Analysis of Patients’ X-ray Exposure in 146 Percutaneous Radiologic Gastrostomies
| Autor: | Martin Reinhardt, Jochen Fuchs, Thomas Kahn, Michael Moche, Alexey Surov, Tim-Ole Petersen, D. Gosch, Patrick Stumpp |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Radiography Abdominal medicine.medical_specialty Percutaneous Radiography medicine.medical_treatment Operative Time Population Radiation Dosage Radiography Interventional Sensitivity and Specificity Flat panel detector 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences Age Distribution 0302 clinical medicine Risk Factors law Germany Prevalence Humans Medicine Fluoroscopy Radiology Nuclear Medicine and imaging Sex Distribution education Aged Retrospective Studies Aged 80 and over Gastrostomy education.field_of_study medicine.diagnostic_test business.industry Reproducibility of Results Image intensifier Middle Aged Radiation Exposure Surgery Computer-Assisted Female 030211 gastroenterology & hepatology Tomography Radiology Tomography X-Ray Computed business Nuclear medicine |
| Zdroj: | RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. 189:820-827 |
| ISSN: | 1438-9010 1438-9029 |
| DOI: | 10.1055/s-0043-109690 |
| Popis: | Purpose Analysis of patient´s X-ray exposure during percutaneous radiologic gastrostomies (PRG) in a larger population. Materials and Methods Data of primary successful PRG-procedures, performed between 2004 and 2015 in 146 patients, were analyzed regarding the exposition to X-ray. Dose-area-product (DAP), dose-length-product (DLP) respectively, and fluoroscopy time (FT) were correlated with the used x-ray systems (Flatpanel Detector (FD) vs. Image Itensifier (BV)) and the necessity for periprocedural placement of a nasogastric tube. Additionally, the effective X-ray dose for PRG placement using fluoroscopy (DL), computed tomography (CT), and cone beam CT (CBCT) was estimated using a conversion factor. Results The median DFP of PRG-placements under fluoroscopy was 163 cGy*cm2 (flat panel detector systems: 155 cGy*cm2; X-ray image intensifier: 175 cGy*cm2). The median DLZ was 2.2 min. Intraprocedural placement of a naso- or orogastric probe (n = 68) resulted in a significant prolongation of the median DLZ to 2.5 min versus 2 min in patients with an already existing probe. In addition, dose values were analyzed in smaller samples of patients in which the PRG was placed under CBCT (n = 7, median DFP = 2635 cGy*cm2), or using CT (n = 4, median DLP = 657 mGy*cm). Estimates of the median DFP and DLP showed effective doses of 0.3 mSv for DL-assisted placements (flat panel detector 0.3 mSv, X-ray image converter 0.4 mSv), 7.9 mSv using a CBCT – flat detector, and 9.9 mSv using CT. This corresponds to a factor 26 of DL versus CBCT, or a factor 33 of DL versus CT. Conclusion In order to minimize X-ray exposure during PRG-procedures for patients and staff, fluoroscopically-guided interventions should employ flat detector systems with short transmittance sequences in low dose mode and with slow image frequency. Series recordings can be dispensed with. The intraprocedural placement of a naso- or orogastric probe significantly extends FT, but has little effect on the overall dose of the intervention. Due to the significantly higher X-ray exposure, the use of a CBCT as well as PRG-placements using CT should be limited to clinically absolutely necessary exceptions with strict indication. Key Points Citation Format |
| Databáze: | OpenAIRE |
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