Ionizing irradiation and the induction of clinically significant disease in the human thyroid gland

Maxon, Harry R.; Thomas, Stephen R.; Saenger, Eugene L.; Buncher, C. Ralph; Kereiakes, James G.

doi:10.1016/0002-9343(77)90552-6

Cited by 202 publications

(58 citation statements)

References 31 publications

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“…Nevertheless, these studies collectively demonstrate a dose-response relationship between external radiation dose and the development of benign thyroid adenomas and thyroid cancers (14). There have been six principal studies involving populations exposed to external radiation (20,(31)(32)(33)(34)(35). The range of median doses evaluated has been between approximately 60 to 8080 mGy to the thyroid.…”

Section: B1 Thyroid Neoplasia: Exposure To External Photon Radiationmentioning

confidence: 99%

Risk of Thyroid Cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station Accident

Davis

Stepanenko

Rivkind³

et al. 2004

Radiation Research

104

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Section: B1 Thyroid Neoplasia: Exposure To External Photon Radiationmentioning

confidence: 99%

Risk of Thyroid Cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station Accident

Davis

Stepanenko

Rivkind³

et al. 2004

Radiation Research

104

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“…Adverse effects of radiation exposure due to scatter during C-arm fluoroscopic imaging include an increased risk of cancer, sterility, and eye damage. [21][22][23] Kahn et al explored radiation used by residents in DHS procedures and showed the primary differentiator in radiation exposure is surgical experience. 24 Multiple studies have also shown that an increase in surgical experience results in a decrease of radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

Assessing Wire Navigation Performance in the Operating Room

Taylor

Thomas

Karam

et al. 2016

Journal of Surgical Education

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Objective-There are no widely accepted, objective, and reliable tools for measuring surgical skill in the operating room (OR). Ubiquitous video and imaging technology provide opportunities to develop metrics that meet this need. Hip fracture surgery is a promising area in which to develop these measures because hip fractures are common, the surgery is used as a milestone for residents, and it demands technical skill. The study objective is to develop meaningful, objective measures of wire navigation performance in the OR.Design-Resident surgeons wore a head-mounted video camera while performing surgical open reduction and internal fixation using a dynamic hip screw. Data collected from video included: duration of wire navigation, number of fluoroscopic images, and the degree of intervention by the surgeon's supervisor. To determine reliability of these measurements, four independent raters performed them for two cases. Raters independently measured the tip-apex distance (TAD), which reflects the accuracy of the surgical placement of the wire, on all 7 cases. Setting-University of Iowa Hospitals and Clinics in Iowa City, IA -a public tertiary academic center.Participants-Seven surgeries were performed by seven different orthopaedic residents. All ten raters were biomedical engineering graduate students.Results-The means and standard deviations for AP, lateral, and combined TAD measurements of the 10 raters were 2.7, 1.9, and 3.7 mm, respectively, and inter-rater reliability produced a Cronbach's Alpha of 0.97. The inter-rater reliability analysis for all 9 video-based measures produced a Cronbach's Alpha of 0.99.Conclusions-Several video-based metrics were consistent across the four video reviewers and are likely to be useful for performance assessment. The TAD measurement was less reliable than previous reports have suggested but remains a valuable metric of performance. Non-experts can reliably measure these values and they offer an objective assessment of OR performance.

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“…2,3 Nevertheless, repeated use of low doses of radiation is still concerning as there is evidence to suggest that exposure to radiation over time is associated with an increased risk of adverse effects such as malignancies, ocular injuries and thyroid disorders. [4][5][6][7][8][9] It is the responsibility of the operating surgeon to minimise radiation exposure to patients by adopting the ALARA (as low as reasonably achievable) principle. 5 Although this same principle should be practised when it comes to our own protection, there seems to be a lack of awareness among surgical trainees.…”

mentioning

confidence: 99%

The effect of surgical experience on the amount of radiation exposure from fluoroscopy during dynamic hip screw fixation

Quah

Mehta

Shivji

et al. 2017

annals

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INTRODUCTION Dynamic hip screw (DHS) fixation for proximal femur fractures is one of the most common procedures in trauma that requires the use of fluoroscopy. Emphasis is often placed on producing the 'perfect picture', which may lead to excessive use of fluoroscopy, without added patient benefit. This study, the largest of its kind, aimed to determine the effect of surgical experience on the amount of radiation exposure from fluoroscopy during DHS fixation. METHODS All hospital admissions for extracapsular proximal femur fractures to our institution between 2007 and 2012 were analysed. Patient demographics, fracture configuration, grade of surgeon and the total radiation dose after fixation were recorded. Analysis of variance was performed to assess differences in radiation levels between different grades of surgeon. RESULTS A total of 1,203 patients with a mean age of 81.3 years (range: 21-105 years) were included in the study. The majority of the fractures were three-part (33.3%), followed by two-part (32.2%), four-part (25.7%) and basicervical (8.9%). Registrars (ST3-ST8) used a significantly higher radiation dose than consultants for all fracture types (p=0.009). When analysed separately by trainee group, the most junior registrars (ST3-ST4) and the most senior registrars (ST7-ST8) were found to use significantly higher radiation levels than consultants (p=0.037 and p<0.001 respectively). CONCLUSIONS The level of surgical experience does influence the amount of radiation exposure from fluoroscopy during DHS fixation. Surgical trainees should not ignore the potential harmful effects of radiation and should be equipped with the knowledge of how to keep the radiation exposure as low as possible.

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Ionizing irradiation and the induction of clinically significant disease in the human thyroid gland

Cited by 202 publications

References 31 publications

Risk of Thyroid Cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station Accident

Risk of Thyroid Cancer in the Bryansk Oblast of the Russian Federation after the Chernobyl Power Station Accident

Assessing Wire Navigation Performance in the Operating Room

The effect of surgical experience on the amount of radiation exposure from fluoroscopy during dynamic hip screw fixation

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