Study of Radiation Dose in Common Fluoroscopy Methods in Adult Patients Referred to Namazi Hospital in Shiraz during 2018-2019
DOI:
https://doi.org/10.22100/ijhs.v10i4.1147Keywords:
Fluoroscopy, Radiation dose, Adult, PatientsAbstract
Background: The basis of the largest source of human radiation exposure is ionizing radiation used in medical and clinical sciences. This study aimed to investigate the radiation dose in common fluoroscopy methods in adult patients referred to Namazi Hospital in Shiraz in 2018.
Methods: This cross-sectional study was conducted on 600 adult patients (18 years and older) who were referred to Namazi Hospital in Shiraz for fluoroscopy. Data were collected using a checklist prepared from patient records, including demographic information of patients including age, gender, height, weight, and BMI, and information related to fluoroscopy including type of fluoroscopy, duration of fluoroscopy, and dose of fluoroscopy. Fluoroscopy-related data were extracted from the PACS system or manually based on the final report of each patient's file. Data were analyzed using SPSS18 software and independent t-tests, ANOVA, and Pearson correlation coefficient.
Results: The mean age of the patients was 48.56 ± 15.59 years (18-90 years). 36.5% were male and 63.5% were female. The mean BMI was 24.85 ± 4.87 (13.43-67.20). The most commonly used fluoroscopy method was B. SW (43.7%), followed by DEFECO (23.5%), and the least used method was RCG in only 10 patients (1.7%). The mean time of fluoroscopy was 2.08 ± 1.51 (0.1-9.60 minutes). The mean dose received in all fluoroscopy methods was 1650.42. A statistically significant relationship was observed between the dose of fluoroscopy and the duration of fluoroscopy (r=0.0403. P-value<0.001) and BMI (r=0.249, P-value<0.001), and the age of the patients had no significant relationship with the dose received in fluoroscopy (r=0.075, P-value=0.066). The difference in the mean duration of fluoroscopy based on different fluoroscopy methods was statistically significant (P-value<0.001). The difference in the mean dose of fluoroscopy based on different fluoroscopy methods was statistically significant (P-value<0.001).
Conclusions: In general, the results of the study showed that most fluoroscopy was performed with the barium swallow method. With increasing fluoroscopy duration and BMI, the dose received by the patient increased significantly, and the highest dose received was observed in the barium enema method and the longest fluoroscopy time was observed in the UGI method, but further and better investigation is still needed to identify the influencing factors.
References
Radiation UNSCotEoA. Sources and effects of ionizing radiation. UNSCEAR 2000 report to the General Assembly, with scientific annexes. Volume I: Sources. 2000.
Radiation UNSCotEoA. Sources and effects of ionizing radiation: sources: United Nations Publications; 2000.
Karatzis EN, Danias PG. Exposure to ionizing radiation from cardiovascular imaging and therapeutic procedures may be a considerable unrecognized risk for subsequent cancer development. 2008.
Ridzwan SFM, Selvarajah SE, Hamid HA. Radiation Dose Management in Fluoroscopy Procedures: Less is More? Jurnal Sains Kesihatan Malaysia (Malaysian Journal of Health Sciences). 2016;14(2).
Wambani JS, Korir GK, Tries MA, Korir IK, Sakwa JM. Patient radiation exposure during general fluoroscopy examinations. Journal of applied clinical medical physics. 2014;15(2):262-70.
Aitchison FA. A Guide to Radiological Procedures E-Book: Elsevier Health Sciences; 2009.
Changizi V, Mianji F, Ghaderbeygizad F, Mohammadi F. Comparing Cardiologists’ Effective Dose of Right and Left Eyes in Femoral and Radial Angiography in a Hospital in Mehran. Journal of Payavard Salamat. 2019;12(5):398-406.
Wachabauer D, Röthlin F, Moshammer HM, Homolka P. Diagnostic Reference Levels for conventional radiography and fluoroscopy in Austria: Results and updated National Diagnostic Reference Levels derived from a nationwide survey. European journal of radiology. 2019;113:135-9.
Tsapaki V, Kottou S, Vano E, Faulkner K, Giannouleas J, Padovani R, et al. Patient dose values in a dedicated Greek cardiac centre. The British journal of radiology. 2003;76(910):726-30.
Pike S. Technical principles for diagnostic fluoroscopic procedures. Hentet fra https://www. imagewisely. org/imaging-modalities/fluoroscopy …; 2014.
Agency IAE. Dosimetry in diagnostic radiology: an international code of practice. IAEA Vienna; 2007.
Pantos I, Patatoukas G, Katritsis DG, Efstathopoulos E. Patient radiation doses in interventional cardiology procedures. Current cardiology reviews. 2009;5(1):1-11.
Russel J. Radiation protection in radiography in the UK. Br J Radiol. 1986;59:747-8.
Parry R, Glaze S, Archer B. The AAPM/RSNA physics tutorial for residents–fluoroscopy: Patient radiation exposure index. Radiographics. 2001;21:1033-45.
Herrmann TL, Fauber TL, Gill J, Hoffman C, Orth DK, Peterson PA, et al. Best practices in digital radiography. Radiologic technology. 2012;84(1):83-9.
Chida K, Saito H, Otani H, Kohzuki M, Takahashi S, Yamada S, et al. Relationship between fluoroscopic time, dose–area product, body weight, and maximum radiation skin dose in cardiac interventional procedures. American Journal of roentgenology. 2006;186(3):774-8.
Lazarus MS, Taragin BH, Malouf W, Levin TL, Nororis E, Schoenfeld AH, et al. Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases. Pediatric radiology. 2019;49(5):600-8.
Bibbo G, Balman D, Linke R. Diagnostic reference levels for common paediatric fluoroscopic examinations performed at a dedicated paediatric Australian hospital. Journal of medical imaging and radiation oncology. 2016;60(4):469-74.
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