Greek dose reference levels in pediatric pelvis computed tomography examinations.

The fact that children do undergo computed tomography (CT) examinations similar to those for adults adults has been a research issue, especially since the former are exposed to greater risk levels (developing stochastic late effects, such as cancer) due to their increased radiosensitivity compared to the latter. In a previous research paper (), the values of dose levels were recorded, analyzed, and compared with the reference values for groups of 0, 1, 5 and 10 y-old children for the regions of head, chest, and abdomen. In this paper, the same age group has been considered for measuring dose levels of the pelvic region. Scanning the pelvic region has been one of the most important CT examination procedures, in which unfortunately part of the lower abdomen region is included without adapting any pediatric protocols. Furthermore, the study determines whether the adjustment of the scanning parameters results in any possible reduction in the radiation dose levels to which the patient is being exposed during the examination. The present work also includes the Greek reference levels for the pelvic CT examination for the 5- and 10-y-old children that have been used for comparison against the European ones.

Factors that influence radiation dose in percutaneous coronary intervention.

AIM: To explore the factors that may influence the radiation dose imparted to the patient in PCI, and investigate whether the use of the latest digital X-ray system based on FP detector technology can have an impact on dose. MATERIALS AND METHOD: Demographic and clinical data such as number of lesions treated, number of stents placed, grade of tortuosity, and stage of occlusion, as well as use of double wire and double balloon technique, ostial stenting or bifurcation stenting, and presence of major complications were recorded, together with radiation parameters. RESULTS: The factors that increased patient radiation dose were (1) patient gender, as men exhibited higher doses than women; (2) complex lesion; (3) increasing number of stents; (4) position of stent; (5) grade of tortuosity; and (6) stage of occlusion. The FP digital system appeared to be settled in a lower-dose rate for fluoroscopy (a factor of 6) and higher for dose per frame in cine (a factor of 3) in comparison with the image intensifier (II) system. There was a marked reduction of DAP when the FP technology was introduced. CONCLUSION: More extensive studies should be performed in the future so as to further investigate the influence of the FP detector in IC.

Dose performance evaluation of a charge coupled device and a flat-panel digital fluoroscopy system recently installed in an interventional cardiology laboratory.

The purpose of the study was to evaluate the dose performance of a flat-panel (FP) and an image intensifier (II) charge coupled device (CCD) digital fluoroscopy X-ray systems newly installed in an Interventional Cardiology (IC) department. Filter entrance dose rate, detector dose rate (during fluoroscopy) and filter entrance dose per image were measured at 70 cm from the focus using 2 mm copper sheets to mimic normal size patient. Image quality was also evaluated. The patient dose survey included 277 patients, which had either a Coronary Angiography (CA) or a Percutaneous Transluminal Coronary Angioplasty (PTCA). Dose area product (DAP), fluoroscopy time (T) and total number of frames (F) values were also collected. The results showed that both systems performed within international recommendations with the exception of higher cine radiation doses, stressing the fact that neither specific protocols of measurement nor reference values for digital equipment were provided by the official bodies.

Occupational dose constraints in interventional cardiology procedures: the DIMOND approach.

Radiation fields involved in angiographic suites are most uneven with intensity and gradient varying widely with projection geometry. The European Commission DIMOND III project addressed among others, the issues regarding optimization of staff doses with an attempt to propose preliminary occupational dose constraints. Two thermoluminescent dosemeters (TLD) were used to assess operators' extremity doses (left shoulder and left foot) during 20 coronary angiographies (CAs) and 20 percutaneous transluminal coronary angioplasties (PTCAs) in five European centres. X-ray equipment, radiation protection measures used and the dose delivered to the patient in terms of dose-area product (DAP) were recorded so as to subsequently associate them with operator's dose. The range of staff doses noted for the same TLD position, centre and procedure type emphasizes the importance of protective measures and technical characteristics of x-ray equipment. Correlation of patient's DAP with staff shoulder dose is moderate whereas correlation of patient's DAP with staff foot dose is poor in both CA and PTCA. Therefore, it is difficult to predict operator's dose from patient's DAP mainly due to the different use of protective measures. A preliminary occupational dose constraint value was defined by calculating cardiologists' annual effective dose and found to be 0.6 mSv.