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Campelo DAM, Asfora VK, Barros VSMD, Renha SK, Khoury HJ. Scan factors and practices associated with radiation doses for chest CT: current Brazilian scenario. J Radiol Prot 2021; 41:481-494. [PMID: 33721853 DOI: 10.1088/1361-6498/abee95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
The main purpose of this study was to compare the parameters of computed tomography (CT) and the corresponding patient doses undergoing chest CT scan examinations in different regions of Brazil, providing the current scenario of how these procedures are being carried out in the country as well as the patient dose distribution. Thirty institutions, across 17 states and the Federal District, participated in the survey. The evaluation included 30 multislice CTs of seven different models, manufactured by General Electric (GE) Healthcare. For each institution, data from 10 adult chest CT examinations, performed without contrast, were collected remotely. The analysis of the results showed a significant difference of the CTDIvolvalues, ranging from 1.1 mGy to 46.6 mGy in seven institutions. The mean value of CTDIvolwas higher than values found in the literature and the UK Reference Levels. It was also observed that, regardless of the region of the country, for the same CT model, different scanning parameters were used, which resulted in CTDIvolup to 5 times higher in some institutions. Repetitions of CT acquisitions and scouts with radiation field dimensions larger than the region of interest were found in 25% of chest examinations, resulting in higher absorbed doses. The results of this work show a mapping of the chest CT procedures, which enables the establishment of strategic plans for the country. In addition, each institution will be able to implement an appropriate optimization program and establish institutional reference levels.
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Affiliation(s)
- D A M Campelo
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - V K Asfora
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - V S M D Barros
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - S K Renha
- Institute of Radiation Protection and Dosimetry, National Commission of Nuclear Energy, Rio de Janeiro, RJ, Brazil
| | - H J Khoury
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
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Khoury HJ, de Barros VSM, Asfora VK, Toroi P. First Latin American and Caribbean interlaboratory comparison exercise for SSDLs on reference irradiation capabilities in personal dose equivalent. J Radiol Prot 2021; 41:37-45. [PMID: 33513585 DOI: 10.1088/1361-6498/abe16f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
A comparison exercise of Latin American and Caribbean Secondary Standards Dosimetry Laboratories (SSDLs) was jointly organized by the International Atomic Energy Agency (IAEA) and the Ionizing Radiation Metrology Laboratory at the Federal University of Pernambuco (LMRI-DEN/UFPE). This exercise was organized during an IAEA regional meeting on the review and update of calibration capabilities in Latin America, held in Recife, during the period from 23 to 27 April 2018 under the technical cooperation project ME-RLA 9085-170572. Fifteen participating SSDLs were required to irradiate optically stimulated personal dosimeters in terms of the personal dose equivalent Hp(10) in137Cs radiation quality. In addition, the IAEA Dosimetry Laboratory in Seibersdorf, Austria, and the National Physical Laboratory in Teddington, Middlesex, UK participated in this exercise as reference institutes. Each participant received 10 dosimeters that were hand-carried directly to the SSDL. Two nominal dose values of 2 mSv and 4 mSv were selected for this exercise. The participants irradiated the dosimeters using the setup and the procedures which are normally used in their standard laboratory for Hp(10) dosimeter irradiations. The dosimeters were evaluated as they were received by the coordinating laboratory, using a single BeOSL Reader. The results show that, except for one laboratory, the differences between the dosimeter reading and the assigned values were within 10%; this is consistent with the expanded uncertainty. The results indicate that most of the participant laboratories have a good capability to irradiate personal dosimeters in the quantity Hp(10).
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Affiliation(s)
- H J Khoury
- Nuclear Energy Department, Federal University of Pernambuco, Av. Prof. Luiz Freire, 1000, Recife, PE 50740-545, Brazil
| | - V S M de Barros
- Nuclear Energy Department, Federal University of Pernambuco, Av. Prof. Luiz Freire, 1000, Recife, PE 50740-545, Brazil
| | - V K Asfora
- Nuclear Energy Department, Federal University of Pernambuco, Av. Prof. Luiz Freire, 1000, Recife, PE 50740-545, Brazil
| | - P Toroi
- Section of Dosimetry and Medical Radiation Physics, IAEA, Vienna, Austria
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Andrade G, Garzón WJ, Khoury HJ, Savignon J, de Barros VSM, Fernandes JL, Abud DG. REDUCTION OF STAFF RADIATION DOSE IN PROSTATIC ARTERY EMBOLISATION. Radiat Prot Dosimetry 2019; 187:1-7. [PMID: 31034554 DOI: 10.1093/rpd/ncz121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 04/01/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
Prostatic artery embolisation (PAE) is used to treat patients with benign prostatic hyperplasia and with lower urinary obstructive tract symptoms. It is an interventional procedure which uses fluoroscopy equipment and can result in exposure to high doses of radiation in patients and staff. We aimed to demonstrate the reduction of radiation doses received by staff during PAE by implementing an optimised protocol called Radiation Exposure Curtailment for Embolisation (RECiFE). This protocol was implemented in cooperation with the medical team and technical team using Siemens Combined Applications to Reduce Exposure (CARE) protocol. The results showed approximately 83% reduction in the radiation doses received by the main physician during PAE. Thus, by adjusting the acquisition parameters of the angiographic equipment and implementing the RECiFE protocol, it is possible to optimise the PAE procedure and reduce the staff radiation dose.
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Affiliation(s)
- G Andrade
- Hospital da Restauração, Av. Gov. Agamenon Magalhães, s/n-Derby, Recife, Brazil
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP, Av. Bandeirantes, 3900-Vila Monte Alegre, Ribeirão Preto, Brazil
| | - W J Garzón
- Laboratorio de Radiaciones Nucleares, Universidad Pedagógica y Tecnológica de Colombia, Avenida Central del Norte 39-115, Tunja, Colombia
| | - H J Khoury
- Departamento de Energía Nuclear, Universidade Federal de Pernambuco, Av. Prof. Luiz Freire, 1000-Cidade Universitaria, Recife, Brazil
| | - J Savignon
- Departamento de Energía Nuclear, Universidade Federal de Pernambuco, Av. Prof. Luiz Freire, 1000-Cidade Universitaria, Recife, Brazil
| | - V S M de Barros
- Departamento de Energía Nuclear, Universidade Federal de Pernambuco, Av. Prof. Luiz Freire, 1000-Cidade Universitaria, Recife, Brazil
| | - J L Fernandes
- Siemens Healthcare Diagnósticos Ltda, Avdas Americas, 3500, Rio de Janeiro, Brazil
| | - D G Abud
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP, Av. Bandeirantes, 3900-Vila Monte Alegre, Ribeirão Preto, Brazil
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Garzón WJ, Kramer R, Khoury HJ, de Barros VSM, Andrade G. Estimation of organ doses to patients undergoing hepatic chemoembolization procedures. J Radiol Prot 2015; 35:629-647. [PMID: 26270613 DOI: 10.1088/0952-4746/35/3/629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The aim of this study is to evaluate organ and tissue absorbed doses to patients undergoing hepatic chemoembolization procedures performed in two hospitals in the city of Recife, Brazil. Forty eight patients undergoing fifty hepatic chemoembolization procedures were investigated. For the 20 cases with PA projection only, organs and tissues dose to KAP conversion coefficients were calculated using the mesh-based anthropometric phantom series FASH and MASH coupled to the EGSnrc Monte Carlo code. Clinical, dosimetric and irradiations parameters were registered for all patients. The maximum organ absorbed doses found were 2.4 Gy, 0.85 Gy, 0.76 Gy and 0.44 Gy for skin, kidneys, adrenals and liver, respectively.
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Affiliation(s)
- W J Garzón
- Department of Nuclear Energy, Federal University of Pernambuco, Recife, Brazil
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Khoury HJ, Garzon WJ, Andrade G, Lunelli N, Kramer R, de Barros VSM, Huda A. Radiation exposure to patients and medical staff in hepatic chemoembolisation interventional procedures in Recife, Brazil. Radiat Prot Dosimetry 2015; 165:263-267. [PMID: 25870436 DOI: 10.1093/rpd/ncv075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to evaluate patient and medical staff absorbed doses received from transarterial chemoembolisation of hepatocellular carcinoma, which is the most common primary liver tumour worldwide. The study was performed in three hospitals in Recife, capital of the state of Pernambuco, located in the Brazilian Northeastern region. Two are public hospitals (A and B), and one is private (C). For each procedure, the number of images, irradiation parameters (kV, mA and fluoroscopy time), the air kerma-area product (PKA) and the cumulative air kerma (Ka,r) at the reference point were registered. The maximum skin dose (MSD) of the patient was estimated using radiochromic film. For the medical staff dosimetry, thermoluminescence dosemeters (TLD-100) were attached next to the eyes, close to the thyroid (above the shielding), on the thorax under the apron, on the wrist and on the feet. The effective dose to the staff was estimated using the algorithm of von Boetticher. The results showed that the mean value of the total PKA was 267.49, 403.83 and 479.74 Gy cm(2) for Hospitals A, B and C, respectively. With regard to the physicians, the average effective dose per procedure was 17 µSv, and the minimum and maximum values recorded were 1 and 41 µSy, respectively. The results showed that the feet received the highest doses followed by the hands and lens of the eye, since the physicians did not use leaded glasses and the equipment had no lead curtain.
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Affiliation(s)
- H J Khoury
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - W J Garzon
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - G Andrade
- IMIP-Institute of Medicine Dr. Fernando Figueira, Recife, PE, Brazil
| | - N Lunelli
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - R Kramer
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - V S M de Barros
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - A Huda
- California State University, Fresno, CA, USA
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