Wyniki wyszukiwania - Biblioteka Nauki

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Patient and physician exposure to X-rays at pediatric interventional cardiology – from world to Poland

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Mirowski M. , Domienik-Andrzejewska J. , Moszura T.

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nr 6

569-580

EN

Ionizing radiation is considered as a harmful factor to health. However, X‑rays are widely used in diagnostic and therapeutic procedures such as those performed during cardiac interventions. Their use is particularly invaluable in saving life procedures when the risk of adverse effects of radiation is relatively low compared to the consequences of non-treated or treated with other invasive methods diseases. One branch of these types of medical procedures is interventional cardiology in pediatrics due to possible higher than in adults risks of developing cancer in exposed to ionizing radiation children. On the other hand, medical staff in particular physician, may be exposed to relatively high radiation levels during their work. Parallel with enlarging workload (growing number of procedures per year), high levels of cumulative doses to most exposed, and often not protected, parts of operator’s body as eye lenses and brain may be achieved. Exposure to X‑rays in pediatric interventional cardiology is a worldwide point of scientific interest from around 65 years, however assessment and simulating low level doses is still developing. In this review found data presents various trials of evaluating doses or levels of exposure to both medical staff and patient as well as methods of optimization and protection against X‑rays in pediatric cardiac interventional procedures. The issue of establishing diagnostic reference levels was also taken into consideration during analysis. Thirty papers from period 2013 to 2023 were analyzed. The main assumption of this condensed review is to reveal radiation protection methods worldwide and in Poland.

2

Exposure to ionizing radiation of medical staff performing vascular and interventional radiology procedures

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Biegała M. , Jakubowska T. , Domienik-Andrzejewska J.

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nr 4

403-410

EN

Objectives Vascular and interventional radiology procedures are characterized by high exposure of personnel to ionizing radiation. This study assessed the exposure of medical personnel to ionizing radiation during vascular radiology and mechanical thrombectomy procedures. Material and Methods During vascular radiology procedures, the exposure of 4 groups of workers participating in the procedures was analyzed, i.e., the main operating physician, an assistant physician, a sterile nurse, and a nurse. Measurements of exposure to ionizing radiation were performed using thermoluminescent dosimetry. Results The registered effective dose during 1 treatment in individual groups is, respectively: mean (M) ± standard deviation (SD) 75±15 μSv, 24±5 μSv, 13±3 μSv, and 8±2 μSv. During mechanical thrombectomy, the operating physician receives an effective dose of M±SD 9±2 μSv. The equivalent doses for the lenses for the operating physician and the doctor assisting during vascular radiology procedures are M±SD 1419±285 μSv and 987±198 μSv, respectively, and for the hands, including the left and right hands, M±SD 4605±930 μSv, 1420±284 μSv, 1898±380 μSv, 1371±274 μSv. Conclusions If the principles of optimizing radiological protection are not applied during vascular radiology procedures, the permissible dose limits and operational limits equivalent to doses to lenses and hands may be exceeded. Exposure during vascular radiology procedures is comparable to exposure during nuclear medicine procedures in terms of the use of glucose labeled with radioactive fluorine.

3

Ionizing radiation and volumetric mammographic density

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Pepłońska B. , Mirowski M. , Kałużny P. , Domienik-Andrzejewska J.

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nr 5

635-649

EN

Objectives Mammographic density (MD) refers to the percentage of dense tissue of an entire breast and was proposed to be used as a surrogate marker for breast cancer. High-dose ionizing radiation (IR) has been recognized as a breast cancer risk factor. The aim of our study was to investigate association between lifetime low dose ionizing radiation (LDIR) and MD. Material and Methods A cross-sectional study included 467 women aged 40–60 years who underwent screening mammography in Łódź, Poland. The digital mammography examination of the breasts included both craniocaudal and mediolateral oblique views. The volumetric breast density (VBD) (%) and fibrograndular tissue volume (FG) (cm3) were determined based on the analysis of mammographic image (“for processing”) using Volpara Imaging Software. The exposure to IR was estimated for each individual, based on the data from interviews about diagnostic or therapeutic medical procedures performed in the area of the neck, chest, abdomen and spine, which involved X-rays and γ rays and the data about the doses derived from literature. Linear and logistic regression were fitted with VBD and FG as the outcomes and organ breast dose, effective dose and number of mammographies as the determinants, adjusted for major confounders. Results The analyses showed no association between VBD or FG and the breast organ dose or the effective dose. The only significant finding observed concerned the association between the number of mammographies and the FG volume with β coefficient: 0.028 (95% CI: 0.012–0.043), and predicted mean FG volume >13.4 cm3 among the women with >3 mammographies when compared to those with none. Conclusions This study does not, in general, provide support for the positive association between LDIR and MD. The weak association of the FG volume with the number of mammographies warrants further verification in larger independent studies.

4

Occupational exposure to ionizing radiation and lens opacity in interventional cardiologists

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Domienik-Andrzejewska J. , Kałużny P. , Piernik G. , Jurewicz J.

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tom 32

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nr 5

663-675

EN

Objectives Interventional cardiologists (ICs) are occupationally exposed to low or moderate doses of ionizing radiation from repeated exposures. It is not clear whether these occupational conditions may affect their eye lens. Therefore, the risk of radiation-induced cataract in the cohort of Polish interventional cardiologists is analyzed in this paper. Material and Methods The study group consisted of 69 interventional cardiologists and 78 control individuals occupationally unexposed to ionizing radiation. The eye lens opacities were examined using a slit camera and evaluated with Lens Opacities Grading System III. Cumulative eye lens doses were estimated retrospectively using a questionnaire including data on occupational history. Results The average cumulative dose to the left and right eye lens of the ICs was 224 mSv and 85 mSv, respectively. Nuclear opalescence and nuclear color opacities in the most exposed left eye were found in 38% of the ICS for both types, and in 47% and 42% of the controls, respectively. Cortical opacities were found in 25% of the ICS and 29% of the controls. Posterior subcapsular opacities were rare: about 7% in the ICs group and 6% in the control group. Overall, there was some, but statistically insignificant, increase in the risk for opacity in the ICs group, relative to the control group, after adjusting for the subjects’ age, gender, smoking status and medical exposure (adjusted OR = 1.47, 95% CI: 0.62–3.59 for the pooled “any-eye any-type” opacity). There was also no evidence for an increased opacity risk with an increase in the dose. Conclusions The study found no statistically significant evidence against the hypothesis that the risk of cataract in the group of the ICs occupationally exposed to low doses of ionizing radiation is the same as in the control group. Nevertheless, the adverse effect of ionizing radiation still cannot be excluded due to a relatively small study sample size. Int J Occup Med Environ Health. 2019;32(5):663–75

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Analysis of dose distribution around a computed tomography scanner in terms of exposure to scattered ionizing radiation of caregivers of pediatric patients

88%

Biegała M. , Brodecki M. , Skoczylas K. , Jakubowska T. , Domienik-Andrzejewska J.

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nr 3

326-334

EN

Objectives During computed tomography (CT), a large amount of ionizing radiation is emitted to ensure high quality of the obtained radiological image. This study measured the dose distribution around the CT scanner and the exposure of people staying near the CT scanner during the examination. Material and Methods The measurements used an anthropomorphic phantom to assess human exposure to ionizing radiation. The probability of inducing leukemia and other cancers as a result of absorbing doses recorded around the CT device was also calculated. Results The highest exposure to scattered radiation in the proximity of the CT scanner is recorded at the gantry of the tomograph, i.e., 55.7 μGy, and the lowest, below lower detection limit of 6 μGy at the end of the diagnostic table. The whole-body detector placed on the anthropomorphic phantom located at the diagnostic table right next to the CT gantry recorded 59.5 μSv and at the end of the table 1.5 μSv. The average doses to the lenses in these locations were: 32.1 μSv and 2.9 μSv, respectively. Conclusions The probability of induction of leukemia or other types of cancer is low, but the need for people to stay in the examination room during a CT examination should be limited to the necessary minimum.