in radiation dose [31].…”

Section: Discussionmentioning

confidence: 99%

Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study

Augustin

Detomas

Hartung

et al. 2023

Rofo

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Annual radiation dose monitoring for catheterization laboratory operators

Alyami,

Nassef

2024

Radiation Physics and Chemistry

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Evaluation of radiation protection effectivity in a cardiac angiography room using visualized scattered radiation distribution

Fujibuchi,

Nakashima,

Arakawa

et al. 2024

J. Radiol. Prot.

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In this study, we devised a radiation protection tool specifically designed for healthcare professionals and students engaged in cardiac catheterization to easily monitor and evaluate scattered radiation distribution across diverse C-arm angles and arbitrary physician associated staff positions - scrub nurse, technologist positions. In this study, scattered radiation distributions in an angiography room were calculated using the Monte Carlo simulation of PHITS code. Four visualizations were performed under different C-arm angles with and without radiation protection: 1) a dose profile, 2) a 2D cross-section, 3) a 3D scattered radiation distribution, and 4) a 4D scattered radiation distribution. The simulation results detailing the scattered radiation distribution in PHITS were exported in Visualization Toolkit (vtk) format and visualized through the open-source visualization application ParaView for analysis. Visualization of the scattered dose showed that dose distribution depends on the C-arm angle and the X-ray machine output parameters (kV, mAs/second, beam filtration) which depend upon beam angulation to the patient body. When irradiating in the PA direction, the protective curtain decreased the dose by 62% at a point 80 cm from the floor, where the physician’s gonads are positioned. Placing the protection board close to the X-ray tube reduced the dose by 24% at a location 160 cm from the floor, where the lens of the eye is situated. Notably, positioning the protection board adjacent to the physician resulted in a 95.4% reduction in incident air kerma. These visualization displays can be combined to understand the spread and direction of the scattered radiation distribution and to determine where and how to operate and place radiation protection devices, accounting for the different beam angulations encountered in interventional cases. This study showed that scatter visualization could be a radiation protection teaching aid for students and medical staff in angiography rooms.

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Effect of Exposure Angulation on the Occupational Radiation Exposure during Cardiac Angiography: Simulation Study

Cited by 6 publications

References 23 publications

Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study

Bilateral inferior petrosal sinus sampling: Procedural data from a German single-center study

Annual radiation dose monitoring for catheterization laboratory operators

Evaluation of radiation protection effectivity in a cardiac angiography room using visualized scattered radiation distribution

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