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Todd Yecies, Timothy D Averch, Michelle J Semins
INTRODUCTION: The risks of exposure to medical ionizing radiation is of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high-volume of fluoroscopy guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low dose computed tomography (CT) scan, and modifying use of current technology such as increasing ultrasound and pulsed fluoroscopy utilization offers the possibility of significantly reducing radiation exposure...
February 2018: Canadian Journal of Urology
Ching-Ching Yang, Pei-Chieh Yu, Jau-Ming Ruan, Yu-Cheng Chen
PURPOSE: The target detectability of cone beam computed tomography (CBCT) performed in image-guided radiation therapy (IGRT) was investigated to achieve sufficient image quality for patient positioning over a course of treatment session while maintaining radiation exposure from CBCT imaging as low as reasonably achievable (ALARA). METHODS: Body CBCT scans operated in half-fan mode were acquired with three different protocols: CBCTlowD , CBCTmidD , and CBCThighD , which resulted in weighted CT dose index (CTDIw ) of 0...
March 8, 2018: Journal of Applied Clinical Medical Physics
George X Ding, Parham Alaei, Bruce Curran, Ryan Flynn, Michael Gossman, T Rock Mackie, Moyed Miften, Richard Morin, X George Xu, Timothy C Zhu
With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients...
February 22, 2018: Medical Physics
Roberto Blanco Sequeiros, Juha-Jaakko Sinikumpu, Risto Ojala, Jyri Järvinen, Jan Fritz
Minimally invasive procedures play a crucial role in the diagnosis and treatment of many pediatric musculoskeletal conditions. Although computed tomography and fluoroscopy are commonly used for image guidance, the associated exposure to ionizing radiation is especially concerning in pediatric patients. Ultrasonography may be used successfully in a subset of interventions, but it is often not useful for complex, deep, and osseous targets. Interventional magnetic resonance imaging (iMRI) facilitates targeting and treatment of musculoskeletal lesions at many locations with high accuracy due to its excellent tissue contrast...
February 2018: Topics in Magnetic Resonance Imaging: TMRI
Sylvain Andresz, Julie Morgan, Pascal Croüail, Fernand Vermeersch
The European ALARA Network regularly organises workshops on topical issues in radiation protection. In light of the Fukushima accident, the most recent workshop questioned the application of the ALARA principle in emergency exposures situations. This memorandum presents the conclusions and recommendations of this workshop. One of the outcomes is that the process of optimisation in emergency exposure situations should be flexible enough to be able to modify or refine decisions over the course of an accident...
January 17, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Nicholas K Cheung, Michelle Boutchard, Michael W Carr, Jens J Froelich
BACKGROUND: Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies. OBJECTIVE: This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms. MATERIALS AND METHODS: Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator...
January 9, 2018: Journal of Neurointerventional Surgery
Andrew M Harris
OBJECTIVE: To compare radiation dosage to the Urologist using an over-couch system, X-ray tube over table, and an under-couch system, X-ray tube under table. Urologist continue to perform more endoscopic surgery requiring fluoroscopy. Fluoroscopy, or electromagnetic radiation, can cause cellular damage when passing through tissue. These systems are compared with respect to radiation dosage to the urologist. METHODS: A single urologic surgeon utilized a dosimeter badge while using an over-couch system...
January 2, 2018: Urology
Mehrdad Abdinian, Rahman Nazeri, Marzieh Ghaiour
Objectives: When a patient has cone beam computed tomography (CBCT) images based on the treatment plan, it is possible to use these images for evaluation of caries, and there is no need for new radiographs, according to the "as low as reasonably achievable" (ALARA) principle. The aim of this study was to determine the effect of filtration and thickness of CBCT cross-sections on detection of proximal caries. Materials and Methods: In this in-vitro study, 100 teeth were placed in the dental sockets of a dry skull, and were fixed in normal proximal contacts...
July 2017: Journal of Dentistry of Tehran University of Medical Sciences
Mesfin Zewdu, Elias Kadir, Melkamu Berhane
Background: Given the fact that children are more sensitive to ionizing radiation than adults, with an increased risk of developing radiation-induced cancer, special care should be taken when they undergo X-ray examinations. The main aim of the current study was to determine Entrance Surface Dose (ESD) to pediatric patients arising from routine x-ray examination in the Radiology Department of Jimma University Specialized Hospital (JUSH). Methods: Descriptive cross-sectional study was conducted on pediatric patients less than 15 years of age who visited to seek x-ray examinations in JUSH...
September 2017: Ethiopian Journal of Health Sciences
P A Bryant, J Croft, P Cole
The principle of As Low As Reasonable Achievable (ALARA) stems from the field of radiological protection. In the UK, this principle has been incorporated into the Health and Safety at Work Act 1974 and rather than applying solely to radiological hazards, applies to all hazards in totality. Given that the current methods for assessing hazards are somewhat isolated, in that one hazard is assessed independently of another, it can be challenging to ensure a truly holistic view of the risks, and demonstrate they have been reduced to ALARA or As Low As Is Reasonably Practicable (ALARP) as required in the UK regulatory regime...
December 6, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Roger Coates, Renate Czarwinski
The system of protection, which provides the basic underpinning philosophy and principles for radiation protection, is constantly evolving in the light of developing scientific understanding and practical experience. Over recent times there has been significant learning from experiences relating to the Fukushima accident, and there is also increasing recognition of the importance of enhancing public understanding of radiation and risk. The practical application of radiation protection is undertaken by thousands of practitioners around the world, and it is IRPA's task to ensure that this experience is fed back for the benefit of all...
November 30, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Lars Stangenberg, Fahad Shuja, I Martijn J van der Bom, Martine H G van Alfen, Allen D Hamdan, Mark C Wyers, Raul J Guzman, Marc L Schermerhorn
High-definition fluoroscopic imaging is required to perform endovascular procedures safely and precisely, especially in complex cases, resulting in longer procedures and increased radiation exposure. This is of importance for training institutions as trainees, even with sound instruction in as low as reasonably achievable (ALARA) principles, tend to have high radiation exposures. Recently, there was an upgrade in the imaging system allowing for comparison of radiation exposure to patients and providers. We performed an analysis of consecutive endovascular aneurysm repair (EVAR) and superficial femoral artery (SFA) interventions in the years 2013 to 2014...
January 1, 2017: Vascular and Endovascular Surgery
Michael C Ost
No abstract text is available yet for this article.
November 14, 2017: Journal of Urology
Benjamin O'Brien, Damian C Balmforth, Ross J Hunter, Richard J Schilling
PURPOSE: Guidelines recommend that radiation exposure during AF catheter ablation procedures should be 'as low as reasonably achievable' (ALARA), particularly since many patients may have multiple procedures. Consequently, avoiding radiation exposure altogether must, if safe to do so, be the ultimate goal. The primary objective was to determine the feasibility and efficacy of fluoroscopy-free AF ablation compared to the fluoroscopy-assisted procedure. METHODS: Patients underwent AF ablation using commercially available technology with no routine pre-procedural imaging...
November 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Ameer E Hassan, Sophie Amelot
Background and Purpose: Per the ALARA principle, reducing the dose delivered to both patients and staff must be a priority for endovascular therapists, who should monitor their own practice. We evaluated patient exposure to radiation during common neurointerventions performed with a recent flat-panel detector angiographic system and compared our results with those of recently published studies. Methods: All consecutive patients who underwent a diagnostic cerebral angiography or intervention on 2 modern flat-panel detector angiographic biplane systems (Innova IGS 630, GE Healthcare, Chalfont St Giles, UK) from February to November 2015 were retrospectively analyzed...
October 2017: Interventional Neurology
Ahmed Hamarsheh, Ahmad Amro
This study investigated 94.4% of Palestinian radio technologists and the mean percentage of correct answers for knowledge and awareness questions was 26.4%. The percentage of correct answers for questions testing knowledge of the ALARA (As Low As Reasonably Achievable) principle and hormesis hypothesis was 66.5% and 17.2%, respectively. Radio technologists with education level higher than bachelor degree and < 5 years' work experience showed a significantly higher level of knowledge. The most radiosensitive organs were correctly identified as the lungs and stomach by 6...
October 30, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
Chadwick L Wright, Katherine Binzel, Jun Zhang, Michael V Knopp
The purpose of this article is to provide a brief overview of the background, basic principles, technological evolution, clinical capabilities, and future directions for functional tumor imaging as PET evolves from the conventional photomultiplier tube-based platform into a fully digital detector acquisition platform. The recent introduction of solid-state digital photon counting PET detector is the latest evolution of clinical PET which enables faster time-of-flight timing resolution that leads to more precise localization of the annihilation events and further contributes to reduction in partial volume and thus makes high definition and ultrahigh definition PET imaging feasible with current standard acquisition procedures...
2017: Contrast Media & Molecular Imaging
Daryoush Fatehi, Ayoob Rostamzadeh
Currently, application of computed tomography (CT) increased in the diagnostic procedures. Hence, respecting to the unnecessary increase in the application of the CT-scans, it needs to prescribe radiological procedures from pelvic and lower abdomen with more caution. Furthermore, due to the unnecessary increasing application of CT-scan in the world, we believe that there is a need to revise, with more precision, for prescription of this radiological procedure. The panel recommended several measures to enhance and enforce radiation-dose optimization, particularly in collaboration with referring physicians...
October 24, 2017: Radiation Protection Dosimetry
John T Eagan, Carolynn T Jones, Gary S Roubin
We describe 5 years of follow-up of a previously reported case of disabling ionizing radiation (IR)-related cutaneous cancer in a high-volume interventional cardiologist. This case illustrates the cycle of exposure, disease, remission, and re-exposure that demonstrates the cause-and-effect relationship between radiation exposure and cutaneous cancer. Prior cautions for working in environments with radiation exposure emphasized strict adherence to the ALARA principle and called for improved radiation protection equipment...
October 16, 2017: Catheterization and Cardiovascular Interventions
Christopher Neil Passmore, Mirela Kirr
One of the main goals for Radiation Safety Professionals is to help maintain radiation worker doses below administrative control levels. In the radiation safety field there is an increasing recognition of the value of dosimetry-related data that can be used to enhance safety programs and regulatory compliance. Mining radiation dosimetry data and rendering results in the form of dashboards provides insights for the Radiation Safety Professionals that could help improve the radiological protection programs effectiveness, enhances quality, and reduces cost...
December 2017: Health Physics
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