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http://dx.doi.org/10.3344/kjp.2013.26.1.51

Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures  

Jung, Cheol Hee (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Ryu, Jae Sung (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Baek, Seung Woo (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Oh, Ji Hye (Seoul National University Hospital)
Woo, Nam Sik (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Kim, Hae Kyoung (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Kim, Jae Hun (Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center)
Publication Information
The Korean Journal of Pain / v.26, no.1, 2013 , pp. 51-56 More about this Journal
Abstract
Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures. Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected. Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians. Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.
Keywords
distance; exposure time; radiation dose; radiation protection;
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Times Cited By KSCI : 2  (Citation Analysis)
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1 Kruger R, Faciszewski T. Radiation dose reduction to medical staff during vertebroplasty: a review of techniques and methods to mitigate occupational dose. Spine 2003; 28: 1608-13.
2 Andreassi MG. The biological effects of diagnostic cardiac imaging on chronically exposed physicians: the importance of being non-ionizing. Cardiovasc Ultrasound 2004; 2: 25.   DOI   ScienceOn
3 Park PE, Park JM, Kang JE, Cho JH, Cho SJ, Kim JH, et al. Radiation safety and education in the applicants of the final test for the expert of pain medicine. Korean J Pain 2012; 25: 16-21.   DOI   ScienceOn
4 Pradhan AS. Evolution of dosimetric quantities of International Commission on Radiological Protection (ICRP): Impact of the forthcoming recommendations. J Med Phys 2007; 32: 89-91.   DOI
5 Miller DL, Vañó E, Bartal G, Balter S, Dixon R, Padovani R, et al. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. J Vasc Interv Radiol 2010; 21: 607-15.   DOI   ScienceOn
6 Harding LK, Thomson WH. International commission on radiation protection. Nucl Med Commun 1990; 11: 585-7.   DOI
7 Cousins C, Sharp C. Medical interventional proceduresreducing the radiation risks. Clin Radiol 2004; 59: 468-73.   DOI   ScienceOn
8 Mroz TE, Yamashita T, Davros WJ, Lieberman IH. Radiation exposure to the surgeon and the patient during kyphoplasty. J Spinal Disord Tech 2008; 21: 96-100.   DOI   ScienceOn
9 Theocharopoulos N, Perisinakis K, Damilakis J, Papadokostakis G, Hadjipavlou A, Gourtsoyiannis N. Occupational exposure from common fluoroscopic projections used in orthopaedic surgery. J Bone Joint Surg Am 2003; 85: 1698-703.   DOI
10 Blattert TR, Fill UA, Kunz E, Panzer W, Weckbach A, Regulla DF. Skill dependence of radiation exposure for the orthopaedic surgeon during interlocking nailing of long-bone shaft fractures: a clinical study. Arch Orthop Trauma Surg 2004; 124: 659-64.   DOI   ScienceOn
11 Bahari S, Morris S, Broe D, Taylor C, Lenehan B, McElwain J. Radiation exposure of the hands and thyroid gland during percutaneous wiring of wrist and hand procedures. Acta Orthop Belg 2006; 72: 194-8.
12 Arnstein PM, Richards AM, Putney R. The risk from radiation exposure during operative X-ray screening in hand surgery. J Hand Surg Br 1994; 19: 393-6.   DOI   ScienceOn
13 Siegel JA, Marcus CS, Sparks RB. Calculating the absorbed dose from radioactive patients: the line-source versus point-source model. J Nucl Med 2002; 43: 1241-4.
14 Bushberg JT, Seibert JA, Leidholdt EM, Boone JM. The essential physics of medical imaging. 3rd ed. Philadelphia, Lippincott Williams & Wilkins. 2011, pp 837-902.
15 Singer G. Occupational radiation exposure to the surgeon. J Am Acad Orthop Surg 2005; 13: 69-76.   DOI
16 Kallmes DF, O E, Roy SS, Piccolo RG, Marx WF, Lee JK, et al. Radiation dose to the operator during vertebroplasty: prospective comparison of the use of 1-cc syringes versus an injection device. AJNR Am J Neuroradiol 2003; 24: 1257-60.
17 Cho JH, Kim JY, Kang JE, Park PE, Kim JH, Lim JA, et al. A study to compare the radiation absorbed dose of the C-arm fluoroscopic modes. Korean J Pain 2011; 24: 199-204.   DOI   ScienceOn