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Augmented Reality for Reducing Intraoperative Radiation Exposure to Patients and Clinicians during X-Ray Guided Procedures
Published in Terry M. Peters, Cristian A. Linte, Ziv Yaniv, Jacqueline Williams, Mixed and Augmented Reality in Medicine, 2018
Nicolas Loy Rodas, Nicolas Padoy
The monitoring of staff’s exposure is currently achieved either by means of dosimeters, which provide the effective dose value at the measuring position, or by using estimations provided by the imaging device (e.g., dose area product). Yet, studies have reported large variations in the occupational exposure per procedure and per person’s body part (Nikodemová et al. 2011), so the full body exposure of clinicians cannot be assessed solely by dosimeters. Also, correlations between the dose values provided by the imaging device and the exposure of clinicians can hardly be found because such estimations do not consider the parameters affecting scattered radiation propagation, which are external to the device (Carinou et al. 2011). Therefore, operators cannot use such values as an indicator of their likely radiation exposure.
Radiation safety
Published in Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead, Cardiovascular Catheterization and Intervention, 2017
Radiation dose to the patient can also be semi- quantitated (Figure 3.6). It is estimated using the dose-area- product (DAP) and/or the air kerma (kinetic energy released in matter). These data are now required as part of the car- diac catheterization report.[9] The DAP is calculated using data derived from an ionization chamber that is placed at the output of the X-ray tube. It is the absorbed radiation dose multiplied by the area radiated and is expressed in Gy/cm[2]. The DAP is a measure of the total X-ray dose that exited the X-ray tube during the procedure. It does not pro- vide information on where the radiation went, but rather only defines how much radiation was emitted. For example, a 5 X 5 cm X-ray field with an entry dose of 1 mGy will result in a DAP value of 25 mGy/cm[2]. The DAP has been shown to correlate with the risk of stochastic injury.[10] The air kerma value reported is an attempt to express how much radiation dose was delivered to the patient’s skin. It is measured in Gray (Gy) units. It is sometimes referred to as the interven- tional reference point and is determined by assuming the patient’s skin is about 15 cm from this isocenter.[11,12] Using the data from the ionizing chamber, and the data regard- ing location of the patient table, X-ray tube, and flat panel detector, a mathematical estimate of skin exposure can be derived. Thus, the air kerma value provides a semi-quantita- tive estimate of the risk for deterministic injury (for the skin in particular) in much the same manner as the DAP pro- vides data for estimating potential stochastic injury. Since the two measures require similar data from the ionizing chamber, the DAP is also referred to in some publications as the air kerma product.
New tools to reduce radiation exposure during aortic endovascular procedures
Published in Expert Review of Cardiovascular Therapy, 2022
Jurre Klaassen, Linde J. Vijn, Constantijn E.V.B. Hazenberg, Joost A. van Herwaarden
Selected studies were grouped based on the examined tool that contributes to reduction of radiation exposure. The following main outcome characteristics were extracted from the selected studies: first author, year of publication and type of study, type of intervention or used model, conclusion, and limitations. Subsequently, if reported, the following characteristics were extracted from all included clinical studies in which (potential) radiation reducing tool is compared with a conventional control group: used tool, number of patients included, type of intervention, procedure time (minutes), cumulative radiation dose expressed in air kerma (AK, mGy) or dose area product (DAP, Gycm2), fluoroscopy time (minutes), and contrast volume (mL). In addition, for studies describing tools used during endovascular cannulation of target vessels, the following characteristics were extracted: used tool, study type, model/intervention, cannulation tasks, cannulation attempts, vessel wall hits, cannulation time (minutes), and fluoroscopy time (minutes).
Radiation exposure during angiographic interventions in interventional radiology – risk and fate of advanced procedures
Published in International Journal of Radiation Biology, 2022
Hanns Leonhard Kaatsch, Julian Schneider, Carolin Brockmann, Marc A. Brockmann, Daniel Overhoff, Benjamin Valentin Becker, Stephan Waldeck
The terms ‘high-dose’ and ‘low-dose’ are commonly used in the context of radiation application ranging from radiation protection to environmental exposure or from radiotherapy to simple X-ray diagnostics. However, these terms are occasionally associated to different dose values causing a misunderstanding when talking about ‘high-’ or ‘low-dose’ radiation exposure (Sohrabi 1997). Within the field of radiology, angiographic interventions and computed tomography are usually referred to as high-dose procedures (Hall and Brenner 2008; Mettler et al. 2008; Jaschke et al. 2020). At the same time, applied dose levels in IR vary depending on the region of interest as well as complexity of the intervention with commonly higher doses in abdominal and neurointerventional procedures among others (Miller et al. 2003; Lee et al. 2019). As an example, dose ranges for angiographic interventions in national reference levels for Germany differ up to factor 10 (from 2500 cGy*cm2 dose area product (DAP) in lower leg percutaneous transluminal angiography to 25,000 cGy*cm2 DAP in intracranial cerebral aneurysm repair) (Loose et al. 2020).
Visibility of anatomical landmarks in the region of the mandibular third molar, a comparison between a low-dose and default protocol of CBCT
Published in Acta Odontologica Scandinavica, 2023
Josefine Cederhag, Durer Iskanderani, Per Alstergren, Xie-Qi Shi, Kristina Hellén-Halme
Two CBCT scans were acquired of each examination site: one scan using the default protocol (90 kV, 5 mA, 9.4 s) and one, the low-dose protocol (90 kV, 2 mA, 9.4 s). All exposures were made with a Veraviewepocs 3D F40 (J Morita Corp.; Kyoto, Japan) using a field of view (FOV) of 4.0 × 4.0 cm and a rotation mode of 180°, voxel size of 0.125 mm. The dose area product (DAP) values provided by the CBCT unit were 330 mGy cm2 for the default protocol and 132 mGy cm2 for the low-dose protocol.