Author: Jonathan Cole

1500-McDonaghFLUG2024CTHA-1Download Ed McDonagh, Louise Giansante, Jodie Basso, Shaira Farooq, Nicos Fotiadis, EW Johnston Purpose: Contrast-enhanced CT scans are routinely acquired before and after microwave liver ablation for planning and assessing the relationship between tumours and ablation zones, i.e. treatment efficacy. However, delivering contrast through peripherally inserted intravenous cannulas limits the number of acquisitions to a maximum of three scans, due to iodinated contrast dose. CT hepatic angiography involves positioning an arterial catheter, usually in the common or proper hepatic artery for selective contrast administration. This both reduces contrast dose and improves image quality for tumour and ablation zone depiction prior to, during and after ablation. Multiple contrast enhanced scans may be performed for improved ablation zone assessment and for on-table ablation zone extension if necessary in the same anaesthetic session. Placement of the catheter requires ultrasound and fluoroscopy guidance. The X-ray angiography suite and the interventional CT scanner are not co-located at our institution, and therefore placing the catheter in the Angiography...

With the increasing number and complexity of interventional cardiology procedures there is the potential of higher occupational radiation doses to interventionists. Significant development has been achieved with mobile lead equivalent radiation protection devices, providing enhanced radiation protection without the requirement of being directly worn by staff. The RAMPART M1128 radiation protection shield is one of these devices. The dose reduction provided to staff within a Cardiac Catheterisation Laboratory was assessed via use of Electronic Personal Dosimeters (EPD) with the Philips live dosimetry system DoseAware (Philips DoseAware). A 60% dose reduction to the primary operator can be achieved with the Rampart device. With further dose reductions possible for other individuals in the range of 65 to 84%. Additionally, dose rate measurements were taken in a simulated clinical set up using a phantom, which showed that the device provided a 65% dose reduction at eye level and 90% dose reduction at chest level for the primary operator position. This shows a potential...

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The England health authority publish annual IRMER reports (CQC, 2022) using only incidents of significance (SAUE). This study considers radiation incidents by healthcare providers in several UK nations and a crown-dependency. As most radiation incidents are non-reportable to the appropriate authority, analysis is limited to SAUE.  This study considers all radiation incidents from reports made to an appointed MPE, including incidents non-reportable to authorities and analysis has been undertaken of those incidents relating to fluoroscopic and interventional examinations. A database was created from 2883 reports of radiation incidents, provided by over 100 healthcare providers to their appointed MPE, during years 2020 – 2024 with further analysis to be undertaken on 2024 data. Each radiation incident was coded using a UK coding taxonomy (RCR, 2019), and the data for each code field was analysed quantitatively. There were 52 radiation incidents relating to fluoroscopy and relating to interventional procedures. Analysis of radiation incidents has been completed detailing: reportable incidents, examination details, duty holders and...

Purpose: According to the Ionizing Radiation (Medical Exposure) Regulations 2017 Reg 12, the radiation dose during all procedures should be kept as low as reasonably practicable [1], however, high dose procedures are unavoidable and can lead to deterministic risk if occurred. According to the NCRP168 [2] and ICRP 2000 [3], deterministic effects can occur at a Peak Skin dose (PSD) of 2Gy or greater and medical follow-up is required. The dose area product (DAP) is the alert indicator used to estimate (PSD). The aim was to review the current DAP alert level utilized in the most common interventional radiology (IR) examinations at UHCW, with particular interest in exams for which the alert level revision was requested. A few exams had frequently been triggering the alert level even though the skin dose remained below the threshold for deterministic effects and this is identified in this report. Methods: PSD was collected using DoseWatch which is installed in all GE interventional radiology suites. DoseWatch...