Patient cumulative radiation exposure in interventional cardiology

Bernier, Marie‐Odile; Jacob, Sophie; Maccia, C.; Bar, Olivier; Catelinois, Olivier; Blanchard, Didier; Laurier, Dominique

doi:10.1051/radiopro/2011157

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…However, such dose limits may be exceeded in the operating room (Feghali et al, 2014), especially during percutaneous vertebroplasty because of potential repetition of scouting exposures due to a limited view of the surgical field (Komemushi et al, 2005;Synowitz and Kiwit, 2006). Thus both patients' and workers' dose reduction are necessary (Bernier et al, 2012;Bourguignon et al, 2017) to reduce the risk of cancer (Jacob et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

et al. 2020

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To assess the impact of a computer assisted navigation system (CAN) (CT-Navigation™ IMACTIS, France) on patient radiation doses during percutaneous CT vertebroplasty a retrospective comparative trial was performed and included 37 patients requiring percutaneous vertebroplasty. This study was approved by CCN (Centre Cardiologique du Nord, Saint-Denis, France) ethical committee; all patients provided informed consent. All procedures were conducted in the interventional radiology department at CCN, by an experienced single radiologist using the same model and CT scan with identical parameters. The interventional dose length product (IDLP), representing the absorbed dose by the length of explored organs during the needle insertion phase, was compared in 15 consecutive patients who underwent a conventional procedure (CT control group), and in 22 patients who underwent CAN CT vertebroplasty (CAN group). The IDLP difference between the two groups was evaluated using Mann–Whitney U test. The median IDLP dose for the CAN group was 305.6 mGy.cm [182.3; 565.4], representing a reduction by a 3.2 factor compared with that of the conventional CT group (median 975.2 mGy.cm [568.3; 1077.1]; p < 0.001). The median procedure duration for the CAN group was 50 min [35; 60] vs. 100 min [82; 100] in the CT group (p < 0.001), representing a 50% reduction. In experienced hands, use of a CT-Navigation™ system (IMACTIS®) significantly reduced both patient radiation dose and procedure duration when compared to conventional CT guided percutaneous vertebroplasty.

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Section: Introductionmentioning

confidence: 99%

Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

et al. 2020

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“…The first is the risk of radiation-induced skin injuries, with also the possible development of radiation-induced cancer of chest organs. 2,3 The other is contrast-induced nephropathy due to the high concentration of contrast media injected into the patient. 4 These side effects can be reduced with lower doses of both x-rays and IRCA, but the resulting images suffer from higher noise level and weaker contrast compared with PCI images of high-dose x-rays and IRCA.…”

Section: Introductionmentioning

confidence: 99%

Convolutional neural network-based image enhancement for x-ray percutaneous coronary intervention

et al. 2018

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Percutaneous coronary intervention (PCI) uses x-ray images, which may give high radiation dose and high concentrations of contrast media, leading to the risk of radiation-induced injury and nephropathy. These drawbacks can be reduced by using lower doses of x-rays and contrast media, with the disadvantage of noisier PCI images with less contrast. Vessel-edge-preserving convolutional neural networks (CNN) were designed to denoise simulated low x-ray dose PCI images, created by adding artificial noise to high-dose images. Objective functions of the designed CNNs have been optimized to achieve an edge-preserving effect of vessel walls, and the results of the proposed objective functions were evaluated qualitatively and quantitatively. Finally, the proposed CNN-based method was compared with two state-of-the-art denoising methods: K-SVD and block-matching and 3D filtering. The results showed promising performance of the proposed CNN-based method for PCI image enhancement with interesting capabilities of CNNs for real-time denoising and contrast enhancement tasks.

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“…The methodology for dosimetric evaluation is detailed elsewhere (Bernier et al, 2012). It allowed obtaining lung and bone marrow doses corresponding to a CA alone, CA and ad hoc PTCA, and CA and elective PTCA.…”

Section: Organ Dosesmentioning

confidence: 99%

“…However, little is known about lung and bone marrow doses and associated cancer risk. With the aim of setting up an epidemiological study to examine the excess risk of radiation-induced cancer due to ICPs, we first presented clinical characteristics and 1-year cumulative doses for a sample of 1591 French patients in a previous article (Bernier et al, 2012). In a second step, a specific risk assessment for cancer was carried out.…”

Section: Introductionmentioning

confidence: 99%

Risk assessment for potential radiation-induced cancer after lung and bone marrow exposure during interventional cardiology procedures

Jacob

Bar²,

Catelinois

et al. 2012

Radioprotection

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Interventional cardiology procedures (ICPs), while providing important benefits topatients, also contribute to their radiation exposure, in particular for the organs surrounding the heart. This paper addresses the issue of radiation exposure to the lung and bone marrow related to coronary interventions in terms of organ doses for coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA), and risk assessment of potential radiation-induced cancer. Dosimetric information on 2095 ICPs from French patients was collected. The median lung dose for CA alone was 34 mGy for men and 22 mGy for women and the median bone marrow dose was 8 mGy and 4 mGy, respectively; doses were slightly higher for CA and ad hoc PTCA and nearly twice as high for CA and elective PTCA. Based on the French national mortality registry and Biological Effects of Ionising Radiation VII models, spontaneous and radiation-induced lung cancers and leukaemia were estimated. For men and women aged at least 60 years old at the first ICP, excess risk of potentially fatal cancers attributable to radiation ranged from 0.4% to 4%. This study provides evidence of the potential risk of radiation-induced cancer after an ICP. The limitations of such calculations are due to the difficulty of taking into account patients' possibly shorter life expectancy than in the general population, linked to their comorbidities and coronary disease. Nevertheless, risk estimates can be used to illustrate the beneficial role of optimisation of doses delivered to the patient.

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Patient cumulative radiation exposure in interventional cardiology

Cited by 3 publications

References 26 publications

Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

Reduction of patient radiation dose during percutaneous CT vertebroplasty: Impact of a new computer-assisted navigation (CAN) system

Convolutional neural network-based image enhancement for x-ray percutaneous coronary intervention

Risk assessment for potential radiation-induced cancer after lung and bone marrow exposure during interventional cardiology procedures

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