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Sample records for medicine interventional radiology

  1. Radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy. Contributed papers

    International Nuclear Information System (INIS)

    2001-01-01

    An International Conference on the Radiological Protection of Patients in Diagnostic and Interventional Radiology, Nuclear Medicine and Radiotherapy organized by the International Atomic Energy Agency and co-sponsored by the European Commission, the Pan American Health Organization and the World Health Organization was held in Malaga, Spain, from 26 to 30 March 2001. The Government of Spain hosted this Conference through the Ministerio de Sanidad y Consumo, the Consejo de Seguridad Nuclear, the Junta de Andalucia, the Universidad de Malaga and the Grupo de Investigacion en Proteccion Radiologica de la Universidad de Malaga (PRUMA). The Conference was organized in co-operation with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), the International Commission on Radiological Protection (ICRP) and the following professional societies: International Organization of Medical Physicists (IOMP), International Radiation Protection Association (IRPA), International Society of Radiation Oncology (ISRO), International Society of Radiology (ISR), International Society of Radiographers and Radiological Technologists (ISRRT) and World Federation of Nuclear Medicine and Biology (WFNMB). This publication contains contributed papers submitted to the Conference Programme Committee. The papers are in one of the two working languages of this Conference, English and Spanish. The topics covered by the Conference are as follows: Radiological protection of patients in general diagnostic radiology (radiography), Radiological protection of patients in general diagnostic radiology (fluoroscopy), Radiological protection issues in specific uses of diagnostic radiology, such as mammography and computed tomography (with special consideration of the impact of digital techniques), Radiological protection in interventional radiology, including fluoroscopy not carried out by radiologists, Radiological protection of patients in nuclear medicine, Developing and

  2. Interventional Radiology: Stroke

    Science.gov (United States)

    ... Government affairs Global outreach Publications Annual Report IR Quarterly Journal of Vascular and Interventional Radiology Newsletters Practice Resources Quality Improvement Clinical practice MACRA Matters Health Policy, Economics, Coding Toolkits Society of Interventional Radiology 3975 Fair ...

  3. Radiological protection in interventional radiology

    International Nuclear Information System (INIS)

    Padovani, R.

    2001-01-01

    Interventional radiology (IR) reduces the need for many traditional interventions, particularly surgery, so reducing the discomfort and risk for patients compared with traditional systems. IR procedures are frequently performed by non-radiologist physicians, often without the proper radiological equipment and sufficient knowledge of radiation protection. Levels of doses to patients and staff in IR vary enormously. A poor correlation exists between patient and staff dose, and large variations of dose are reported for the same procedure. The occurrence of deterministic effects in patients is another peculiar aspect of IR owing to the potentially high skin doses of some procedures. The paper reviews the use of IR and the radiological protection of patients and staff, and examines the need for new standards for IR equipment and the training of personnel. (author)

  4. Proceedings of the Session of Radiological Protection in Medicine

    International Nuclear Information System (INIS)

    2016-01-01

    The Argentine Society for Radiation Protection has organized the Radiological Protection Session in Medicine 2016 in order to continue with the radiological update on specific radiological topics in radiology, nuclear medicine and interventional medicine, as well as to optimize the radiological protection of workers, patients and the public. [es

  5. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  6. Practical interventional radiology

    International Nuclear Information System (INIS)

    Lammer, J.; Schreyer, H.

    1991-01-01

    The book is intended as a practical guide and manual for interventional radiology applications. Main emphasis is placed on the performance of the various techniques, with explanations of the various steps to be taken, illustrated by drawings or pictures. Indications, contra-indications and clinical achievements are given in brief. There is one chapter each for the following techniques: angioplasty - intra-arterial fibrinolysis - vascular stents - neuroembolisation - embolisation of other vessels - biliary interventions - abscess drainage - nephrostomy and ureteral manipulations -percutaneous fine-needle biopsy - vena cava filters - interventional radiology in infants. (orig.)

  7. Radiology in veterinary medicine

    International Nuclear Information System (INIS)

    Hrusovsky, J.; Benes, J.

    1985-01-01

    A textbook is presented for pregraduate and postgraduate students of veterinary medicine, offering an extensive review of all aspects of radiology as applied in veterinary sciences. Based on findings published in the literature and the authors' own research, the textbook familiarizes the reader with the problems of nuclear physics, biological effects of ionizing radiation on animals, the principles of biological cycles of radionuclides in the atmosphere, the fundamentals of radiochemistry, dosimetry, radiometry and nuclear medicine. Radiation protection of animals, raw materials, feeds, foodstuff and water, and the questions of the aplications of ionizing radiation and of radionuclides in veterinary medicine are discussed in great detail. The publication is complemented with numerous photographs, figures and graphs. (L.O.)

  8. Handbooks in radiology: Nuclear medicine

    International Nuclear Information System (INIS)

    Datz, F.L.

    1988-01-01

    This series of handbooks covers the basic facts, major concepts and highlights in seven radiological subspecialties. ''Nuclear Medicine'' is a review of the principles, procedures and clinical applications that every radiology resident and practicing general radiologist should know about nuclear medicine. Presented in an outline format it covers all of the organ systems that are imaged by nuclear medicine

  9. Anesthesia for interventional radiology

    International Nuclear Information System (INIS)

    van Sonnenberg, E.; Casola, G.; Varney, R.R.; D'Agostino, H.B.; Zornow, M.; Mazzie, W.

    1989-01-01

    We recognized that the complexity and surgical nature of many interventional radiology procedures dictate essential radiologic involvement into traditional anesthesiologic areas. They reviewed our experience with a variety of interventional procedures to document complications and problems related to anesthetic use (or misuse) and compile recommendations for rational monitoring and control for these procedures. In particular, the authors have studied complications of drug therapies and the treatment of these complications; use of complex anesthesia procedures (e.g., epidural anesthesia, succinylcholine blockage); reasons for choice of drugs (e.g., fentanyl vs meperidine vs morphine); and medico-legal aspects of radiologist performing traditional anesthesiology-type procedures

  10. [Radiation protection in interventional radiology].

    Science.gov (United States)

    Adamus, R; Loose, R; Wucherer, M; Uder, M; Galster, M

    2016-03-01

    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x‑ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X‑ray protection measures plus lead-containing eyeglasses.

  11. New era of the relationship between Chinese interventional radiology sub-society and journal of interventional radiology

    International Nuclear Information System (INIS)

    Li Linsun

    2009-01-01

    The past decades have witnessed interventional radiology in China to go from a very initial clinical practice to an important medical player in modern medicine. Recently, a friendly collaboration has been successfully established between the Chinese Interventional Radiology Sub-society and the Journal of Interventional Radiology. The Chinese Interventional Radiology Sub-society will take the full responsibility for the academic governance of the Journal of Interventional Radiology and the Journal of Interventional Radiology will formally become the sole interventional academic periodical of the Chinese Interventional Radiology Sub-society in China. This collaboration will surely make Chinese interventional radiology to initiate a new era,promote the further development of interventional radiology at home and enable the Journal of Interventional Radiology to step into the international medical circle. (authors)

  12. Radiological Protection in Medicine

    International Nuclear Information System (INIS)

    Valetin, J.

    2011-01-01

    This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report

  13. Attention for pediatric interventional radiology

    International Nuclear Information System (INIS)

    Zhu Ming; Cheng Yongde

    2005-01-01

    Radiological interventions possess wide utilization in the diagnosis and treatment for pediatric patients. Pediatric interventional radiology is an important branch of interventional radiology and also an important branch of pediatric radiology. Pediatric interventional radiology has grown substantially over the last 30 years, radiologists closely cooperation with surgeons and other physicians providing a new horizon in the management of pediatric diseases in western countries. It includes pediatric cardiac interventional radiology, pediatric neuro-interventional radiology, pediatric vascular interventional radiology, pediatric nonvascular interventional radiology, pediatric tumor interventional radiology and others. In the United States, every children hospital which owns two hundred beds has to have special trained interventional radiologists in radiologic department installing with advanced digital subtraction angiographic equipment. Interventional therapeutic procedures and diagnostic angiography have been proceeding more and more for the congenital and acquired diseases of children. The promising results give use uprising and interventional therapy as an alternative or a replacement or supplement to surgical operation. Pediatric interventional radiology is rather underdeveloped in China with a few special pediatric interventional radiologist, lack of digital subtraction angiography equipment. Pediatric radiologists have no enough field for interventional procedures such as pediatric neuro-interventional radiology and pediatric vascular interventional radiology. In the contrary adult interventional radiologists do have better interventional jobs in China and Pediatric cardiologists also share the same trend. They perform angiocardiography for congenital heart diseases and treat congenital heart disease with interventional procedures including balloon dilation of valves and vessels, coil embolization of collaterals, patent ducts and other arterial fistulae

  14. Poul Erik Andersen's radiological work on Osteochondrodysplasias and interventional radiology

    DEFF Research Database (Denmark)

    Andersen, Poul Erik

    2011-01-01

    Hospital. His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology, the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe, where he is a fellow and has passed the European Board...... of Interventional Radiology - The European qualification in Interventional Radiology....

  15. Interventional vascular radiology

    International Nuclear Information System (INIS)

    Yune, H.Y.

    1984-01-01

    The papers published during this past year in the area of interventional vascular radiology presented some useful modifications and further experiences both in the area of thromboembolic therapy and in dilation and thrombolysis, but no new techniques. As an introductory subject, an excellent monograph reviewing the current spectrum of pharmacoangiography was presented in Radiographics. Although the presented material is primarily in diagnostic application of various pharmacologic agents used today to facilitate demonstration of certain diagnostic criteria of various disease processes, both vasodilatory and vasoconstrictive reaction to these agents are widely used in various therapeutic vascular procedures. This monograph should be reviewed by every angiographer whether or not he or she performs interventional procedures, and it would be very convenient to have this table available in the angiography suite. In a related subject, Bookstein and co-workers have written an excellent review concerning pharmacologic manipulations of various blood coagulative parameters during angiography. Understanding the proper method of manipulation of the bloodclotting factors during angiography, and especially during interventional angiography, is extremely important. Particularly, the method of manipulating the coagulation with the use of heparin and protamine and modification of the platelet activity by using aspirin and dipyridamole are succinctly reviewed. The systemic and selective thrombolytic activities of streptokianse are also discussed

  16. Role of radiology in occupational medicine

    International Nuclear Information System (INIS)

    Vehmas, T.

    2004-01-01

    This review discusses the contribution of radiology to occupational medicine as well as work-related problems in radiology dept.s. Research issues are emphasized. Radiology has been used especially when diagnosing occupational respiratory and locomotive system problems and solvent-induced encephalo- and hepatopathy. The aim of research in these areas is usually to characterize occupational diseases and to identify physico-chemical hazards in the work place by comparing between groups of workers and non-exposed controls. Radiological imaging allows an objective characterization of the disease, and it may clarify the pathogenesis of the process and provide a useful epidemiological tool. Advanced statistical methods are often needed to adjust analyses for confounding variables. As the diagnostic requirements are increasing, more sensitive and sophisticated radiological methods, such as high-resolution computed tomography, magnetic resonance imaging and magnetic resonance spectroscopy, may be required for the early recognition of occupational health risks. This necessitates good cooperation between occupational health units and well-equipped imaging dept.s. Considering occupational problems in radiology departments, the increasing use of digital radiology requires ergonomic measures to control and prevent locomotive problems caused by work with computers. Radiation protection measures are still worth concern, especially in interventional radiology

  17. [Brief history of interventional radiology].

    Science.gov (United States)

    Tang, Zhenliang; Jia, Aiqin; Li, Luoyun; Li, Chunyu

    2014-05-01

    In 1923, angiography was first successively used for the human body. In 1953, a Swedish doctor Sven-Ivar Seldinger pioneered the Seldinger technique, which laid down the foundation of interventional radiology. In 1963, Charles Dotter first proposed the idea of interventional radiology. In 1964, Charles Dotter opened a new era of percutaneous angioplasty through accidental operation, marking the formation of interventional radiology. On this basis, the techniques of balloon catheter dilation and metal stent implantation was developed. Endovascular stent was proposed in 1969. In 1973, the percutaneous angioplasty has been a breakthrough with the emergence of soft double-lumen balloon catheter. Percutaneous coronary angioplasty is applied in 1977. Since the 1990s, balloon angioplasty relegated to secondary status with the emergence of metal stent. Currently, endovascular stent have entered a new stage with the emergence of temporary stent and stent grafts and biological stent. Transcatheter arterial embolization had been one of the most important basic techniques for interventional radiology since 1965, it had also been a corresponding development with the improvement of embolic agents and catheter technology for the treatment of diseases now. Transjugular intrahepatic portosystemic stent-shunt is a comprehensive interventional radiology technology since 1967, in which the biliary system can be reached through a jugular vein, and the improvement appeared with balloon expandable stent in 1986.Since 1972, non-vascular interventional techniques was another important branch of interventional radiology. Currently, it is applied in the diagnosis and treatment of many diseases of the internal organs like the pancreas, liver, kidney, spinal cord, Fallopian tubes, esophagus and other organs. In 1973, Chinese radiologist first conducted the angiography test. Interventional radiology was introduced into China in the 1980s, it was readily developed through the sponsoring of

  18. First Central and Eastern European Workshop on Quality control, patient dosimetry and radiation protection in diagnostic and interventional radiology and nuclear medicine

    International Nuclear Information System (INIS)

    National Frederic Joliot-Curie Research Institute for Radiobiology and Radiohygiene

    2007-01-01

    First Central and Eastern European Workshop on Quality Control, Patient Dosimetry and Radiation Protection in Diagnostic and Interventional Radiology and Nuclear Medicine, scientifically supported and accredited as a CPD event for medical physicists by EFOMP, National 'Frederic Joliot-Curie' Research Institute for Radiobiology and Radiohygiene (NRIRR), Budapest, Hungary, April 25-28, 2007. Topics of the meeting included all areas of medical radiation physics except radiation therapy. A unique possibility was realized by inviting four European manufacturers of quality control instrumentation, not only for exhibiting but they also had 45 minutes individual presentations about each manufacturer's product scale and conception. Further sessions dealt with dosimetry, optimization, quality control and testing, radiation protection and standardization, computed tomography and nuclear medicine, in 29 oral presentations and 1 poster of the participants. (S.I.)

  19. White Paper: Curriculum in Interventional Radiology.

    Science.gov (United States)

    Mahnken, Andreas H; Bücker, Arno; Hohl, Christian; Berlis, Ansgar

    2017-04-01

    Purpose  Scope and clinical importance of interventional radiology markedly evolved over the last decades. Consequently it was acknowledged as independent subspecialty by the "European Union of Medical Specialists" (UEMS). Based on radiological imaging techniques Interventional Radiology is an integral part of Radiology. Materials und Methods  In 2009 the German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a structured training in Interventional Radiology. In cooperation with the German Society of Neuroradiology (DGNR) this training was extended to also cover Interventional Neuroradiology in 2012. Tailored for this training in Interventional Radiology a structured curriculum was developed, covering the scope of this modular training. Results  The curriculum is based on the DeGIR/DGNR modular training concept in Interventional Radiology. There is also an European Curriculum and Syllabus for Interventional Radiology developed by the "Cardiovascular and Interventional Radiological Society of Europe" (CIRSE). The presented curriculum in Interventional Radiology is designed to provide a uniform base for the training in Interventional Radiology in Germany, based on the competencies obtained during residency. Conclusion  This curriculum can be used as a basis for training in Interventional Radiology by all training sites. Key Points: · Interventional Radiology is an integral part of clinical radiology. · The German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a curriculum in Interventional Radiology. · This curriculum is an integrative basis for the training in interventional. Citation Format · Mahnken AH, Bücker A, Hohl C et al. White Paper: Curriculum in Interventional Radiology. Fortschr Röntgenstr 2017; 189: 309 - 311. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Sedoanalgesia in interventional radiology

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.

    2002-01-01

    Purpose: Development of a save and effective protocol for analgosedation of patients undergoing painful interventional procedures. Material and Methods: In a prospective trial a consecutive series of 72 adult patients underwent analgosedation during painful interventions. A radiologist performed the analgosedation, the patients received a combination of a shortly effective piperidine derivative (Alfentanil [Rapifen trademark ]; 7.5-15 μg/kg body weight) and Benzodiazepine (midazolam [Dormicum trademark ]; 20 μg/kg body weight). After pre-procedure oxygenation patients were continuously monitored. Pain and discomfort were scored using an established visual-analog pain score (0-10). A control group (n=24) had received midazolam, pentazocine or fentanyl according to the study protocol. Results: All procedures could be carried out by an interventional radiologist and a nurse and/or technologist only. In 69/72 cases adequate analgosedation could be achieved. Injection of alfentanil was titrated, with a rapid onset and short acting effect of the analgesia. Patients reported an average pain score of 2.6 vs. 4.5 in the control group. Over 55% experienced no or mild pain (score 0-3), in the control group only 8% reached this level. Conclusion: A combination of shortly effective alfentanil and midazolam allows interventional radiologists to perform major procedures alone under effective analgosedation. This medication scheme is superior to the medication upon demand. (orig.) [de

  1. Interventional neuroradiology techniques in interventional radiology

    CERN Document Server

    Murphy, Kieran; Robertson, Fergus; Watkinson, Anthony

    2013-01-01

    This book provides accessible technique-specific information on interventional radiology procedures, in a format suitable for reference in the IR treatment room or as a carry-around guide. Offers step-by-step points, key point summaries and illustrations.

  2. Computational radiology for orthopaedic interventions

    CERN Document Server

    Li, Shuo

    2016-01-01

    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  3. Interventional radiology in congenital and acquired cardiovascular diseases

    International Nuclear Information System (INIS)

    Ivanitskij, A.V.

    2000-01-01

    Interventional cardiology is a part of interventional radiology applying in urology, neurology, gynecology and other branches of medicine. The present-day achievements in interventional radiology in cardiovascular diseases: balloon valvuloplasty in cardiac diseases (isolated pulmonary arterial stenosis, aortic and mitral stenosis), balloon vasodilatation (peripheral pulmonary arterial stenosis, aortic coarctation), embolization of the vessels and pathological communications, atrioseptostomy, transcatheter closure of atrial septal defects are presented. It is shown that the achievements in interventional radiology in cardiovascular diseases are intimately associated with the progress in cannulation of heart and angiography [ru

  4. Patient dosimetry in interventional radiology

    International Nuclear Information System (INIS)

    Silva, Mauro Wilson O. da; Canevaro, Lucia V.; Rodrigues, Barbara Beatriz D.

    2009-01-01

    Mapping skin doses in interventional radiology is useful to determine the probability of a possible injury, to detect areas of overlapping field and to obtain a permanent register of the most exposed skin areas. A method for the evaluation of patient doses in interventional radiology procedures is the slow film, Kodak EDR2 (Extended Dose Range). Kodak EDR 2 film was calibrated in the range of 50 kVp to 120 kVp beam qualities. Its dose-response curve was plotted up to the saturation point of 1000 mGy. Dose responses are a function of facility dependent factors including processing conditions the density sampling, and exposure monitoring equipment. The distribution and the form of all the irradiation fields have been registered in the Kodak EDR 2 films. The Dosimetric analysis was performed in a sample of 37 patients submitted the procedures coronariography and angioplasty. The film has a threshold of saturation around 1 Gy, the applied methodology is efficient to quantify the doses and to identify the distribution of the fields. (author)

  5. Patient dose in interventional radiology

    International Nuclear Information System (INIS)

    Fernandez Bordes, M.; Berenguer, R.; Gomez, P.; Bejar, M.J.; Gonzalez, S.

    2001-01-01

    This paper presents the estimation of dose-area product (DAP) received by 128 patients during different interventional radiological procedures in the Hospital Universitario de Salamanca, analyzing the differences between procedures classified as either vascular, non vascular, diagnostic or therapeutic. These differences can be assessed and reference dose levels can be established as a function of the variation of those parameters. Comparisons between dose-area product values obtained from this study are made with the data from nine other patient dose surveys, although explanations for some of the differences could not be obtained in some cases. The reference values in these procedures in our centre are very high due to a great number of images, so the clinical protocol should be changed to avoid this problem. (author)

  6. The interventional radiology business plan.

    Science.gov (United States)

    Beheshti, Michael V; Meek, Mary E; Kaufman, John A

    2012-09-01

    Strategic planning and business planning are processes commonly employed by organizations that exist in competitive environments. Although it is difficult to prove a causal relationship between formal strategic/business planning and positive organizational performance, there is broad agreement that formal strategic and business plans are components of successful organizations. The various elements of strategic plans and business plans are not common in the vernacular of practicing physicians. As health care becomes more competitive, familiarity with these tools may grow in importance. Herein we provide an overview of formal strategic and business planning, and offer a roadmap for an interventional radiology-specific plan that may be useful for organizations confronting competitive and financial threats. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  7. Deepening the reform of interventional radiology education and speeding up the development of interventional radiology

    International Nuclear Information System (INIS)

    Lu Chuan; Liu Linxiang; Cheng Yongde

    2010-01-01

    For recent years, although interventional radiology in China has achieved rapid development, it is still facing some rigorous challenges, such as the lack of personnel in interventional field and the flowing-away of certain patients who are definitely suitable for interventional therapy. This paper aims to discuss the reform of interventional radiology education for the undergraduates, postgraduates and clinical practitioners in the medical colleges in order to seek effective solutions to these issues the interventional radiology has confronted with. (authors)

  8. Radiological protection in medicine: work of ICRP Committee 3

    International Nuclear Information System (INIS)

    Vañó, E.; Cosset, J.M.; Rehani, M.M.

    2012-01-01

    Committee 3 of the International Commission on Radiological Protection (ICRP) is concerned with protection in medicine, and develops recommendations and guidance on the protection of patients, staff, and the public against radiation exposure in medicine. This paper presents an overview of the work of Committee 3 over recent years, and the work in progress agreed at the last annual meeting in Bethesda, MD in October 2011. The reports published by ICRP dealing with radiological protection in medicine in the last 10 years cover topics on: education and training in radiological protection; preventing accidental exposures in radiation therapy; dose to patients from radiopharmaceuticals; radiation safety aspects of brachytherapy; release of patients after therapy with unsealed radionuclides; managing patient dose in digital radiology and computed tomography; avoidance of radiation injuries from medical interventional procedures; pregnancy and medical radiation; and diagnostic reference levels in medical imaging. Three new reports will be published in the coming months dealing with aspects of radiological protection in fluoroscopically guided procedures outside imaging departments; cardiology; and paediatric radiology. The work in progress agreed by Committee 3 is also described.

  9. Applying 'Evidence-Based Medicine' Theory to Interventional Radiology.Part 2: A Spreadsheet for Swift Assessment of Procedural Benefit and Harm

    International Nuclear Information System (INIS)

    MacEneaney, Peter M.; Malone, Dermot E.

    2000-01-01

    AIM: To design a spreadsheet program to analyse interventional radiology (IR) data rapidly produced in local research or reported in the literature using 'evidence-based medicine' (EBM) parameters of treatment benefit and harm. MATERIALS AND METHODS: Microsoft Excel TM was used. The spreadsheet consists of three worksheets. The first shows the 'Levels of Evidence and Grades of Recommendations' that can be assigned to therapeutic studies as defined by the Oxford Centre for EBM. The second and third worksheets facilitate the EBM assessment of therapeutic benefit and harm. Validity criteria are described. These include the assessment of the adequacy of sample size in the detection of possible procedural complications. A contingency (2 x 2) table for raw data on comparative outcomes in treated patients and controls has been incorporated. Formulae for EBM calculations are related to these numerators and denominators in the spreadsheet. The parameters calculated are benefit -- relative risk reduction, absolute risk reduction, number needed to treat (NNT). Harm -- relative risk, relative odds, number needed to harm (NNH). Ninety-five per cent confidence intervals are calculated for all these indices. The results change automatically when the data in the therapeutic outcome cells are changed. A final section allows the user to correct the NNT or NNH in their application to individual patients. RESULTS: This spreadsheet can be used on desktop and palmtop computers. The MS Excel TM version can be downloaded via the Internet from the URL ftp://radiography.com/pub/TxHarm00.xls. CONCLUSION: A spreadsheet is useful for the rapid analysis of the clinical benefit and harm from IR procedures. MacEneaney, P.M. and Malone, D.E

  10. Internal medicine. An illustrated radiological guide

    Energy Technology Data Exchange (ETDEWEB)

    Al-Tubaikh, Jarrah Ali [Universitaetsklinikum Muenchen, Klinikum Grosshadern (Germany). Inst. fuer Klinische Radiologie; Sabah Hospital, Kuwait (Kuwait). Dept. of Diagnostic Radiology

    2010-07-01

    This book explains how radiology can be a powerful tool for establishing the diagnosis of many internal medicine diseases that are usually diagnosed on the basis of their laboratory or clinical presentation. It is organized in the classic fashion for internal medicine books, with eleven chapters covering the different internal medicine specialties. Within these chapters, more than 450 diseases are considered, some of which are rarely encountered but are nonetheless significant. For each disease, radiological and clinical features are displayed in images and high-quality digital medical illustrations, and those differential diagnoses are identified that can be ruled out by imaging alone. In addition, the pathophysiology underlying the radiological features is described, enabling the reader to understand why a particular sign is seen on MR images, CT scans, or plain radiographs. The book will serve as an excellent radiological atlas for internal medicine practitioners and family physicians, showing disease presentations that may be hard to find in standard medical textbooks and explaining which imaging modalities are likely to be most informative in particular patients. (orig.)

  11. Glove Perforations During Interventional Radiological Procedures

    International Nuclear Information System (INIS)

    Leena, R. V.; Shyamkumar, N. K.

    2010-01-01

    Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

  12. Clinical dosimetry in diagnostic and interventional radiology

    International Nuclear Information System (INIS)

    Dimcheva, M.; Sergieva, S.; Jovanovska, A.

    2012-01-01

    Full text: Introduction: Diagnostic and interventional procedures involving x-rays are the most significant contributor to total population dose form man made sources of ionizing radiation. Purpose and aim: X-ray imaging generally covers a diverse range of examination types, many of which are increasing in frequency and technical complexity. Materials and methods: The European Directives 96/29 and 97/43 EURATOM stress the importance of accurate dosimetry and require calibration of all measuring equipment related to application of ionizing radiation in medicine. Results: The paper gives and overview of current system of dosimetry of ionizing radiations that is relevant for metrology and clinical applications. It also reflects recently achieved international harmonization in the field promoted by International Atomic Energy Agency (IAEA). Discussion: Objectives of clinical dose measurements in diagnostic and interventional radiology are multiple, as assessment of equipment performance, or assessment of risk emerging from use of ionizing radiation Conclusion: Therefore, from the clinical point of view, the requirements for dosimeters and procedures to assess dose to standard dosimetry phantoms and patients in clinical diverse modalities, as computed tomography are presented

  13. Interventional radiology to treat severe obstetric hemorrhages

    OpenAIRE

    Lippi, Umberto Gazi

    2011-01-01

    ABSTRACT The author discusses the recent role of interventional radiology to prevent postpartum hemorrhagic complications that represent an important cause of maternal morbidity and mortality all over the world. Hence, hemorrhage control is mandatory. Traditional management and recent minimally invasive radiological procedures by means of inserting occluding balloons into appropriate vessels are analyzed. It is advisable that maternity hospitals have protocols for the management of obstetric ...

  14. Optimization approach within an interventional radiology department

    International Nuclear Information System (INIS)

    Mozziconacci, J.G.; Brot, A.M.; Jarrige, V.

    2009-01-01

    The authors present an approach aimed at optimizing working conditions and radioprotection for the different actors in interventional radiology. This approach comprises a monitoring of personnel dosimetry, a workstation analysis with risk assessment, and the taking into account of patient dosimetry. For each of these aspects, the authors discuss procedures and available devices (dosemeters and other detection or dose measurement equipment)

  15. Toward safe actuation for robotized interventional radiology

    OpenAIRE

    Esteveny, Laure

    2014-01-01

    In the context of interventional radiology, robotic-assisted surgery limits practitioners’ exposure to radiations and brings more accuracy to perform complex interventions. However, the presence of robot in the environment is a potential danger for the patient and the medical staff in case of unexpected interactions and manipulations.In this PhD thesis, we first focus on safety problems. An intrinsically safe mechanism is proposed. The achieved prototype allows to follow both planned trajecto...

  16. Training in Radiation Protection for Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vano, E.; Guibelalde, E.

    2002-07-01

    Several potential problems have been detected in the safety aspects for the practice of interventional radiology procedures: a) An important increase in the number cases and their complexity and the corresponding increase of installations and specialists involved; b) New X ray systems more sophisticated, with advanced operational possibilities, requiring special skills in the operators to obtain the expected benefits;c) New medical specialists arriving to the interventional arena to profit the benefits of the interventional techniques without previous experience in radiation protection. For that reason, education and training is one of the basic areas in any optimisation programme in radiation protection (RP). the medical field and especially interventional radiology requires actions to promote and to profit the benefit of the new emerging technologies for training (Internet, electronic books, etc). The EC has recently sponsored the MARTIR programme (Multimedia and Audio-visual Radiation Protection Training in Interventional Radiology) with the production of two videos on basic aspects of RP and quality control and one interactive CD-ROM to allow tailored individual training programmes. those educational tools are being distributed cost free in the main European languages. To go ahead with these actions, the EC has decided to promote during 2002, a forum with the main Medical European Societies involved in these interventional procedures. (Author)

  17. Training in Radiation Protection for Interventional Radiology

    International Nuclear Information System (INIS)

    Vano, E.; Guibelalde, E.

    2002-01-01

    Several potential problems have been detected in the safety aspects for the practice of interventional radiology procedures: a) An important increase in the number cases and their complexity and the corresponding increase of installations and specialists involved; b) New X ray systems more sophisticated, with advanced operational possibilities, requiring special skills in the operators to obtain the expected benefits;c) New medical specialists arriving to the interventional arena to profit the benefits of the interventional techniques without previous experience in radiation protection. For that reason, education and training is one of the basic areas in any optimisation programme in radiation protection (RP). the medical field and especially interventional radiology requires actions to promote and to profit the benefit of the new emerging technologies for training (Internet, electronic books, etc). The EC has recently sponsored the MARTIR programme (Multimedia and Audio-visual Radiation Protection Training in Interventional Radiology) with the production of two videos on basic aspects of RP and quality control and one interactive CD-ROM to allow tailored individual training programmes. those educational tools are being distributed cost free in the main European languages. To go ahead with these actions, the EC has decided to promote during 2002, a forum with the main Medical European Societies involved in these interventional procedures. (Author)

  18. Safety of Conscious Sedation In Interventional Radiology

    International Nuclear Information System (INIS)

    Arepally, Aravind; Oechsle, Denise; Kirkwood, Sharon; Savader, Scott J.

    2001-01-01

    Purpose: To identify rates of adverse events associated with the use of conscious sedation in interventional radiology.Methods: In a 5-month period, prospective data were collected on patients undergoing conscious sedation for interventional radiology procedures (n = 594). Adverse events were categorized as respiratory, sedative, or major adverse events. Respiratory adverse events were those that required oral airway placement, ambu bag, or jaw thrust. Sedation adverse events were unresponsiveness, oxygen saturation less than 90%, use of flumazenil/naloxone, or agitation. Major adverse events were hypotension, intubation, CPR, or cardiac arrest. The frequency of adverse events for the five most common radiology procedures were determined.Results: The five most common procedures (total n = 541) were biliary tube placement/exchange (n = 182), tunneled catheter placement (n 135), diagnostic arteriography (n = 125), vascular interventions (n = 52), and other catheter insertions (n = 46). Rates for respiratory, sedation, and major adverse events were 4.7%, 4.2%, and 2.0%, respectively. The most frequent major adverse event was hypotension (2.0%). Biliary procedures had the highest rate of total adverse events (p < .05) and respiratory adverse events (p < .05).Conclusion: The frequency of adverse events is low with the use of conscious sedation during interventional procedures. The highest rates occurred during biliary interventions

  19. Interventional radiology in pain treatment

    International Nuclear Information System (INIS)

    Kastler, B.

    2007-01-01

    Disease whether it is acute, chronic, or at end stage, is all too regularly accompanied by pain. Pain is often difficult to control, in malignant disease in particular, even by using appropriate medications. Anesthesiologists and pain therapists have developed new invasive therapies including nerve block, sympatholysis, and neurolysis useful for both diagnosis and pain management. To insure the efficiency and safety of these procedures, and furthermore for elaborate techniques such as vertebroplasty, cementoplasty, and radio frequency bone ablation, imaging guidance becomes mandatory. This state-of-the-art book describes the techniques elaborated by interventional radiologists in the treatment and palliation of a variety of benign and malignant painful conditions. Each chapter written by an expert in the field concentrates on a particular aspect of pain management, with emphasis on practical issues. This book will serve as an invaluable source of information for the radiologist willing to learn about new pain therapy techniques aimed at optimizing or replacing more invasive traditional methods. (orig.)

  20. Interventional Radiology of Male Varicocele: Current Status

    Energy Technology Data Exchange (ETDEWEB)

    Iaccarino, Vittorio, E-mail: vittorio.iaccarino@unina.it; Venetucci, Pietro [University of Naples ' Federico II' , Diagnostic Imaging Department-Cardiovascular and Interventional Radiology, School of Medicine (Italy)

    2012-12-15

    Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

  1. Interventional Radiology of Male Varicocele: Current Status

    International Nuclear Information System (INIS)

    Iaccarino, Vittorio; Venetucci, Pietro

    2012-01-01

    Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence and persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.

  2. Interventional Radiology Readiness Assessment Tool for Global Health

    Directory of Open Access Journals (Sweden)

    Aaron D. Kline

    2017-05-01

    Full Text Available The Interventional Radiology Readiness Assessment Tool for Global Health is a new tool to methodically evaluate the environment of a medical institution for interventional radiology services given the existing infrastructure. Global health provides an exciting opportunity for interventional radiology to impact health outcomes in developing countries. A systematic and thoughtful approach to integrating interventional radiology services in the health care institutions of resource poor countries is needed in order to maximize global health efforts and outcomes.

  3. Protection of staff in interventional radiology

    International Nuclear Information System (INIS)

    Melkamu, M. A.

    2013-04-01

    This project focuses on the interventional radiology. The main objective of this project work was to provide a guidance and advice for occupational exposure and hospital management to optimize radiation protection safety and endorse safety culture. It provides practical information on how to minimize occupational exposure in interventional radiology. In the literature review all considerable parameters to reduce dose to the occupationally exposed are well discussed. These parameters include dose limit, risk estimation, use of dosimeter, personal dose record keeping, analysis of surveillance of occupational dose, investigation levels, and proper use of radiation protection tools and finally about scatter radiation dose rate. In addition the project discusses the ways to reduce occupational exposure in interventional radiology. The methods for dose reduction are minimizing fluoroscopic time, minimizing the number of fluoroscopic image, use of patient dose reduction technologies, use of collimation, planning interventional procedures, positioning in low scattered areas, use of protective shielding, use of appropriate fluoroscopic imaging equipment, giving training for the staff, wearing the dosimeters and know their own dose regularly, and management commitment to quality assurance and quality control system and optimization of radiation protection of safety. (author)

  4. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

    International Nuclear Information System (INIS)

    Tsetis, Dimitrios; Uberoi, Raman; Fanelli, Fabrizio; Roberston, Iain; Krokidis, Miltiadis; Delden, Otto van; Radeleff, Boris; Müller-Hülsbeck, Stefan; Szerbo-Trojanowska, Malgorzata; Lee, Michael; Morgan, Robert; Brountzos, Elias; Belli, Anna Maria

    2016-01-01

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

  5. The Provision of Interventional Radiology Services in Europe: CIRSE Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Tsetis, Dimitrios, E-mail: tsetis@med.uoc.gr [University of Crete, Interventional Radiology Unit, Department of Radiology, University Hospital Heraklion, Faculty of Medicine (Greece); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliff Hospital, Radiology Department (United Kingdom); Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [Sapienza – University of Rome, Interventional Radiology Unit, Department of Radiological Sciences (Italy); Roberston, Iain, E-mail: bsiriain@gmail.com [Gartnavel General Hospital, Interventional Radiology Unit (United Kingdom); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Foundation Trust, Department of Radiology (United Kingdom); Delden, Otto van, E-mail: o.m.vandelden@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de [University Hospital of Heidelberg, Department for Diagnostic and Interventional Radiology (Germany); Müller-Hülsbeck, Stefan, E-mail: muehue@diako.de [Ev.-Luth. Diakonissenanstalt zu Flensburg – Zentrum für Gesundheit und Diakonie, Diagnostische u. Interventionelle Radiologie/Neuroradiologie (Germany); Szerbo-Trojanowska, Malgorzata, E-mail: m.trojanowska@umlub.pl [Medical University of Lublin, Interventional Radiology (Poland); Lee, Michael, E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Brountzos, Elias, E-mail: ebrountz@med.uoa.gr [National and Kapodistrian University of Athens (Greece); Belli, Anna Maria, E-mail: Anna.belli@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom)

    2016-04-15

    Interventional Radiology (IR) is an essential part of modern medicine, delivering minimally invasive patient-focused care, which has been proven to be safe and effective in both elective and emergency settings. The aim of this document is to outline the core requirements and standards for the provision of Interventional Radiological services, including training, certification, manpower, and accreditation. The ultimate challenge will be the adoption of these recommendations by different countries and health economies around the world, in turn ensuring equal access to IR treatments for all patients, the appropriate distribution of resources for IR service provision as well as the continued development of safe and high-quality IR services in Europe and beyond.

  6. Training for Radiation Protection in Interventional Radiology

    International Nuclear Information System (INIS)

    Bartal, G.; Sapoval, M.; Ben-Shlomo, A.

    1999-01-01

    Program in radiological equipment has incorporated more powerful x-ray sources into the standard Fluoroscopy and CT systems. Expanding use of interventional procedures carries extensive use of fluoroscopy and CT which are both associated with excessive radiation exposure to the patient and personnel. During cases of Intravenous CT Angiography and direct Intraarterial CT Angiography, one may substitute a substantial number of diagnostic angiography checks. Basic training in interventional radiology hardly includes some of the fundamentals of radiation protection. Radiation Protection in Interventional Radiology must be implemented in daily practice and become an integral part of procedure planning strategy in each and every case. Interventional radiological most master all modern imaging modalities in order to choose the most effective, but least hazardous one. In addition, one must be able to use various imaging techniques (Fluoroscopy, CTA, MM and US) as a stand-alone method, as well as combine two techniques or more. Training programs for fellows: K-based simulation of procedures and radiation protection. Special attention should be taken in the training institutions and a basic training in radiation protection is advised before the trainee is involved in the practical work. Amendment of techniques for balloon and stent deployment with minimal use of fluoroscopy. Attention to the differences between radiation protection in cardiovascular and nonvascular radiology with special measures that must be taken for each one of them (i.e., peripheral angiography vs. stenting, Endo luminal Aortic Stent Graft, or nonvascular procedures such as biliary or endo urological stenting or biliary intervention). A special emphasis should be put on the training techniques of Interventional Radiologists, both beginners and experienced. Patient dose monitoring by maintaining records of fluoroscopic time is better with non-reset timer, but is optional. Lee of automated systems that

  7. Contrast media properties in interventional radiology

    International Nuclear Information System (INIS)

    Laerum, F.; Enge, I.

    1989-01-01

    Potential hazards of the use of contrast media (CM) in interventional radiology are analyzed by looking into each procedure regarding interactions of CM with pharmaceutical additives, with technical equipment possibly affecting CM stability, and special local or systemic demands related to the procedure. Also the impact of these factors upon the physiological mechanisms are taken into account. (H.W.). 32 refs.; 4 figs.; 2 tabs

  8. Direct radiological magnification in experimental medicine

    International Nuclear Information System (INIS)

    Poulsen Nautrup, C.; Berens von Rautenfeld, D.

    1991-01-01

    Some aspects of direct radiological magnification in experimental medicine are shown by teratological investigations of the fetal rat skeleton and by indirect lymphadenography in rabbits. A combination of microfocal radiography and high-resolution non-screen films or digital image processing allows the evaluation of structures with a minimum size of 5 μm. Pseudo-3D images correlate directly with scanning electron micrographs of equivalent casts. Therefore radiography with direct magnification can make difficult preparations and time-consuming staining processes unnecessary. Besides saving time, the main advantage of this method is the amount of new information it yields. For the first time, for example, the filling mechanism becomes visible even in minute vessels, such as the intranodal sinuses, which measure about 10 μm. Hitherto, we have only been able to infer this mechanism from histological specimens. A further benefit of direct radiological magnification over the conventional microscopical method is the smaller number of experimental animals needed. (orig.) [de

  9. ICRP and radiological protection in medicine

    International Nuclear Information System (INIS)

    Cousins, Claire

    2017-01-01

    Standards in relation to radiological protection in medicine are well-documented, particularly with the recent update of the Basic Safety Standards. The principles of justification and optimisation remain key, as dose limitation is not applicable in medical practice. Appropriate justification relies on the knowledge, experience and discretion of the relevant medical practitioners and this may be overlooked in the race for diagnosis and treatment. One argument would be further regulation of medical exposures, although it is difficult to see how this could be imposed without denying patients essential investigations and treatments. Another contentious issue is individual patient dose management with the possible creation of a 'radiation passport'. Individual radiation susceptibility is a topic that has attracted much attention, but how to manage such persons, if identified, raises further questions. Communicating radiation risks and benefits to patients appropriately needs to be addressed, including who should be responsible for this, given accurate knowledge is a prerequisite. Ethics in radiological protection is also being widely discussed and this in relation to medical practice, which already involves numerous ethical issues, is likely to be open to debate in the near future. (authors)

  10. Anesthesia Practices for Interventional Radiology in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Vari, Alessandra, E-mail: alessandra.vari@uniroma1.it [University La Sapienza, Department of Anesthesiology, Intensive Care and Pain Medicine (Italy); Gangi, Afshin, E-mail: gangi@unistra.fr [Les Hôpitaux Universitaires de Strasbourg, Chef de Pôle, Imagerie (France)

    2017-06-15

    PurposeThe Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe.MethodsAnonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology.ResultsPredictable differences between countries and national regulations were confirmed, showing how significantly many “local” factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care.ConclusionSignificant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

  11. Anesthesia Practices for Interventional Radiology in Europe

    International Nuclear Information System (INIS)

    Vari, Alessandra; Gangi, Afshin

    2017-01-01

    PurposeThe Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe.MethodsAnonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology.ResultsPredictable differences between countries and national regulations were confirmed, showing how significantly many “local” factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care.ConclusionSignificant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

  12. Practical impact of the evolution and changes of ICRP recommendations on radiological protection in medicine

    Energy Technology Data Exchange (ETDEWEB)

    Mattsson, S.; Almen, A. [Lund Univ. (Sweden). Dept. of Radiation Physics

    1995-12-31

    The International Commission on Radiological Protection (ICRP) has given recommendations concerning the radiological protection of the patient in diagnostic radiology, nuclear medicine and radiation therapy, as well as of the worker in medicine and dentistry. In spite of these earlier recommendations, the situation in medicine is far from optimal showing a wide distribution of patient doses among various departments and hospitals without any similar variation in diagnostic information. There is a special need to emphasise such areas, which have the potential of high patient dose and/or high risk, e.g. interventional radiography, computed tomography, and paediatric radiology. For medical exposures, ICRP (Publication 60) still indicates that if the practice is justified and the protection optimised, dose limits should not be applied. However, it does recommend the development of reference levels as a quantitative guide to optimisation. Consideration should also be given to potential accidents and intervention. (Author).

  13. Radiological Protection of Patients in Nuclear Medicine

    International Nuclear Information System (INIS)

    Rojo, A.M.

    2011-01-01

    Full text: This lecture aims at presenting the state of the art of radiological protection of patients in nuclear medicine focusing on three aspects of interest where to achieve improvement. The hierarchy of the justification principle of the radiation protection is one of them. There seems for a change to be presented in the paradigm of the radiological protection of patients. The role of the physician who prescribes the medical practice becomes more relevant, together with the nuclear medicine specialist who should be co-responsible for the application of this justification principle. Regarding the doses optimization and the implementation of Dose Reference Level the involvement extends far beyond the physician and radioprotection officer. It is clear that the Medical Physicist is to play a very relevant role in the coordination of actions, as the nuclear medicine technician is to execute them. Another aspect to consider is patient specific dosimetry. It should become a routine practice through calculation of the absorbed dose based on biodistribution data. It should be assessed for each individual patient, as it depends on a number of patient-specific parameters, such as gender, size and the amount of fatty tissue in the body, as well as the extent and nature of the disease. In most cases, dosimetry calculations are not carried out and patients are administered standard levels of activity. There may be situations with a lack of knowledge on internal dosimetry as in many centers either none or only one or two medical physics experts are available. It shows that a formal training for experts in internal dosimetry at national level is required. However up to now, there has been no satisfactory correlation between absorbed dose estimates and patient response. Moreover, the radiation protection for the patient is not assured, as the dose values given are often numbers without connection to radiobiological and/or hematological findings. Pending tasks related to

  14. Dosimetry with slow films in Interventional Radiology

    International Nuclear Information System (INIS)

    Ten, J.I.; Guibelalde, E.; Fernandez, J.M.; Canevaro, L.; Ramirez, R.; Vano, E.

    1998-01-01

    In this work it is presented a method for evaluation of patients doses in Interventional Radiology (RI). The method proposed in this work allows the simultaneous valoration of the product dose-area (PDA), the dose in the patient skin (DES) and the distribution of the irradiated fields, all of they together with their corresponding dose levels. The latter sometimes can be essential since the possible damages in skin depend not only of the doses, but also the irradiated area. The method has been resulted adequate for to evaluate doses to patients in Interventional Radiology procedures. It was possible to apply it as a routine form seeing that its not interfering significantly in the normal development of the medical intervention. The fundamental advantages of this dosimetric method in relation with the unique PDA measure or with the utilization of TLD is that it provide information about the total irradiated area, distribution and length of fields, collimation and wedge used besides that allow to determine the most irradiated zone. The visualization of the irradiated regions and the length fields utilized suggest the possibility to optimize the realization protocols of the interventional procedure in the cases in which it is considered that the doses have been very elevated. (Author)

  15. Radiological protection of patients in nuclear medicine

    International Nuclear Information System (INIS)

    Harding, L.K.

    2001-01-01

    The key factor in medical exposure is justification, that is ensuring that the benefit exceeds the risk. Nuclear medicine studies are comparable in cost to more sophisticated radiological tests such as ultrasound, computed tomography or magnetic resonance. Radiation doses are similar from X ray and nuclear medicine procedures. Having justified exposures the next step is optimization, namely using a radiation dose as low as is reasonably practicable. Diagnostic reference levels may be set nationally or locally such that the balance of diagnostic quality and radiation burden is optimized. In therapy the aim is to achieve a therapeutic dose while keeping the dose to non-target tissues as low as reasonably practicable. Variations in activities may be required for overweight patients, those in severe pain, those with certain conditions and in the case of tomography. Any woman who has missed a period should be assumed to be pregnant; there should be notices to patients emphasizing this. Following the administration of longer lived pharmaceuticals it is important to avoid pregnancy for a time such that the dose to a foetus will not exceed 1 mGy. A similar situation applies to a child who is being breastfed when a mother receives a radiopharmaceutical. In the case of children undergoing investigations the activity needs to be reduced to maintain the same count density as in adults. With the administration of an incorrect pharmaceutical an attempt should be made to enhance excretion, and the referring doctor and the patient should be informed. Extravasation usually requires no action. Positron emission tomography results in higher doses both to staff and patients. Research should use subjects over the age of 50, and avoid anyone who is pregnant or is a child. Nuclear medicine procedures result in a very small loss in life expectancy compared with other common risks. (author)

  16. Pediatric interventional radiology: Indications, techniques, and management

    International Nuclear Information System (INIS)

    Towbin, R.B.; Ball, W.S. Jr.

    1987-01-01

    This course develops a practical approach to pediatric interventional radiology. Radiologic intervention in the pediatricage group is possible by attending to the care and special needs of the child. The authors also emphasize their approach to patient preparation, sedation and anesthesia, nursing care, monitoring of the patient during the procedure, and follow-up care. The course is divided into nonvascular and vascular sections. The discussion of nonvascular procedures focus on the chest and the GU and GI systems. Biopsy techniques and drainage of effusions and abscesses within the chest are discussed. A variety of GU procedures are presented including insertion of a nephrostomy tube and percutaneous tract dilation for placement of internal stents, percutaneous stone removal, and percutaneous surgery for pyeloplasty. The authors approach to percutaneous pyeloplasty is briefly discussed. Intervention within the GI system includes percutaenous aspiration, drainage, and biopsies. Emphasis is placed on the selection of embolic agents and catheter delivery systems, techniques, and current treatment concepts. The authors describe experience with embolization of vascular malformations, renovascular disease, uncontrollable hemorrhage, and selected neoplastic processes. Comments on the indications for and techniques of transluminal angioplasty and fibrinolytic therapy in children conclude the lecture

  17. Analgosedation and monitoring in interventional radiology

    International Nuclear Information System (INIS)

    Girolami, Guido; Steinbrich, Roman; Jacob, Augustinus Ludwig

    2010-01-01

    This article deals with the change of treatment in interventional radiology during the last decade adding a wider margin of safety through automated monitoring and better patient comfort through a combination of sedation and analgetics. In this regard it is very important to ensure adherence to standard procedures that are as simple as possible, to provide adequate training of staff members and to keep a succinct procedure protocol to ensure a high quality of care. Guidelines and checklists for the safe performance of this 'comfort-therapy' are given. (orig.)

  18. Radiation safety concerns during interventional radiology

    International Nuclear Information System (INIS)

    Victor Raj, D.; Livingstone, Roshan Samuel

    2001-01-01

    Interventional radiological procedures are on the increase by virtue of the fact that these procedures replace highly invasive surgical and other procedures. Radiation dose to patients and hospital workers are of significance since these procedures tend to impart large dose to them. Moreover, long term risk from radiation absorbed by patients is of concern since the life expectancy of major fraction of patients is long after undergoing the procedure. This study intends to measure radiation dose imparted to patients as well as personnel- radiologists, technologists, nurses, etc. and estimate the risk factor involved

  19. Radiological protection in medicine. ICRP Publication 105

    International Nuclear Information System (INIS)

    2011-01-01

    This report was prepared to underpin the Commission's 2007 Recommendations with regard to the medical exposure of patients, including their comforters and carers, and volunteers in biomedical research. It addresses the proper application of the fundamental principles (justification, optimisation of protection, and application of dose limits) of the Commission's 2007 Recommendations to these individuals. With regard to medical exposure of patients, it is not appropriate to apply dose limits or dose constraints, because such limits would often do more harm than good. Often, there are concurrent chronic, severe, or even life-threatening medical conditions that are more critical than the radiation exposure. The emphasis is then on justification of the medical procedures and on the optimisation of radiological protection. In diagnostic and interventional procedures, justification of procedures (for a defined purpose and for an individual patient), and management of the patient dose commensurate with the medical task, are the appropriate mechanisms to avoid unnecessary or unproductive radiation exposure. Equipment features that facilitate patient dose management, and diagnostic reference levels derived at the appropriate national, regional, or local level, are likely to be the most effective approaches. In radiation therapy, the avoidance of accidents is a predominant issue. With regard to comforters and carers, and volunteers in biomedical research, dose constraints are appropriate. Over the last decade, the Commission has published a number of documents that provided detailed advice related to radiological protection and safety in the medical applications of ionising radiation. Each of the publications addressed a specific topic defined by the type of radiation source and the medical discipline in which the source is applied, and was written with the intent of communicating directly with the relevant medical practitioners and supporting medical staff. This report

  20. Active electronic personal dosemeter in interventional radiology

    International Nuclear Information System (INIS)

    Prlic, I.; Suric Mihic, M.; Vucic, Z.

    2008-01-01

    A recently developed active electronic personal dosemeter (AEPD) was utilised in order to measure the levels and the structure of occupational exposure to scattered X-ray radiation of medical staff who performed percutaneous revascularisation therapy that involves interventional radiology (IR) on the pelvis and upper leg arteries. The AEPDs, placed on the operators' and assistants' chests, that is, above the protective apron, continuously measured and recorded the received doses and, as a novelty, dose rates as a function of time, thus yielding a unique record of occupational doses and dose rates pattern at the working place. This paper presents and discusses one typical daily pattern in which seven percutaneous interventions were performed. (authors)

  1. Relevant radiological anatomy of the pig as a training model in interventional radiology

    International Nuclear Information System (INIS)

    Dondelinger, R.F.; Ghysels, M.P.; Brisbois, D.; Donkers, E.; Snaps, F.R.; Saunders, J.; Deviere, J.

    1998-01-01

    The use of swine for teaching purposes in medicine and surgery has largely increased in recent years. Detailed knowledge of the porcine anatomy and physiology is a prerequisite for proper use of pigs as a teaching or an experimental model in interventional radiology. A systematic study of the radiological anatomy was undertaken in more than 100 female pigs aged 6-8 weeks. All studies were performed under general anesthesia in a single session. Animals were sacrificed at the end of the study. Selective angiographies were systematically obtained in all anatomical territories. In other animals CT and MRI examinations were performed and were correlated to anatomical sections and acrylic casts of the vascular structures. Endoscopical examinations of the upper gastrointestinal tract, including retrograde opacification of the biliary and pancreatic ducts, were added in selected animals. The main angiographic aspects of the brain, head and neck, thorax, abdomen, and pelvis were recorded. Similarities and differences in comparison with human anatomy are stressed. Potential applications in interventional radiology are indicated. (orig.)

  2. [Fibromyalgia: behavioral medicine interventions].

    Science.gov (United States)

    Petermann, F; Holtz, M C; van der Meer, B; Krohn-Grimberghe, B

    2007-10-01

    The etiology of fibromyalgia as a chronic disease is still unexplained. This article gives an overview of the newest treatment methods of behavioral medicine of the fibromyalgia syndrome with regard to the state of research of etiology and diagnosis of this disease. Methods such as operant conditioning, cognitive-behavioral approaches, patient education and relaxation methods are discussed.

  3. [Evaluation of patient doses in interventional radiology].

    Science.gov (United States)

    Ropolo, R; Rampado, O; Isoardi, P; Gandini, G; Rabbia, C; Righi, D

    2001-01-01

    To verify the suitability of indicative quantities to evaluate the risk related to patient exposure, in abdominal and vascular interventional radiology, by the study of correlations between dosimetric quantities and other indicators. We performed in vivo measurements of entrance skin dose (ESD) and dose area product (DAP) during 48 procedures to evaluate the correlation among dosimetric quantities, and an estimation of spatial distribution of exposure and effective dose (E). To measure DAP we used a transmission ionization chamber and to evaluate ESD and its spatial distribution we used radiographic film packed in a single envelope and placed near the patient's skin. E was estimated by a calculation software using data from film digitalisation. From the data derived for measurements in 27 interventional procedures on 48 patients we obtained a DAP to E conversion factor of 0.15 mSv / Gy cm2, with an excellent correlation (r=.99). We also found a good correlation between DAP and exposure parameters such as fluoroscopy time and number of images. The greatest effective dose was evaluated for a multiple procedure in the hepatic region, with a DAP value of 425 Gy cm2. The greatest ESD was about 550 mGy. For groups of patients undergoing similar interventional procedures the correlation between ESD and DAP had conversion factors from 6 to 12 mGy Gy-1 cm-2. The evaluation of ESD and E by slow films represents a valid method for patient dosimetry in interventional radiology. The good correlation between DAP and fluoroscopy time and number of images confirm the suitability of these indicators as basic dosimetric information. All the ESD values found are lower than threshold doses for deterministic effects.

  4. Vascular Closure Devices in Interventional Radiology Practice

    International Nuclear Information System (INIS)

    Patel, Rafiuddin; Muller-Hulsbeck, Stefan; Morgan, Robert; Uberoi, Raman

    2015-01-01

    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient

  5. Occupational exposures from selected interventional radiological procedures

    International Nuclear Information System (INIS)

    Janeczek, J.; Beal, A.; James, D.

    2001-01-01

    The number of radiology and cardiology interventional procedures has significantly increased in recent years due to better diagnostic equipment resulting in an increase in radiation dose to the staff and patients. The assessment of staff doses was performed for cardiac catheterization and for three other non-cardiac procedures. The scattered radiation distribution resulting from the cardiac catheterization procedure was measured prior to the staff dose measurements. Staff dose measurements included those of the left shoulder, eye, thyroid and hand doses of the cardiologist. In non-cardiac procedures doses to the hands of the radiologist were measured for nephrostomy, fistulogram and percutaneous transluminal angioplasty procedures. Doses to the radiologist or cardiologist were found to be relatively high if correct protection was not observed. (author)

  6. Precaution of medical risk in intervention radiology department

    International Nuclear Information System (INIS)

    Zhang Chunyang

    2008-01-01

    The article introduces the denomination, desire of precaution and content of medical risks of interventional radiology in brief. To strengthen the management of medical risk is an effective way to decrease malpractice and improve the safety of patients. The medical risk of interventional radiology possesses distinct characteristics, therefore the management should be strictly executed according to the principles. (authors)

  7. Occupational Radiation Protection in Interventional Radiology: A Joint Guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology

    Science.gov (United States)

    2010-01-01

    advised to use eye protection at all times [2, 15]. Leaded eyeglasses are an alternative to ceiling-suspended shields for this purpose. Leaded eye...glasses with large lenses and protective side shields pro- vide more protection than eyeglasses without these features. They help to minimize scatter...CIRSE GUIDELINES Occupational Radiation Protection in Interventional Radiology: A Joint Guideline of the Cardiovascular and Interventional Radiology

  8. Radiological protection in interventional cardiology in Chile

    International Nuclear Information System (INIS)

    Ramirez, A.; Leyton, F.A.; Farias, E.; Silva, A.M.; Vano, E.; Oyarzun, C.; Gamarra, J.; Ortiz, P.

    2001-01-01

    In September 2000, an expert mission was assigned to Chile, under the regional project named 'International BBS in Medical Practices Radiation Protection and Quality Assurance In Interventional Radiology' (ARCAL XLIX). The objective of the mission was to evaluate the level of radiation protection (RP) and safety in interventional cardiology ( IC ) installations. A team of local cardiologists, medical physicists and technologists was created for this purpose and during one week, several cardiology laboratories were evaluated and some basic quality controls (QC) were carried out. A basic pilot training course in radiation protection was imparted at the Hospital of the University of Chile in Santiago de Chile and some of the key objectives for a future national quality assurance programme were presented during the national congress of IC. In addition, a national survey on radiation protection aspects was circulated and its results evaluated. These activities enabled the local team to become familiar with the methodology of assessment of the level of protection and the organization of a programme, which was illustrated with the examples of similar European programmes. As result of these actions, several proposals were made to both the local authorities and the IAEA. The most important were: a) to initiate a basic QC programme, b) to organize a training in RP for cardiologists in order to formalize their accreditation, c) to improve personal occupational dosimetry, d) to initiate a programme of patient dosimetry, e) to optimize the technical and clinical protocols, f) to create a national registry of incidents with skin injuries. (author)

  9. Interventional urology: endourology in small animal veterinary medicine.

    Science.gov (United States)

    Berent, Allyson C

    2015-07-01

    The use of novel image-guided techniques in veterinary medicine has become more widespread, especially in urologic diseases. With the common incidence of urinary tract obstructions, stones disease, renal disease, and urothelial malignancies, combined with the recognized invasiveness and morbidity associated with traditional surgical techniques, the use of minimally invasive alternatives using interventional radiology and interventional endoscopy techniques has become incredibly appealing to owners and clinicians. This article provides a brief overview of some of the most common procedures done in endourology in veterinary medicine to date, providing as much evidence-based medicine as possible when comparing with traditional surgical alternatives. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Interventional radiology virtual simulator for liver biopsy.

    Science.gov (United States)

    Villard, P F; Vidal, F P; ap Cenydd, L; Holbrey, R; Pisharody, S; Johnson, S; Bulpitt, A; John, N W; Bello, F; Gould, D

    2014-03-01

    Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

  11. Antiplatelet and Anticoagulant Drugs in Interventional Radiology

    International Nuclear Information System (INIS)

    Altenburg, Alexander; Haage, Patrick

    2012-01-01

    In treating peripheral arterial disease, a profound knowledge of antiplatelet and anticoagulative drug therapy is helpful to assure a positive clinical outcome and to anticipate and avoid complications. Side effects and drug interactions may have fatal consequences for the patient, so interventionalists should be aware of these risks and able to control them. Aspirin remains the first-line agent for antiplatelet monotherapy, with clopidogrel added where dual antiplatelet therapy is required. In case of suspected antiplatelet drug resistance, the dose of clopidogrel may be doubled; prasugrel or ticagrelor may be used alternatively. Glycoprotein IIb/IIIa inhibitors (abciximab or eptifibatide) may help in cases of hypercoagulability or acute embolic complications. Desmopressin, tranexamic acid, or platelet infusions may be used to decrease antiplatelet drug effects in case of bleeding. Intraprocedurally, anticoagulant therapy treatment with unfractionated heparin (UFH) still is the means of choice, although low molecular-weight heparins (LMWH) are suitable, particularly for postinterventional treatment. Adaption of LMWH dose is often required in renal insufficiency, which is frequently found in elderly patients. Protamine sulphate is an effective antagonist for UFH; however, this effect is less for LMWH. Newer antithrombotic drugs, such as direct thrombin inhibitors or factor X inhibitors, have limited importance in periprocedural treatment, with the exception of treating patients with heparin-induced thrombocytopenia (HIT). Nevertheless, knowing pharmacologic properties of the newer drugs facilitate correct bridging of patients treated with such drugs. This article provides a comprehensive overview of antiplatelet and anticoagulant drugs for use before, during, and after interventional radiological procedures.

  12. Diagnostic interventions in nuclear medicine

    International Nuclear Information System (INIS)

    Thrall, J.H.; Swanson, D.P.

    1989-01-01

    Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references

  13. Radiation protection in interventional radiology; Strahlenschutz in der interventionellen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Adamus, R.; Loose, R.; Galster, M. [Klinikum Nuernberg Nord, Institut fuer Diagnostische und Interventionelle Radiologie, Nuernberg (Germany); Wucherer, M. [Klinikum Nuernberg Nord, Institut fuer Medizinische Physik, Nuernberg (Germany); Uder, M. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Radiologie, Erlangen (Germany)

    2016-03-15

    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x-ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X-ray protection measures plus lead-containing eyeglasses. (orig.) [German] Die Anwendung ionisierender Strahlung in der Medizin scheint sowohl fuer Patienten als auch fuer beruflich exponierte Personen sicher zu sein. Die interventionellen Entwicklungen der letzten Jahre mit sehr durchleuchtungs- und dosisintensiven Eingriffen erfordern allerdings eine Intensivierung des Strahlenschutzes. Es empfiehlt sich, die zur Verfuegung stehenden Moeglichkeiten auszuschoepfen. Neben den Geraeteoptionen muss der Strahlenschutz am Eingriffstisch durch Bleilamellenaufstecker und montiertes Bleiglas intensiv betrieben werden. Besonderen Fokus muss auf den Schutz der Augen zur Kataraktvermeidung gelegt werden. Da dessen Ausbildung nach neuen Erkenntnissen moeglicherweise nicht mehr deterministisch zu sehen ist, hat die Internationale Strahlenschutzkommission (IRCP) den Grenzwert von 150 auf 20 Mikrosievert (mSv)/Jahr erniedrigt. Messungen belegen, dass unter Einhaltung aller Strahlenschutzmassnahmen plus Bleiglasbrille dieser einzuhalten ist. (orig.)

  14. A Checklist to Improve Patient Safety in Interventional Radiology

    International Nuclear Information System (INIS)

    Koetser, Inge C. J.; Vries, Eefje N. de; Delden, Otto M. van; Smorenburg, Susanne M.; Boermeester, Marja A.; Lienden, Krijn P. van

    2013-01-01

    To develop a specific RADiological Patient Safety System (RADPASS) checklist for interventional radiology and to assess the effect of this checklist on health care processes of radiological interventions. On the basis of available literature and expert opinion, a prototype checklist was developed. The checklist was adapted on the basis of observation of daily practice in a tertiary referral centre and evaluation by users. To assess the effect of RADPASS, in a series of radiological interventions, all deviations from optimal care were registered before and after implementation of the checklist. In addition, the checklist and its use were evaluated by interviewing all users. The RADPASS checklist has two parts: A (Planning and Preparation) and B (Procedure). The latter part comprises checks just before starting a procedure (B1) and checks concerning the postprocedural care immediately after completion of the procedure (B2). Two cohorts of, respectively, 94 and 101 radiological interventions were observed; the mean percentage of deviations of the optimal process per intervention decreased from 24 % before implementation to 5 % after implementation (p < 0.001). Postponements and cancellations of interventions decreased from 10 % before implementation to 0 % after implementation. Most users agreed that the checklist was user-friendly and increased patient safety awareness and efficiency. The first validated patient safety checklist for interventional radiology was developed. The use of the RADPASS checklist reduced deviations from the optimal process by three quarters and was associated with less procedure postponements.

  15. Patient Safety in Interventional Radiology: A CIRSE IR Checklist

    NARCIS (Netherlands)

    Lee, M. J.; Fanelli, F.; Haage, P.; Hausegger, K.; van Lienden, K. P.

    2012-01-01

    Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and

  16. Radiation risk evaluation and reference doses in interventional radiology

    International Nuclear Information System (INIS)

    Faulkner, K.; Vano, E.; Padovani, R.; Zoetelief, J.

    2001-01-01

    In interventional radiology, there are two potential hazards to the patient. These are somatic risks and, for certain procedures, deterministic injuries. The task of radiation protection in interventional radiology is to minimise somatic risks and avoid deterministic injuries. Radiation protection tools and protocols must be developed to achieve these two objectives. Reference doses have been proposed as a method of identifying high dose centres and equipment. The role of reference doses in interventional radiology will be discussed. There are two approaches to reference doses in interventional radiology. These are the measurement of patient entrance skin dose or skin dose rate, or image intensifier input dose rate. Alternatively, dose area product or effective dose to the patient may be monitored. These two main approaches have their advantages and disadvantages. (author)

  17. Radiological protection of the worker in medicine and dentistry

    International Nuclear Information System (INIS)

    1990-01-01

    The first three sections of this report concern general understanding of radiation protection, basic concepts for all workers, and practical problems common to all users of radiation in medicine and dentistry. The remaining sections cover specialist topics covering practical aspects in diagnostic radiology, dental radiography, the use of unsealed radionuclides (in the laboratory, diagnostic and therapeutic uses) balneotherapy, brachytherapy and external beam radiotherapy. (author)

  18. Interventional techniques in medicine and radioprotection

    International Nuclear Information System (INIS)

    Le Guen, B.; Bar, O.; Benderitter, M.; Bourguignon, M.; Chevillard, S.; Gauron, Ch.; Lallemand, J.; Lombard, J.; Maccia, C.; Sapoval, M.; Bernier, M.O.; Pirard, Ph.; Jacob, S.; Donadille, L.; Aubert, B.; Clairand, I.; Mozziconacci, J.G.; Brot, A.M.; Jarrige, V.; Huet, Ch.; Marchal, C.; Martin, M.; Bar, O.; Degrange, J.P.; Livarek, B.; Menechal, Ph.; Sapoval, M.; Pellerin, O.

    2009-01-01

    This document gathers the slides of the available presentations given during this conference day. Nineteen presentations are assembled in the document and deal with: 1 - Interventional radiology: why is it developing? (M. Sapoval); 2 - exposure particularities in interventional radiology (O. Bar); 3 - doses received by organs in interventional cardiology (C. Maccia); 4 - Patients exposure: description of cumulated exposure of patients treated in interventional cardiology (M.O. Bernier); 5 - 2004 inquiry to dermatologists about post-interventional radiology radio-dermatitis (P. Pirard); 6 - exposure and risks to operators (S. Jacob); 7 - dosimetric evaluation techniques and results about interventional imaging operators' extremities (L. Donadille and F. Merat); 8 - bibliographic study of doses received by operators with non-protected organs (B. Aubert); 9 - ORAMED European project: optimization of operational dosimeter uses in interventional radiology (I. Clairand); 10 - reference levels and dosimetric evaluation of patients (C. Maccia); 11 - optimization in coronary angioplasty (J.G. Mozziconacci, A.M. Brot and V. Jarrige); 12 - dosimetry in medical over-exposure situation (C. Huet); 13 - significant radioprotection events in interventional radiology declared to the Nuclear Safety Authority (ASN) - status and experience feedback (C. Marchal); 14 - interventional radiology and unwanted effects (M. Benderitter); 15 - global analyses and new exposure indicators in human epidermis cells (M. Martin); 16 - radioprotection regulations and training (O. Bar); 17 - zoning and workplace analysis in interventional cardiology (J.P. Degrange); 18 - guide of good clinical practices: example of interventional cardiology (B. Livarek); 19 - how to encourage the radioprotection optimization in interventional radiology: the ASN's point of view (P. Menechal). (J.S.)

  19. Radiology

    International Nuclear Information System (INIS)

    Sykora, A.

    2006-01-01

    In this text-book basic knowledge about radiology, biomedical diagnostic methods (radiography, computer tomography), nuclear medicine and safety and radiation protection of personnel on the radiodiagnostic place of work are presented

  20. A probable radiological emergency in nuclear medicine

    International Nuclear Information System (INIS)

    Colombo, J.C.

    1998-01-01

    Full text: When a therapeutic dose of 131 I is indicated, especially in the thyroid carcinomas, the authorized doctor must always have present the possibility that the patient eliminates high activities of the radio-active material with the vomit. Keeping in mind that dose of 100 to 200 mCi is habitual in the carcinoma of thyroid, this episode can constitute a true radiological emergency, particularly because the first ones in taking knowledge of the fact can be people without appropriate preparation to this situation, what can cause contaminations difficult to manage them. Because it is not acceptable that a source open of high activity remains without treatment long time, the authorized doctor must act immediately, for that which should be prepared with anticipation, and have the necessary elements, to have an operative routine and to administer the storage of the polluted elements appropriately. To such an effect, we have orchestrated a sequential program of performance of 11 points, in the cases of plentiful vomits, with contamination of floors and things of the room. The program begins with the writing instructions for the patient and the personnel of infirmary in case of feeling desires to vomit, and de program is completed in case of being necessary. The elements are detailed in a handbag that contains for radiological emergencies for vomit. It notes that the low cost of the elements and clothes kind for surgery disposable. It discusses about the necessity of having prepared rooms for to receive patient with treatment with 131 I, in the clinics and public hospitals. (author) [es

  1. Nuclear medicine and radiologic imaging in sports injuries

    International Nuclear Information System (INIS)

    Glaudermans, Andor W.J.M.; Gielen, Jan L.M.A.; Antwerp Univ. Hospital, Edegem; Antwerp Univ. Hospital, Edegem; Zwerver, Johannes

    2015-01-01

    This comprehensive book describes in detail how nuclear medicine and radiology can meet the needs of the sports medicine physician by assisting in precise diagnosis, clarification of pathophysiology, imaging of treatment outcome and monitoring of rehabilitation. Individual sections focus on nuclear medicine and radiologic imaging of injuries to the head and face, spine, chest, shoulder, elbow and forearm, wrist and hand, pelvic region, knee, lower leg, ankle and foot. The pathophysiology of sports injuries frequently encountered in different regions of the body is described from the perspective of each specialty, and the potential diagnostic and management benefits offered by the new hybrid imaging modalities - SPECT/CT, PET/CT, and PET/MRI - are explained. In addition, a range of basic and general issues are addressed, including imaging of the injuries characteristic of specific sports. It is hoped that this book will promote interdisciplinary awareness and communication and improve the management of injured recreational or elite athletes.

  2. Nuclear medicine and radiologic imaging in sports injuries

    Energy Technology Data Exchange (ETDEWEB)

    Glaudermans, Andor W.J.M. [Groningen Univ. (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Dierckx, Rudi A.J.O. [Groningen Univ. (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium); Gielen, Jan L.M.A. [Antwerp Univ. Hospital, Edegem (Belgium). Dept. of Radiology; Antwerp Univ. Hospital, Edegem (Belgium). Dept. of Sports Medicine; Antwerp Univ. Hospital, Edegem (Belgium). Dept. of Medicine; Zwerver, Johannes (ed.) [Groningen Univ. (Netherlands). Center for Sports Medicine

    2015-10-01

    This comprehensive book describes in detail how nuclear medicine and radiology can meet the needs of the sports medicine physician by assisting in precise diagnosis, clarification of pathophysiology, imaging of treatment outcome and monitoring of rehabilitation. Individual sections focus on nuclear medicine and radiologic imaging of injuries to the head and face, spine, chest, shoulder, elbow and forearm, wrist and hand, pelvic region, knee, lower leg, ankle and foot. The pathophysiology of sports injuries frequently encountered in different regions of the body is described from the perspective of each specialty, and the potential diagnostic and management benefits offered by the new hybrid imaging modalities - SPECT/CT, PET/CT, and PET/MRI - are explained. In addition, a range of basic and general issues are addressed, including imaging of the injuries characteristic of specific sports. It is hoped that this book will promote interdisciplinary awareness and communication and improve the management of injured recreational or elite athletes.

  3. Basic principles for intervention after a nuclear or radiological emergency

    International Nuclear Information System (INIS)

    Per Hedemann Jensen

    1996-01-01

    The current status of internationally agreed principles for intervention after a nuclear accident or radiological emergency and the international development of intervention guidance since the Chernobyl accident are reviewed. The experience gained after the Chernobyl accident indicates that the international advice on intervention existing at the time of the Chernobyl accident was not fully understood by decision makers neither in Western Europe nor in the former USSR and that the guidance failed to address adequately the difficult social problems which can arise after a serious nuclear accident. The radiation protection philosophy of today distinguishes between practices and interventions. The radiological protection system of intervention includes justification of the protective action and optimization of the level of protection achieved by that action. Dose limits do not apply in intervention situations. The inputs to justification and optimization studies include factors that are related to radiological protection, whereas the final decisions on introduction of countermeasures would also depend on other factors. The basic principles for intervention as recommended by international organisations are discussed in detail and the application of the principles on a generic basis is illustrated for long-term protective actions. The concepts of intervention level, operational intervention level and action level are presented and the relation between these quantities is illustrated. The numerical guidance on intervention in a nuclear accident or radiological emergency or a chronic exposure situation given by ICRP, IAEA and in the Basic Safety Standards is presented. (author)

  4. The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Tapping, Charles R., E-mail: crtapping@doctors.org.uk; Bratby, Mark J., E-mail: mark.bratby@ouh.nhs.uk [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom)

    2013-08-01

    Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies.

  5. The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

    International Nuclear Information System (INIS)

    Tapping, Charles R.; Bratby, Mark J.

    2013-01-01

    Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies

  6. Training in radiological protection at the Institute of Naval Medicine

    International Nuclear Information System (INIS)

    Powell, P.E.; Robb, D.J.

    1991-01-01

    The Training Division at the Institute of Naval Medicine, Alverstoke, UK, provides courses in radiological protection for government and military personnel who are radiation protection supervisors, radiation safety officers, members of naval emergency monitoring teams and senior medical officers. The course programmes provide formal lectures, practical exercises and tabletop exercises. The compliance of the Ministry of Defence with the Ionising Radiations Regulations 1985 and the implementation of Ministry of Defence instructions for radiological protection rely to a large extent on its radiation protection supervisors understanding of the training he receives. Quality assurance techniques are therefore applied to the training. (author)

  7. National radiology standards in X-ray diagnostic incl. interventional radiology

    International Nuclear Information System (INIS)

    Valek, V.; Kratochvil, P.

    2005-01-01

    In 2004 the Ministry of Health care started within the frame of the program for support of quality in health care a project consisting of 4 separate tasks: creating of standards for medical irradiation in radiodiagnostics, in radiotherapy , in nuclear medicine and creating of standards for patients dose assessment in radiophysics. This document continues with description of a part of the project aimed on X-ray radiodiagnostics. The authors of the project were chosen based on their bids to the public grant issued by the Ministry of Health care. The authors used recommendations, guidelines and instructions of international professional societies and IAEA, as well as the already existing procedures and practices while considering possibilities and state of the praxis in the Czech Republic. The outcome of authors work is now an interim version of a document that will be published in the bulletin of the Ministry of Health care. The document contains a set of standards that cover the whole range o fall complimentarily performed ways of patients irradiation in X-ray diagnostics and interventional radiology . The standards are divided to several categories according to the requirement of the Ministry of Health care based on the diagnostic appliances used for diagnostic irradiation i.e. radiography , fluoroscopy, mammography, stomatology, computer tomography, angiography, interventional radiography and cardiography. (authors)

  8. Physical and cognitive task analysis in interventional radiology

    International Nuclear Information System (INIS)

    Johnson, S.; Healey, A.; Evans, J.; Murphy, M.; Crawshaw, M.; Gould, D.

    2006-01-01

    AIM: To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. MATERIALS AND METHODS: Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. RESULTS: Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. CONCLUSIONS: Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model

  9. Malpractice claims in interventional radiology: frequency, characteristics and protective measures.

    Science.gov (United States)

    Magnavita, N; Fileni, A; Mirk, P; Magnavita, G; Ricci, S; Cotroneo, A R

    2013-04-01

    The use of interventional radiology procedures has considerably increased in recent years, as has the number of related medicolegal litigations. This study aimed to highlight the problems underlying malpractice claims in interventional radiology and to assess the importance of the informed consent process. The authors examined all insurance claims relating to presumed errors in interventional radiology filed by radiologists over a period of 14 years after isolating them from the insurance database of all radiologists registered with the Italian Society of Medical Radiology (SIRM) between 1 January1993 and 31 December 2006. In the period considered, 98 malpractice claims were filed against radiologists who had performed interventional radiology procedures. In 21 cases (21.4%), the event had caused the patient's death. In >80% of cases, the event occurred in a public facility. The risk of a malpractice claim for a radiologist practising interventional procedures is 47 per 1,000, which corresponds to one malpractice claim for each 231 years of activity. Interventional radiology, a discipline with a biological risk profile similar to that of surgery, exposes practitioners to a high risk of medicolegal litigation both because of problems intrinsic to the techniques used and because of the need to operate on severely ill patients with compromised clinical status. Litigation prevention largely depends on both reducing the rate of medical error and providing the patient with correct and coherent information. Adopting good radiological practices, scrupulous review of procedures and efficiency of the instruments used and audit of organisational and management processes are all factors that can help reduce the likelihood of error. Improving communication techniques while safeguarding the patient's right to autonomy also implies adopting clear and rigorous processes for obtaining the patient's informed consent to the medical procedure.

  10. Assessments of medical exposures during interventional radiology procedures

    International Nuclear Information System (INIS)

    Navarro, V. C. C.; Navarro, M. V. T.; Maia, A. F.

    2013-01-01

    This study aims to contribute to the construction of a scenario regarding patient radiation exposure in Brazilian interventional radiology, aiming to provide data for the future drafting of specific legislation on interventional radiology because there is currently a lack of safety regulations for haemodynamics services in this country. Fourteen haemodynamics services in the states of Santa Catarina and Bahia were evaluated. The radiological devices were characterised through measurements of air kerma-area product, entrance surface air kerma (Ke), exposure time, spatial resolution (SR), low-contrast resolution and half value layer. During the evaluation of instrument parameters, several non-conformities were found according to current Brazilian regulations, with SR presenting the most critical situation. The results of the present study indicate the need for the optimisation of clinical practices in complex radiological procedures, although the overall results for the dose scenario in the present study revealed values similar to those reported in international publications. (authors)

  11. Education and training in radiological protection for diagnostic and interventional procedures ICRP 113 in brief

    International Nuclear Information System (INIS)

    Salama, S.; Gomaa, M. A.; Alshoufi, J.H.

    2013-01-01

    The international commission on radiological protection (ICRP) is the primary body in protection against ionizing radiation. Among its latest publication is ICRP publication 113 e ducation and training in radiological protection for diagnostic and interventional procedures . This document introduces diagnostic and interventional medical procedures using ionizing radiations in deep details. The document is approved by the commission in October 2010 and translated into Arabic at December 2011. This work is a continuation of the efforts series to translate some of the most important of the radiological protection references into the Arabic; aiming to maximize the benefit. The previous translation include WHO handbook on indoor radon: a public health perspective, issued by world health organization 2009 and Radiation Protection in Medicine, ICRP Publication 105 2007 that translated into Arabic with support of Arab atomic energy authority at 2011.

  12. Interventional radiology as clinical specialty and how this affects the radiology specialty as a whole

    International Nuclear Information System (INIS)

    Tsetis, D.

    2015-01-01

    maintain high quality clinical standards, Radiology departments must carry out regular audit and where available submitting data to national or international registries. Furthermore, IRs have a duty of care to ensure that the IR procedures are safe and effective which can only be demonstrated by high quality research. For IR to survive as clinical specialty, IR training must be adapted in order to ensure that future IR’s will acquire both clinical knowledge and confidence in the disease processes as well as in dealing with patients. Core IR training must include communication skills, clinical assessment and knowledge of the various alternative treatments to IR both surgical and medical. In order to fulfill these expectations, IR training must move to a certified residency program; an attractive format would be one year of internship, three years of Diagnostic Radiology, and then two years of IR. this IR certification will hopefully have a huge impact on local organizational issues so that at a local institution the IR service will be listed next to surgery and medicine. towards this direction, appropriate curricula and formal assessment of the appropriate skills such as the european Board of Interventional Radiology (eBIR) examination are available to ensure the high standards of the future IR workforce. the CIRSe Clinical Practice in IR Manual provides a comprehensive approach to patient care, including numerous well-structured forms for gathering data on patient or social history and conducting examinations are part of its content (www.cirse.org/Clinical_Practice) In my opinion the continuous effort to upgrade IR practice, also points to the only direction for the entire Radiology specialty to survive: the radiologist should be part of clinical decision-making, a true active clinical partner, with up-to-date clinical knowledge about a medical subspecialty. the reality is that clinicians have started to learn about the images in their subspecialty territory, and through

  13. Nanotechnology and its Relationship to Interventional Radiology. Part I: Imaging

    International Nuclear Information System (INIS)

    Power, Sarah; Slattery, Michael M.; Lee, Michael J.

    2011-01-01

    Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.

  14. Nanotechnology and its relationship to interventional radiology. Part I: imaging.

    LENUS (Irish Health Repository)

    Power, Sarah

    2011-04-01

    Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.

  15. Nanotechnology and its relationship to interventional radiology. Part I: imaging.

    LENUS (Irish Health Repository)

    Power, Sarah

    2012-02-01

    Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I of the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.

  16. Attention to the application of vein anaesthesia in interventional radiology

    International Nuclear Information System (INIS)

    Xie Zonggui; Cheng Yongde

    2006-01-01

    Interventional radiology is mostly carried out under local anesthesia with micro invasive characteristics. However, the questions of patient's pain, nerve intense, change of blood pressure and heart rate always influence the performance of operation. General anaesthesia in interventional radiology is a comparatively simple venous anaesthesia modality with a controlled dose of anesthetics injecting via periphery vein through persistent minimally injecting pump to keep the patient in dormancy under electrocardiographic monitoring. It doesn't require a tube insertion of trachea. The anaesthesia depth and time are under control. The half-life of the anaesthesia drugs is short with less side-effect. It is necessary to introduce the advanced anaesthesia into common interventional radiological therapy with attentions of promoting the development through new modalities. (authors)

  17. Study of radiation exposure profiles in interventional radiology professionals

    International Nuclear Information System (INIS)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Alvarez, Matheus; Rosa, Maria E.D.; Miranda, Jose R.A.; Freitas, Carlos C.M. de; Moura, Regina; Pina, Diana R. de

    2014-01-01

    Interventional Radiology is the radiology area that provides the highest dose values to the medical staff. Recent surveys show that personal dosimeters may underestimate the radiation dose values in interventional physicians, especially in the extremities and crystalline. The objective of this work was to study the exposure levels to radiation from medical staff in different interventional radiology procedures. Therefore, thermoluminescent dosimeters type LiF: Mg, Ti (TLD-100) were used positioned in the main interventional physician and an assistant in the following locations: some inches below the crystalline, thyroid, chest, gonads, hand and foot. By comparing the values obtained with the annual reference dose levels in workers, maximum numbers of annual procedures were found. Altogether, there were 23 procedures evaluated: 10 diagnostics, 9 angioplasties and 4 stents. The maximum number of annual procedures were estimated by discounting the percentages of attenuation of radiological protection. For procedures of the type diagnosis, angioplasty and stent for the main interventionist, the maximum number of annual procedures were 641, 445 and 113 respectively, while for the interventionists assistants were 930, 1202 and 215 respectively. As each interventionist body region is subject to different levels of exposure, detailed studies of exposure in each region provide better conclusions about what actions are necessary to ensure radiological protection professionals

  18. Evaluation of medical radiation exposure in pediatric interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Navarro, Valeria Coelho Costa; Navarro, Marcus Vinicius Teixeira; Oliveira, Aline da Silva Pacheco, E-mail: vccnavarro@gmail.com [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Salvador, BA (Brazil); Maia, Ana Figueiredo [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil); Oliveira, Adriano Dias Dourado [Sociedade Brasileira de Hemodinamica e Cardiologia Intervencionista, Salvador, BA (Brazil)

    2012-07-15

    Objective: To evaluate pediatric radiation exposure in procedures of interventional radiology in two hospitals in the Bahia state, aiming at contributing to delineate the scenario at the state and national levels. The knowledge of exposure levels will allow an evaluation of the necessity of doses optimization, considering that peculiarities of radiology and pediatrics become even more significant in interventional radiology procedures which involve exposure to higher radiation doses. Materials and Methods: A total of 32 procedures were evaluated in four rooms of the two main hospitals performing pediatric interventional radiology procedures in the Bahia state. Air kerma rate and kerma-area product were evaluated in 27 interventional cardiac and 5 interventional brain procedures. Results: Maximum values for air kerma rate and kerma-area product and air kerma obtained in cardiac procedures were, respectively, 129.9 Gy.cm{sup 2} and 947.0 mGy; and, for brain procedures were 83.3 Gy.cm{sup 2} and 961.0 mGy. Conclusion: The present study results showed exposure values up to 14 times higher than those found in other foreign studies, and approximating those found for procedures in adults. Such results demonstrate excessive exposure to radiation, indicating the need for constant procedures optimization and evaluation of exposure rates. (author)

  19. 100 classic papers of interventional radiology: A citation analysis.

    Science.gov (United States)

    Crockett, Matthew T; Browne, Ronan Fj; MacMahon, Peter J; Lawler, Leo

    2015-04-28

    To define the 100 citation classic papers of interventional radiology. Using the database of Journal Citation Reports the 40 highest impact factor radiology journals were chosen. From these journals the 100 most cited interventional radiology papers were chosen and analysed. The top paper received 2497 citations and the 100(th) paper 200 citations. The average number of citations was 320. Dates of publication ranged from 1953 - 2005. Most papers originated in the United States (n = 67) followed by Italy (n = 20) and France (n = 10). Harvard University (n = 18) and Osped Civile (n = 11) were the most prolific institutions. Ten journals produced all of the top 100 papers with "Radiology" and "AJR" making up the majority. SN Goldberg and T Livraghi were the most prolific authors. Nearly two thirds of the papers (n = 61) were published after 1990. This analysis identifies many of the landmark interventional radiology papers and provides a fascinating insight into the changing discourse within the field. It also identifies topics, authors and institutions which have impacted greatly on the specialty.

  20. Deterministic effects of interventional radiology procedures

    International Nuclear Information System (INIS)

    Shope, Thomas B.

    1997-01-01

    The purpose of this paper is to describe deterministic radiation injuries reported to the Food and Drug Administration (FDA) that resulted from therapeutic, interventional procedures performed under fluoroscopic guidance, and to investigate the procedure or equipment-related factors that may have contributed to the injury. Reports submitted to the FDA under both mandatory and voluntary reporting requirements which described radiation-induced skin injuries from fluoroscopy were investigated. Serious skin injuries, including moist desquamation and tissues necrosis, have occurred since 1992. These injuries have resulted from a variety of interventional procedures which have required extended periods of fluoroscopy compared to typical diagnostic procedures. Facilities conducting therapeutic interventional procedures need to be aware of the potential for patient radiation injury and take appropriate steps to limit the potential for injury. (author)

  1. Interventional radiological treatment in complications of pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Memis, Ahmet E-mail: ahmemis@yahoo.com; Parildar, Mustafa

    2002-09-01

    Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices.

  2. Slovenian experience from diagnostic angiography to interventional radiology

    Directory of Open Access Journals (Sweden)

    Pavcnik Dusan

    2014-12-01

    Full Text Available Background. The purpose of writing this article is to document the important events and people in the first 50 years of diagnostic angiography and interventional radiology in Slovenia. During this period not only did the name of the institutions and departments change, but also its governance.

  3. Radiation Protection Knowledge, Attitude, and Practice (KAP in Interventional Radiology

    Directory of Open Access Journals (Sweden)

    Fatemeh Shabani

    2018-03-01

    Full Text Available Objectives: Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP level of radiation protection (RP among interventional radiology staff in Iranian health care centers across the country. Methods: We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician. The questionnaire was divided into three sections to assess KAP regarding RP. Results: Significant differences exist in RP KAP mean scores based on educational age (p 0.050. We found a significant difference between RP KAP mean scores and different regions (p < 0.050. Conclusions: Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments.

  4. Diagnostic and interventional radiology in gynecologic neoplasms

    International Nuclear Information System (INIS)

    Thorvinger, B.

    1990-05-01

    The role and clinical value of the modern radiologic methods for evaluation of gynecologic tumors is not finally settled. The aims of our investigation were therefore to compare clinical examination with CT in patients with possible recurrence of cervical carcinoma; to evaluate the usefulness of CT in patients with fistulas following gynecologic tumors or their treatment; to evaluate the ability of transabdominal US and MR imaging in intrauterine staging including myometrial invasion on patients with endometrial carcinoma; to evaluate CT in the capacity of monitoring therapy response, probable recurrence or clinical remission in patients with ovarian carcinoma; and to evaluate the effect of intraarterial occlusion in facilitating surgery and in evaluating the role of the intraarterial infusion in gynecologic tumors otherwise refractory to all therapy given. CT was more accurate (91%) than clinical pelvic examination (78%) in revealing extensive disease after radiation and/ or surgical treatment. CT was also a most valuable tool in demonstrating genital fistulas following gynecologic malignancy or its treatment. Transabdominal US did not improve staging in early endometrila carcinoma while MR had potential for delineating intrauterine tumor growth (accuracy for myometrial invasion 95%). CT was most valuable in the evaluation of therapeutic response of ovarian malignancy. For possible recurrence or in clinical remission, only positive CT was of clinical significance. The potentials of transcatheter intraarterial management in order to facilitate operability are also discussed. (92 refs.)

  5. Main problem impeding the development of interventional radiology in China and its countermeasures

    International Nuclear Information System (INIS)

    Ouyang Yong; Ni Caifang

    2007-01-01

    Based on the review of development course of interventional radiology in China during the period of more than twenty years, to analyse emphatically the main problems impeding the continuous development of interventional radiology, included the branch position of 'Interventional Radiology' not be defined clearly in the medicines, the professional association not to do its best in the management and guidance, the professional quality of the personnel not to be properly trained, as well as the insufficiencies of foundation and experimental studies, etc. And in this paper, the corresponding countermeasures of solving those problems have been primarily explored by the authors, and pointed out as follows: to improve perfectly the branch construction of the 'Interventional Radiology' and the training system of special personnel; to raise the grade and function of the professional association and periodical; to lay stress on the foundation and experimental studies; to further deepen the clinical study and correctly deal with the relation between this branch and the other clinical departments, etc. (authors)

  6. Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

    International Nuclear Information System (INIS)

    O'Brien, Jeremy; Baerlocher, Mark Otto; Asch, Murray R.; Hayeems, Eran; Kachura, John R.; Collingwood, Peter

    2007-01-01

    Purpose. To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods. An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results. Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200-500 (49%) or 500-1,000 (39%) beds. Procedures listed by respondents as most commonly performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion. Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty

  7. General comments on radiological patient protection in nuclear medicine

    International Nuclear Information System (INIS)

    Tellez de Cepeda, M.; Plaza, R.; Corredoira, E.; Martin Curto, L.M.

    2001-01-01

    In this paper an observation series about different aspects of the radiological protection of the patient in nuclear medicine is provided. It includes: The specific legislation contribution, the justification and, especially, optimization, as a fundamental base of the quality guarantee program, the importance of the fulfillment of the program and the importance of getting done the corresponding internal audits of the pursuit, the communication between the different groups of professionals implicated and between these and the patient, the volunteers who collaborate in the patient's care and the people in the patient's environment, knowing that the patient is a source of external radiation and contamination. (author) [es

  8. Diagnostic radiology 1987

    International Nuclear Information System (INIS)

    Margulis, A.R.; Gooding, C.A.

    1987-01-01

    This is the latest version of the continuing education course on diagnostic radiology given yearly by the Department of Radiology at the University of California, San Francisco. The lectures are grouped into sections on gastrointestinal radiology, mammography, uroradiology, magnetic resonance, hepatobiliary radiology, pediatric radiology, ultrasound, interventional radiology, chest radiology, nuclear medicine, cardiovascular radiology, and skeletal radiology. Each section contains four to eight topics. Each of these consists of text that represents highlights in narrative form, selected illustrations, and a short bibliography. The presentation gives a general idea of what points were made in the lecture

  9. Basic interventional radiology in the abdomen.

    Science.gov (United States)

    Calero García, R; Garcia-Hidalgo Alonso, M I

    2016-05-01

    This article describes the different basic nonvascular interventional techniques in the abdomen that all general radiologists should be familiar with. It explains the indications and approaches for the different procedures (punctures, biopsies, drainage of collections, cholecystostomies, and nephrostomies). It also discusses the advantages and disadvantages of the different imaging techniques that can be used to guide these procedures (ultrasound, CT, and fluoroscopy) as well as the possible complications that can develop from each procedure. Finally, it shows the importance of following up patients clinically and of taking care of catheters. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  10. Intervention radiology in postoperative recurrent goiter

    International Nuclear Information System (INIS)

    Galkin, E.V.

    1995-01-01

    Roentgenoendovascular functional thyroidectomy was used to suppress the pathological activity of the thyroid in postoperative recurrent goiter. The method consists in vascular isolation of hyperplastic stump of the thyroid by catheterization of the left and right thyroid arteries, followed by their material occlusion. For embolization, a wide spectrum of nonlyzed synthetic, organic, and inorganic materials were used. The results of roentgenoendovascular functional thyroidectomy in 14 patients with postoperative recurrent goiter are analyzed. The advantages of roentgenoendovascular occlusion of the thyroid arteries before subtotal thyroidectomy are emphasized. A stabile clinical and hormonal remission and reduction of the thyroid in size to stage 1 were observed during three years following roentgenoendovascular intervention [ru

  11. Interventional radiology in the cancer patient

    International Nuclear Information System (INIS)

    Wallace, S.; Charnsangavej, C.

    1987-01-01

    The contributions of the interventional radiologist in the diagnosis and management of the cancer patient include angiography and intraarterial CT-angiography, intraarterial infusion therapy, embolization, chemoembolization, biopsy and drainage procedures, central venous catheter reposition and retrieval, and stent dilation of stenotic tubular structures in the following organ systems: (1) Kidney. Arterial embolization, therapeutic delay, enphrectomy, and medroxyprogesterone yield a response rate of 28% in patients with renal cell carcinoma and pulmonary parenchymal metastases. (2) Liver. The carcinoid syndrome secondary to hepatic metastases can be controlled by embolization in 87% of patients. Islet cell carcinoma of the pancreas with hepatic metastases is successfully managed in 75% of patients. Chemoembolization (Ivalon and cisplatin) has been effective in 60% of patients with hepatic metastases from ocular melanoma. (3) Bone. A 73% 3-year survival rate is now possible with the inraarterial infusion of cisplatin, while Adriamycin is given intravenously in patients with osteosarcoma. Limb salvage is now possible in 80% of cases. Cancers of the vulva, vagina, urethra, and penis have been successfully treated with intraarterial infusion of chemotherapy followed by radiation therapy. (5) An expansile metallic stent is available to alleviate obstructions of the vena cava, the aorta and its major branches, the tracheobronchial tree, and the common duct. These techniques are demonstrated and results discussed

  12. Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology.

    Science.gov (United States)

    Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

    2018-03-01

    Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Significant differences exist in RP KAP mean scores based on educational age (p 0.050). We found a significant difference between RP KAP mean scores and different regions (p physics officers design strategic plans to enhance the quality of such services in radiation departments.

  13. The Role of Interventional Radiology in Obstetric Hemorrhage

    International Nuclear Information System (INIS)

    Gonsalves, M.; Belli, A.

    2010-01-01

    Obstetric hemorrhage remains a major cause of maternal morbidity and mortality worldwide. Traditionally, in cases of obstetric hemorrhage refractory to conservative treatment, obstetricians have resorted to major surgery with the associated risks of general anesthesia, laparotomy, and, in the case of hysterectomy, loss of fertility. Over the past two decades, the role of pelvic arterial embolization has evolved from a novel treatment option to playing a key role in the management of obstetric hemorrhage. To date, interventional radiology offers a minimally invasive, fertility-preserving alternative to conventional surgical treatment. We review current literature regarding the role of interventional radiology in postpartum hemorrhage, abnormal placentation, abortion, and cervical ectopic pregnancy. We discuss techniques, success rates, and complications.

  14. The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association

    Energy Technology Data Exchange (ETDEWEB)

    Millward, S.F.; Holley, M.L. [Univ. of Western Ontario, London Health Sciences Centre, Dept. of Radiology, London, Ontario (Canada)

    2001-04-01

    To evaluate the current status of interventional radiology in Canada. A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to

  15. Active pixel as dosimetric device for interventional radiology

    International Nuclear Information System (INIS)

    Servoli, L.; Baldaccini, F.; Biasini, M.; Checcucci, B.; Chiocchini, S.; Cicioni, R.; Conti, E.; Di Lorenzo, R.; Dipilato, A.C.; Esposito, A.; Fanó, L.; Paolucci, M.; Passeri, D.; Pentiricci, A.

    2013-01-01

    Interventional Radiology (IR) is a subspecialty of radiology comprehensive of all minimally invasive diagnostic and therapeutic procedures performed using radiological devices to obtain image guidance. The interventional procedures are potentially harmful for interventional radiologists and medical staff due to the X-ray diffusion by the patient's body. The characteristic energy range of the diffused photons spans few tens of keV. In this work we will present a proposal for a new X-ray sensing element in the energy range of interest for IR procedures. The sensing element will then be assembled in a dosimeter prototype, capable of real-time measurement, packaged in a small form-factor, with wireless communication and no external power supply to be used for individual operators dosimetry for IR procedures. For the sensor, which is the heart of the system, we considered three different Active Pixel Sensors (APS). They have shown a good capability as single X-ray photon detectors, up to several tens keV photon energy. Two dosimetric quantities have been considered, the number of detected photons and the measured energy deposition. Both observables have a linear dependence with the dose, as measured by commercial dosimeters. The uncertainties in the measurement are dominated by statistic and can be pushed at ∼5% for all the sensors under test

  16. Radiological Interventions for Correction of Central Venous Port Catheter Migrations

    International Nuclear Information System (INIS)

    Gebauer, Bernhard; Teichgraeber, Ulf Karl; Podrabsky, Petr; Werk, Michael; Haenninen, Enrique Lopez; Felix, Roland

    2007-01-01

    The purpose of the study is to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency, a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5F angiographic catheters (pigtail, Sos Omni), goose-neck snare, or combinations thereof. One patient showed spontaneous reposition of the catheter tip. In 27 of 29 patients (93%), radiological-interventional port catheter correction was successful. In two patients, port catheter malposition correction was not possible because of the inability to catch either the catheter tip or the catheter in its course, possibly due to fibrin sheath formation with attachment of the catheter to the vessel wall. No disconnection or port catheter dysfunction was observed after correction. In migrated catheter tips, radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis, port catheter correction is often more challenging

  17. Patient radiation doses and reference levels in pediatric interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Habib Geryes, Bouchra; Lachaux, Julie; Boddaert, Nathalie; Brunelle, Francis [Hopital Universitaire Necker Enfants Malades, Department of Paediatric Radiology, Paris (France); Bak, Adeline; Ozanne, Augustin; Saliou, Guillaume [Hopital Bicetre, Hopitaux Universitaires Paris-Sud, Department of Neuroradiology, Le Kremlin Bicetre (France); Naggara, Olivier [Hopital Universitaire Necker Enfants Malades, Department of Paediatric Radiology, Paris (France); Centre Hospitalier Sainte-Anne, Universite Paris Descartes Sorbonne Paris Cite, Centre de Psychiatrie et Neurosciences, INSERM S894, DHU Neurovasculaire, Paris (France); Centre Hospitalier Sainte-Anne, Department of Neuroradiology, Universite Paris Descartes, Sorbonne Paris Cite, INSERM UMR894, Paris (France)

    2017-09-15

    To describe, in a multicentric paediatric population, reference levels (RLs) for three interventional radiological procedures. From January 2012 to March 2015, children scheduled for an interventional radiological procedure in two French tertiary centres were retrospectively included and divided into four groups according to age: children younger than 2 years (A1), aged 2-7 years (A5), 8-12 years (A10) and 13-18 years (A15). Three procedures were identified: cerebral digital subtraction angiography (DSA), brain arteriovenous malformation (bAVM) embolization, and head and neck superficial vascular malformation (SVM) percutaneous sclerotherapy. Demographic and dosimetric data, including dose area product (DAP), were collected. 550 procedures were included. For DSA (162 procedures), the proposed RL values in DAP were 4, 18, 12 and 32 Gy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. For bAVM embolization (258 procedures), values were 33, 70, 105 and 88 Gy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. For SVM sclerotherapy (130 procedures), values were 350, 790, 490 and 248 mGy.cm{sup 2} in groups A1, A5, A10 and A15, respectively. Consecutive data were available to permit a proposal of reference levels for three major paediatric interventional radiology procedures. (orig.)

  18. Staff doses in intervention radiology in Portugal in 1999-2006

    International Nuclear Information System (INIS)

    Matins, Maria B.; Alves, Joao G.

    2008-01-01

    Full text: The annual effective doses received by the staff working in the field of interventional radiology in public hospitals and private clinics in Portugal in the period 1999-2006 was analysed and is presented in this paper. The work was carried out based on the occupational dose data reported to the Central Dose Registry of the Nuclear and Technological Institute (ITN) by the individual monitoring companies operating in the country. Previous studies have shown that the relative proportion of workers in each field of activity is approximately 80% for medicine, 13% for industry, 6% for research and 1% for mining, as there are no nuclear power plants in the country. The highest contribution to the total collective dose is due to the medical sector. Interventional radiology represents approximately 11% of the number of workers in the medical sector and the dose values associated to this type of activity are generally high. The aim of this work is to characterize the occupational exposure in interventional radiology, identifying the professions of the individuals working in this field and related doses. The annual whole body doses evaluated in the period 1999-2006 was used to derive the distribution of workers by effective dose intervals for every profession namely, medical doctors, nurses, radiology technicians, auxiliary and administrative staff. The respective annual average doses and collective doses as well as the total average and total collective doses for the interventional radiology field are presented. From the analysis of the data it can be inferred that medical doctors and nurses are more exposed than other staff categories. (author)

  19. Radiation dose reduction: comparative assessment of publication volume between interventional and diagnostic radiology.

    Science.gov (United States)

    Hansmann, Jan; Henzler, Thomas; Gaba, Ron C; Morelli, John N

    2017-01-01

    We aimed to quantify and compare awareness regarding radiation dose reduction within the interventional radiology and diagnostic radiology communities. Abstracts accepted to the annual meetings of the Society of Interventional Radiology (SIR), the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), the Radiological Society of North America (RSNA), and the European Congress of Radiology (ECR) between 2005 and 2015 were analyzed using the search terms "interventional/computed tomography" and "radiation dose/radiation dose reduction." A PubMed query using the above-mentioned search terms for the years of 2005-2015 was performed. Between 2005 and 2015, a total of 14 520 abstracts (mean, 660±297 abstracts) and 80 614 abstracts (mean, 3664±1025 abstracts) were presented at interventional and diagnostic radiology meetings, respectively. Significantly fewer abstracts related to radiation dose were presented at the interventional radiology meetings compared with the diagnostic radiology meetings (162 abstracts [1% of total] vs. 2706 [3% of total]; P radiology abstracts (range, 6-27) and 246±105 diagnostic radiology abstracts (range, 112-389) pertaining to radiation dose were presented at each meeting. The PubMed query revealed an average of 124±39 publications (range, 79-187) and 1205±307 publications (range, 829-1672) related to interventional and diagnostic radiology dose reduction per year, respectively (P radiology community over the past 10 years has not mirrored the increased volume seen within diagnostic radiology, suggesting that increased education and discussion about this topic may be warranted.

  20. Patient Safety in Interventional Radiology: A CIRSE IR Checklist.

    LENUS (Irish Health Repository)

    2012-02-01

    Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland.

  1. Action research regarding the optimisation of radiological protection for nurses during vascular interventional radiology

    International Nuclear Information System (INIS)

    Mori, Hiroshige

    2015-01-01

    The optimisation and decision-making processes for radiological protection have been broadened by the introduction of re-examination or feedback after introducing protective measures. In this study, action research was used to reduce the occupational exposure of vascular interventional radiology (IR) nurses. Four radiological protection improvement measures were continuously performed in cooperation with the researchers, nurses and stakeholders, and the nurses’ annual effective doses were compared before and after the improvements. First, the dosimetry equipment was changed from one electronic personal dosimeter (EPD) to two silver-activated phosphate glass dosimeters (PGDs). Second, the nurses were educated regarding maintaining a safe distance from the sources of scattered and leakage radiation. Third, portable radiation shielding screens were placed in the IR rooms. Fourth, the x-ray units’ pulse rates were reduced by half. On changing the dosimetry method, the two PGDs recorded a 4.4 fold greater dose than the single EPD. Educating nurses regarding radiological protection and reducing the pulse rates by half decreased their effective doses to one-third and two-fifths of the baseline dose, respectively. No significant difference in their doses was detected after the placement of the shielding screens. Therefore, the action research effectively decreased the occupational doses of the vascular IR nurses. (practical matter)

  2. Physicians' liability in interventional radiology and endovascular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Mavroforou, Anna E-mail: amavroforou@hotmail.com; Giannoukas, Athanasios; Mavrophoros, Dimitrios; Michalodimitrakis, Emmanuel

    2003-06-01

    Introduction/objective: Modern practice in Radiology has rapidly changed over the last decades incorporating invasive techniques. Additionally, litigation in medical practice has arisen as an important issue. This article aims to highlight issues related to malpractice in interventional radiology and endovascular therapy in order to point out the importance of the written informed consent. Methods and material: Search of relevant literature from the Pubmed. Results: The role of radiologist has been greatly transformed over the last decades. He is not only entitled to participate in the diagnosis but also he undertakes therapeutic procedures, either alone or as a member of a team. Thus the radiologist is now more exposed to actions that maximize litigation risk. Adequate communication and a written consent form seem to be mandatory before any invasive radiological procedure. Patient should know in detail the benefits and the risks of the scheduled procedure and whether the proposed therapy is a new form of treatment or part of a randomized trial. Discussions and conclusion: Interventional radiologist or physician is exposed to high litigation risk. This certainly requires an urgent adaptation of his practice and attitude to the new reality. Written patient's informed consent remains an integral part of the communication between physicians and patients, and importantly is offering professional protection along these lines.

  3. Physicians' liability in interventional radiology and endovascular therapy

    International Nuclear Information System (INIS)

    Mavroforou, Anna; Giannoukas, Athanasios; Mavrophoros, Dimitrios; Michalodimitrakis, Emmanuel

    2003-01-01

    Introduction/objective: Modern practice in Radiology has rapidly changed over the last decades incorporating invasive techniques. Additionally, litigation in medical practice has arisen as an important issue. This article aims to highlight issues related to malpractice in interventional radiology and endovascular therapy in order to point out the importance of the written informed consent. Methods and material: Search of relevant literature from the Pubmed. Results: The role of radiologist has been greatly transformed over the last decades. He is not only entitled to participate in the diagnosis but also he undertakes therapeutic procedures, either alone or as a member of a team. Thus the radiologist is now more exposed to actions that maximize litigation risk. Adequate communication and a written consent form seem to be mandatory before any invasive radiological procedure. Patient should know in detail the benefits and the risks of the scheduled procedure and whether the proposed therapy is a new form of treatment or part of a randomized trial. Discussions and conclusion: Interventional radiologist or physician is exposed to high litigation risk. This certainly requires an urgent adaptation of his practice and attitude to the new reality. Written patient's informed consent remains an integral part of the communication between physicians and patients, and importantly is offering professional protection along these lines

  4. Optimization of Patient Doses in Interventional Radiology and Cardiology

    International Nuclear Information System (INIS)

    Nikodemova, D.; Boehm, K.

    2011-01-01

    Interventional radiology and cardiology belongs to the imaging modalities connected with significantly higher radiation exposure of patients and medical staff, compared to the exposure during other diagnostic procedures. The objective of this presentation is to promote typical technical parameters and parameters related to the radiation policy, used during the most frequent endovascular and cardiology procedures, as well as the monitoring of the exposure of patients. The presented study reports the results of collecting the data of monitoring doses received by 318 patients undergoing interventional examinations in 3 various departments of the Slovak National Institute of Cardiology and Vascular Diseases. There were 9 different endovascular and cardiology procedures reviewed. The reported patient's radiation exposures were established by using the KAP values, directly shown on the display of the X-ray equipment. From the measured KAP values the entrance surface doses were calculated. Equivalent doses have been measured on hands, legs and other parts of medical staff body, by using electronic dosimeters or thermoluminescent dosimeters. The presented results have covered a wide range of the measured fluoroscopy time values, different number of acquisitions used in various interventional procedures, various cumulated KAP values and also a wide range of the cumulated entrance surface doses. The occupational doses of the operators, followed during dose measurements on their left hands, covered the range from 0.1 μSv to 1513 μSv for one examination performed. The important contribution of the presented results to the radiation protection policy in the Slovak Republic is the mapping of the current situation of the radiation exposure of patients undergoing the chosen interventional examinations and the professional radiation exposure level of interventional operators, providing the most significant interventional procedures in the Slovak interventional hospitals. The

  5. Fatal mediastinal biopsy: How interventional radiology saves the day

    Directory of Open Access Journals (Sweden)

    Y Yaacob

    2012-01-01

    Full Text Available This was a case of a 35-year-old man with mediastinal mass requiring computed tomography (CT-guided biopsy for tissue diagnosis. A posterior approach with an 18-gauge biopsy needle was used to obtain tissue sample. Post biopsy, patient condition deteriorated and multiphase CT study detected active bleeding in arterial phase at the biopsy site with massive hemothorax. Subsequent angiography showed arterial bleeder arising from the apical branch of the right pulmonary artery. Selective endovascular embolization with NBCA (n-Butyl cyanoacrylate was successful. Patient survived the complication. The case highlighted a rare complication in a common radiology procedure and the value of the interventional radiology unit in avoiding a fatal outcome.

  6. Should there be greater exposure to interventional radiology in the undergraduate curriculum?

    Directory of Open Access Journals (Sweden)

    Ojha U

    2017-12-01

    Full Text Available Utkarsh Ojha,1 Raihan Mohammed,2 Sayinthen Vivekanantham3 1Faculty of Medicine, Imperial College London, London, 2Department of Medicine, University of Cambridge, Cambridge, 3University of Aberdeen, Aberdeen, UK Abstract: Medical imaging has been one of the most revolutionary innovations in medicine. Today, as health care professionals shift their focus toward more sophisticated technology and minimally invasive procedures, interventional radiology (IR has become a rapidly expanding specialty. Despite these advances, there is a lack of doctors specializing in this field. A growing body of evidence suggests that the low number of applicants for posts may be due to poor exposure to the specialty at medical school. In this article, we outline the importance of IR in today’s health care system. Next, we evaluate the evidence that there is a lack of knowledge of IR not only among medical students in the UK but globally. We further discuss how a more effective incorporation of IR in the undergraduate curriculum can enhance medical students’ interest in the field and subsequently increase the number of doctors specializing in IR. Finally, we suggest alternative strategies to gauge medical students’ interest in IR, including teaching via e-learning and virtual reality. Keywords: interventional radiology, diagnostic imaging, innovation, medical education, e-learning, virtual reality

  7. Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Durran, Alexandra C., E-mail: durranjobs@hotmail.com [Peninsula Radiology Academy, Plymouth International Business Park (United Kingdom); Watts, Christopher, E-mail: Christopher.watts@salisbury.nhs.uk [Salisbury District Hospital (United Kingdom)

    2012-12-15

    Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units of heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.

  8. Surgical and interventional radiological management of adult epistaxis: systematic review.

    Science.gov (United States)

    Swords, C; Patel, A; Smith, M E; Williams, R J; Kuhn, I; Hopkins, C

    2017-12-01

    There is variation regarding the use of surgery and interventional radiological techniques in the management of epistaxis. This review evaluates the effectiveness of surgical artery ligation compared to direct treatments (nasal packing, cautery), and that of embolisation compared to direct treatments and surgery. A systematic review of the literature was performed using a standardised published methodology and custom database search strategy. Thirty-seven studies were identified relating to surgery, and 34 articles relating to interventional radiology. For patients with refractory epistaxis, endoscopic sphenopalatine artery ligation had the most favourable adverse effect profile and success rate compared to other forms of surgical artery ligation. Endoscopic sphenopalatine artery ligation and embolisation had similar success rates (73-100 per cent and 75-92 per cent, respectively), although embolisation was associated with more serious adverse effects (risk of stroke, 1.1-1.5 per cent). No articles directly compared the two techniques. Trials comparing endoscopic sphenopalatine artery ligation to embolisation are required to better evaluate the clinical and economic effects of intervention in epistaxis.

  9. Dosimetry in diagnostic and interventional radiology - ICRU and IAEA activities

    International Nuclear Information System (INIS)

    Zoetelief, J.; Pernicka, F.

    2002-01-01

    Full text: Main aims of patient dosimetry in diagnostic and interventional radiology are to determine dosimetric quantities for establishment and use of guidance levels or diagnostic reference levels and for comparative risk assessment. In the latter case, the average doses to the organs and tissues at risk should be assessed. Only limited number of measurements serve to potential risk assessment of the examination and intervention. An additional objective of dosimetry in diagnostic and interventional radiology is the assessment of equipment performance. Ionization chambers are the main devices used for dosimetric measurements in diagnostic and interventional radiology but other devices with special properties are also used. Important examples are thermoluminescent detectors (TLDs) and semiconductor detectors. For most dosemeters used in x-ray medical imaging the desired quantity for calibration of dosemeters is the air kerma free-in-air. Calibrations should be made at appropriate radiation qualities, for which recommendations are available for conventional radiology. It is important that the calibrations are traceable to the international measurement system. The uncertainty of dose measurements in medical x-ray imaging, for comparative risk assessments as well as for quality assurance, should not exceed about 7 per cent in terms of the expanded uncertainty using a coverage factor of 2. The dosimetric approaches in general diagnostic radiology, mammography and computed tomography are slightly different, resulting in application specific dosimetric quantities. Consequently, different protocols for patient dosimetry are available for these different purposes. In general diagnostic radiology, various quantities and terminologies have been used for the specification of dose on the central beam axis at the point where the x-ray beam enters the patient (or a phantom representing the patient). These include the exposure at skin entrance (ESE), the input radiation exposure

  10. Exposure of interventional radiology practitioners: contribution of capillaroscopy

    International Nuclear Information System (INIS)

    Gauron, C.; Wild, P.; Grzebyk, M.; Derock, C.; Champion, K.; Cohen, P.; Fiessinger, J.N.; Menez, C.; Carpentier, P.; De Gaudemaris, R.; Tellart, A.S.; Sobaszek, A.; Thiel, H.; Chamoux, A.; Donnadille, L.; Pennarola, R.; Perdereau, B.; Choudat, D.

    2013-09-01

    The objectives of this survey are to confirm or invalidate results of a preliminary study which highlighted capillary anomalies on an exposed population of practitioners performing interventional radiology treatments, and to study the influence of exposure characteristics (duration, dose level, fractioning) on the occurrence of these capillary anomalies. The authors present the studied cohort, the study process (capillaroscopy, capillaroscope reading and studies parameters, definition of synthetic indexes), briefly present the exposure assessment, statistical analysis, and ethical aspects. Results are discussed in terms of population and exposure characteristics, of number of coded capillaroscopic parameters, of statistical analysis of synthetic indexes. The survey questionnaire is given in appendix

  11. Radiation exposure of patients and operators during interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Krahe, T.; Ewen, K.; Lackner, K.; Koester, O.; Nicolas, V.

    1986-08-01

    Surface doses received by patients and operators were measured during 30 interventional radiological procedures (ten percutaneous transhepatic biliary drainages, ten percutaneous nephrostomies, ten percutaneous transluminal angioplasties). In addition, organ doses to the patient were determined using an Alderson-Rando phantom. These served as a basis for calculating the so-called somatic dose indices. It was found that the somatic radiation risk to the patient is relatively small despite prolonged periods of fluoroscopy. However, exposure of the hands and lenses of the operator could easily reach the limits thought acceptable while carrying out these procedures with additional angiography. (orig).

  12. Is hair loss a reality in neuro-interventional radiology?

    LENUS (Irish Health Repository)

    Gavagan, L

    2012-02-01

    Reports in the literature of radiation-induced hair loss are becoming increasingly common. This work describes a retrospective dose study of patients (n = 958) undergoing diagnostic (primarily cerebral angiograms) and therapeutic (primarily cerebral embolisation) procedures in a neuro-interventional suite. A comparison of patient doses as dose area product (DAP) readings from a single-plane image intensifier system (mean DAP value of 8772 cGy cm(2)) were compared with patient doses from a flat panel biplane system (mean DAP value of 7855 cGy cm(2)). Over 80 % of patients requiring neuro-interventional procedures were found to undergo two procedures or more. An estimated 7 % of therapeutic procedures were found to reach the International Commission on Radiological Protection threshold for temporary epilation.

  13. Interventional radiological therapy of benign low back pain syndromes

    International Nuclear Information System (INIS)

    Huegli, R.W.; Jacob, A.L.; Steinbrich, W.

    2007-01-01

    Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed

  14. Nordic Intervention Criteria for Nuclear or Radiological Emergencies. Recommendations

    International Nuclear Information System (INIS)

    2001-01-01

    Recommendations of the Nordic radiation protection authorities on application of international criteria in a nuclear or radiological emergency in the Nordic countries are presented. The recommendations are focused on the generic intervention levels for various actions to protect members of the public and workers undertaking an intervention. Prompt precautionary actions for the near zones around the Finnish and Swedish nuclear power plants are defined. These actions are; preventive sheltering, iodine prophylaxis and precautionary evacuation. No special intervention levels for these precautionary actions have been set, because implementation of these actions is always based on very limited information about an accident. These actions can be initiated on a mere indication of possible release of radioactivity. The indication might be an alarm or any other predefined signal. Intervention level for actions to protect members of the public are based on the concept of avertable dose. They are in line with the international recommendations. With regard to iodine prophylaxis, a national approach is recommended due to different national policies of advance distribution of iodine tablets. The longer term intervention actions, temporary relocation and permanent resettlement, will be based not only on radiation protection factors but also on wider judgement of the overall situation. For that reason, no generic intervention levels, in terms of radiation dose, are recommended. The intervention levels for various protective actions are in the following table.Table 1. Generic intervention levels for actions to protect members of the public.Protective action. Generic intervention level as an avertable dose. Sheltering: 10 mSv within two days (effective dose); Iodine prophylaxis: National recommendations; Evacuation: 50 mSv within one week (effective dose); Temporary relocation: No predetermined intervention level; Permanent resettlement: No predetermined intervention level. Workers

  15. Patterns, incidence and predictive factors for pain after interventional radiology

    International Nuclear Information System (INIS)

    England, A.; Tam, C.L.; Thacker, D.E.; Walker, A.L.; Parkinson, A.S.; DeMello, W.; Bradley, A.J.; Tuck, J.S.; Laasch, H.-U.; Butterfield, J.S.; Ashleigh, R.J.; England, R.E.; Martin, D.F.

    2005-01-01

    AIM: To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures. MATERIALS AND METHODS: All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure. RESULTS: One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study. Significant increases in VAS score occurred 8 h after percutaneous biliary procedures (+47.7 mm, SD 14.9 mm; p=0.001), 6 h after central venous access and gastrostomy insertion (+23.7 mm, SD 19.5 mm; p=0.001 and +28.4 mm, SD 9.7 mm; p=0.007, respectively) and 4 h after oesophageal stenting (+27.8 mm, SD 20.2 mm, p=0.001). Non-significant increases in VAS pain score were observed after duodenal and colonic stenting (duodenal: +5.13 mm, SD 7.47 mm; p=0.055, colonic: +23.3 mm, SD 13.10 mm, p=0.250) at a mean of 5 h (range 4-6 h). Patients reported a significant reduction in pain score for nephrostomy insertion (-28.4 mm, SD 7.11 mm, p=0.001). Post-procedural analgesia was required in 99 patients (69.2%), 40 (28.0%) requiring opiates. Maximum post-procedural VAS pain score was significantly higher in patients who had no pre-procedural analgesia (p=0.003). CONCLUSION: Post-procedural pain is common and the pattern and severity of pain between procedures is variable. Pain control after interventional procedures is often inadequate, and improvements in pain management are required

  16. Needlestick Injuries in Interventional Radiology Are Common and Underreported.

    Science.gov (United States)

    Deipolyi, Amy R; Prabhakar, Anand M; Naidu, Sailendra; Oklu, Rahmi

    2017-12-01

    Purpose To determine the prevalence of and risk factors for needlesticks in interventional radiology physicians, as well as the attitudes, behaviors, and conditions that promote or interfere with reporting of these injuries. Materials and Methods A total of 3889 interventional radiologists from academic and private practice in the United States were surveyed by emailing all interventional radiologist members of the Society of Interventional Radiology, including attending-level physicians and trainees (April-August 2016). The institutional review board waived the need for consent. Questions inquired about the nature, frequency, and type of needlestick and sharps injuries and whether and to whom these incidents were reported. Stepwise regression was used to determine variables predicting whether injuries were reported. Results In total, 908 (23%) interventional radiologists completed at least a portion of the survey. Eight hundred fourteen (91%) of 895 respondents reported a prior needlestick injury, 583 (35%) of 895 reported at least one injury while treating an HIV-positive patient, and 626 (71%) of 884 reported prior training regarding needlestick injury. There was, on average, one needlestick for every 5 years of practice. Most needlestick or sharps injuries were self inflicted (711 [87%] of 817) and involved a hollow-bore device (464 [56%] of 824). Only 566 (66%) of 850 injuries were reported. The most common reasons for not reporting included perceived lack of utility of reporting (79 [28%] of 282), perceived low risk for injury (56 [20%] of 282), noncontaminated needle (53 [19%] of 282), too-lengthy reporting process (37 [13%] of 282), and associated stigma (23 [8%] of 282). Only 156 (25%) of 624 respondents informed their significant other. Stepwise regression assessing variables affecting the likelihood of reporting showed that male sex (P = .009), low-risk patient (P < .0001), self injury (P = .010), trainee status (P < .0001), and the total number of prior

  17. Opportunity of interventional radiology: advantages and application of interventional technique in biological target therapy

    International Nuclear Information System (INIS)

    Teng Gaojun; Lu Qin

    2007-01-01

    Interventional techniques not only provide opportunity of treatment for many diseases, but also alter the traditional therapeutic pattern. With the new century of wide application of biological therapies, interventional technique also shows extensive roles. The current biological therapy, including gene therapy, cell transplantation therapy, immunobiologic molecule therapy containing cell factors, tumor antibody or vaccine, recombined proteins, radioactive-particles and targeting materials therapy, can be locally administrated by interventional techniques. The combination of targeting biological therapies and high-targeted interventional technique holds advantages of minimal invasion, accurate delivery, vigorous local effect, and less systemic adverse reactions. Authors believe that the biological therapy may arise a great opportunity for interventional radiology, therefore interventional colleagues should grasp firmly and promptly for the development and extension in this field. (authors)

  18. Competitiveness of the match for interventional radiology and neuroradiology fellowships.

    Science.gov (United States)

    Chen, Jim Y; Agarwal, Vikas; Orons, Philip D

    2014-11-01

    Overall resident interest in certain subspecialties changes with time. We sought to investigate the latest 6-year trend in interventional radiology (IR) and neuroradiology fellowship applications and how it has affected competitiveness in obtaining a position. We analyzed statistics published by the National Resident Matching Program in Results and Data: Specialties Matching Service from 2008 to 2013. From these data, we calculated the positions per IR applicant (PPIRA) and positions per neuroradiology applicant (PPNRA) for each year. The number of positions per applicant is one way to assess specialty competitiveness on a supply-and-demand basis. A lower PPIRA or PPNRA indicates a more competitive year. PPIRA has decreased every year, from 1.71 to the present 0.84, and contributed to 52 applicants being unmatched in 2013, up from 9 in 2008. Accordingly, the number of unfilled positions has decreased from 86 in 2008 to 8 in 2013. PPNRA waxed and waned from 2008 to 2010 but stabilized at around 1.15 thereafter. The number of unfilled positions has never dropped below 46. The number of unmatched applicants was consistently in the teens, except in 2011, when it increased to 23. Interest in IR fellowship has increased significantly over the past 6 years, whereas interest in neuroradiology fellowships has plateaued. IR fellowships have become increasingly competitive, leading to many unmatched residents. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Reconciling quality and cost: A case study in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Li; Mahnken, Andreas [University Hospital Giessen and Marburg, Philipps University of Marburg, Department of Diagnostic and Interventional Radiology, Baldinger Strasse, Marburg (Germany); Domroese, Sascha [University Hospital Giessen and Marburg, Philipps University of Marburg, Division of Controlling, Baldinger Strasse, Marburg (Germany)

    2015-10-15

    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 EUR to 294 EUR, and marginal delay costs from approximately 2000 EUR to 500 EUR, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 EUR. The yearly delay cost saved was approximately 150,000 EUR. With increased revenue of 10,000 EUR in project phase 2, the yearly total cost saved was approximately 290,000 EUR. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. (orig.)

  20. Organ doses in interventional radiology procedures: Evaluation of software

    International Nuclear Information System (INIS)

    Tort, I.; Ruiz-Cruces, R.; Perez-Martinez, M.; Carrera, F.; Ojeda, C.; Diez de los Rios, A.

    2001-01-01

    Interventional Radiology (IR) procedures require large fluoroscopy times and important number of radiological images, so the levels of radiation to patient are high, which leads us to calculate the organ doses. The objective of this work is to estimate and make a comparison of the results given by the different software that we have to do the calculation of organ doses in complex procedures of IR. To do this, 28 patients have been selected, distributed in the 3 procedures with highest doses. The determination of organ doses and effective doses has been made using the projections utilized and different software based on Monte Carlo Methods: Eff-dose, PCXMC and Diasoft. We have obtained very high dispersion in the average organ dose between the 3 programs. In many cases, it is higher than 25% and in some particular cases, it is greater than 100%. Dispersion obtained in effective doses is not so high, being under 20% in all cases. This shows that a better solution is needed to solve the problem of the organ doses calculation; a more accurate method is necessary that brings us to a trustworthy approach to reality, and, at the moment, that we do not dispose of it. (author)

  1. Interventional radiology (IVR). The history, status quo, and prospect

    International Nuclear Information System (INIS)

    Furui, Shigeru; Kohtake, Hiroshi

    2007-01-01

    Interventional radiology (IVR) is a clinical practice that therapy and/or biopsy are performed under guidance by images obtainable by the contrast angiography, ultrasonography, CT, MRI and so on. This paper describes its history, present status and future prospect. Actual operation procedure, recent trend and progress as well are explained in the order of arterial embolization, IVR in hepatic tumors, PTA (percutaneous transluminal angiography) and MS (metallic stent indwelling), MS applied to others than artery, S-G (stent-graft), IVR in portal hypertension, development of IVR devices in Japan, and radiation exposure and its protection in IVR. Many IVR devices have been developed in Japan for as long as these 30 years, a part of which is marketed. Skin exposure in patients is unavoidable in IVR with X-ray and thereby regulations by Food and Drug Administration (FDA) and International Commission of Radiological Protection (ICRP) are introduced for their benefit. Systems for dose estimation in patients and efforts to reduce the dose are mentioned to be important and radiologists themselves should make effort to decrease their own exposure in consideration of the dose limits defined in the law. Problems in Japan are expensiveness of IVR devices, and slow-paced approval of new devices by authority and by health insurance agent. The author recommends doctors to have expert radiologist's advice in IVR. (R.T.)

  2. Reconciling quality and cost: A case study in interventional radiology.

    Science.gov (United States)

    Zhang, Li; Domröse, Sascha; Mahnken, Andreas

    2015-10-01

    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.

  3. Educational activities regarding exposure reduction in interventional radiology

    International Nuclear Information System (INIS)

    Tajima, Osamu; Yabe, Hitoshi; Katoh, Kyoichi; Ueki, Junko; Nakamura, Kimiyuki; Nakatani, Akira; Wakamatsu, Osamu; Satoh, Tsugio; Nakazawa, Yasuo

    2000-01-01

    As interventional radiology (IVR) has become widespread recently, skin injury caused by exposure to radiation have been reported in academic meetings, and are a major concern in academic circles. In 1986, The Japanese Society of Circulation Imaging Technology (CITEC)'s organized a group to engage in an actual condition survey on cineangiography. We have studied exposed doses to patients in the event of cardiac catheterization using ancate data available in Japan and made efforts to spread methods of reducing exposure doses through academic meetings and medical journal. In 1998, we set up the Radiation Exposure Control Committee. The committee's objectives were to reduce exposure doses to patients and operators during cardiovascular examinations, and establish concrete of technical methods and protection guidelines for exposed dose reduction. We have studied presentations at academic meetings and study meetings, etc., and classified the results into the following 5 categories: methods of reducing radiation by X-ray equipment, methods of reducing exposure using X-ray protection devices, exposure dosimetry, clinical cases of radiation exposure, and QC, QA. The committee issued a textbook based on the reports and have educated, guided and enlightened radiological technologists, nurses and ME by holding the 'Seminar for reduction technique of radiation exposure in circulator organs.' (author)

  4. Reconciling quality and cost: A case study in interventional radiology

    International Nuclear Information System (INIS)

    Zhang, Li; Mahnken, Andreas; Domroese, Sascha

    2015-01-01

    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 EUR to 294 EUR, and marginal delay costs from approximately 2000 EUR to 500 EUR, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 EUR. The yearly delay cost saved was approximately 150,000 EUR. With increased revenue of 10,000 EUR in project phase 2, the yearly total cost saved was approximately 290,000 EUR. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. (orig.)

  5. Intravascular Ultrasound and its Use in Vascular Interventional Radiology

    International Nuclear Information System (INIS)

    Klepanec, A.; Vulev, I.; Vozar, M.; Balazs, T.; Madaric, J.; Holoman, M.

    2009-01-01

    Intravascular ultrasound has become in invasive vascular radiology in the last decade the important part of diagnostic and also therapeutic procedures in management of vascular diseases. The basic possibilities for the use of IVUS include diagnostic procedures in vascular pathology assessment and therapeutic indications in the field of peripheral vascular interventions (PVI). Unlike other image modalities (CT, MRI, ultrasound) IVUS enables gather unique image in r eal time r ight from the vessel lumen, what helps to add important information regarding vessel wall, plate morphology, thrombi and cross-sectional vessel area. After initial use of intravascular ultrasound in coronary circulation, using IVUS is nowadays widely extended especially in aortic diseases, carotid and renal arteries and arteries of the lower extremities. This review article summarizes possibilities of intravascular ultrasound utilization in diagnostic process and therapy from peripheral vascular diseases up to thoracoabdominal aorta diseases and our experience with this new diagnostic modality. (author)

  6. Celiac artery stenosis/occlusion treated by interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

    2009-08-15

    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  7. Preliminary characterization of dose in personnel of interventional radiology

    International Nuclear Information System (INIS)

    Godolfim, Laura Larre; Anes, Mauricio; Bacelar, Alexandre; Lykawka, Rochelle

    2016-01-01

    Exposure to X-rays of Interventional Radiology professionals (IR) impacts in the high dose rate received by these individuals, and there are reports of biological effects of this professional activity. Therefore, it is fomented greater control over the doses received by these workers. This research intends to characterize the doses received by the professionals during IR procedures. We evaluated the doses of radiologists, anesthesiologists and nursing staff of the Hospital de Clinicas de Porto Alegre, through measures with dosimeters of the OSL type, distributed in up to six regions of the body of these professionals. Until now were accompanied 33 cholangiography procedures and 29 embolization procedures. As a preliminary result, it was possible to identify a wide variation between doses of the professionals of the same function in each procedure. In overview, the dose of the professionals presented in descending order as a radiologist 1> radiologist 2 > anesthetist > nursing. (author)

  8. Interventional radiology - Health at work references Nr 130

    International Nuclear Information System (INIS)

    Machacek, C.; Menechal, P.; Megnigbeto, C.; Aubert, B.; Rehel, J.L.; Vidal, J.P.; Biau, A.; Lahaye, T.; Gauron, C.; Barret, C.; Donnarieix, D.; Gambini, D.; Guerin, C.; Marande, J.L.; Marelle, P.; Pierrat, N.

    2012-06-01

    After having noticed that interventional radiology is used in most of medical and surgical specialities, and indicated the factors influencing operator exposure, this sheet indicates the different types of personnel concerned by these practices, the hazards and risks associated with exposure to direct or scattered radiation, the way risk is assessed and exposure levels are determined (definition of controlled and surveyed areas, personnel classification, selection of a dosimetric control method), how a risk management strategy is defined and implemented (risk reduction methods, technical measures for the installation and for personnel, information and training actions, prevention measures, procedures in case of incident or dysfunction), how medical survey is performed for the personnel, in case of pregnancy, and by using a medical file and performing a post-professional follow-up, and by taking on anomalies and incidents. It also describes how risk management is to be assessed, and mentions some other risks

  9. Entrance surface dose in cerebral interventional radiology procedures

    International Nuclear Information System (INIS)

    Barrera-Rico, M.; López-Rendón, X.; Vega-Montesino, S.; Gamboa-deBuen, I.

    2014-01-01

    During interventional radiology procedures patients receive doses which exceed thresholds for non-stochastic effects on the skin, such as erythema (2 Gy) and epilation (3 Gy), so the entrance surface dose imparted during these proceedings should be monitored. The aim of this work was to determine the entrance surface dose (ESD) in patients who undergo diagnostic or therapeutic procedures at the Instituto Nacional de Neurología y Neurocirugía (INNN). The procedures were performed using two systems for neuroradiology, an Axiom Artis and an Artis Zeego from Siemens. The ESD was measured, for diagnostic and therapeutic procedures, using 15 × 15 cm 2 of Gafchromic XR-RV3 film and/or 25 TLD-100 chips that were attached in a holder of 15 × 15 cm 2 in the posteroanterior and left and right lateral positions during all the procedures. The results show that the maximum ESD measured was lower than 1 Gy for the nine diagnostic procedures evaluated whereas four of the ten therapeutic procedures were greater than 2 Gy in at least one position. Seven patients were monitored, three of which have presented epilation and one erythema. - Highlights: • We measured the entrance surface dose in cerebral interventional radiology. • Entrance surface doses were lower than 1 Gy for diagnostic procedures. • In four therapeutic procedures entrance surface doses were greater than 2 Gy. • Three patients presented epilation and one erythema

  10. Analysis of data relative to the update of diagnostic reference levels in radiology and nuclear medicine. 2011-2012 review

    International Nuclear Information System (INIS)

    2014-01-01

    Applying the Order of 24 October 2011 on diagnostic reference levels, departments of radiology and nuclear medicine must send a sample of 'patient' dosimetric data to the IRSN each year. The results of the analysis of dosimetric data performed between the 1 January 2011 and the 31 December 2012 presented in this report should enable the authority to define the needs for updating regulations. Professional involvement in DRLs improved globally over the 2011-2012 period but is heterogeneous according to the imaging area considered. The participation of conventional radiology professionals is still low, with less than 30% against over 75% in CT and 85% in nuclear medicine. Data collection in pediatrics, considering all the fields of medical imaging, remains extremely limited. This shows almost no dose assessment for children by imaging departments, and has the effect of not allowing authorities to provide professionals with DRLs representative of pediatric practices. The analysis of radiology doses and nuclear medicine administered activities by IRSN shows an overall decrease of statistical indicators on which DRLs are indexed. These results lead to proposals for updating reference values for a large number of examinations. In addition to the analysis of data collected for examinations currently mentioned in regulatory texts, IRSN recommends to update DRLs in a more general way by changing the strategy for collecting and updating pediatric DRLs, by including interventional radiology - specialty in which the radiation protection presents a major challenge - by introducing a more ambitious indicator than the 75. percentile in conventional radiology and nuclear medicine - the 25. percentile statistical indicator, and by taking into account new technologies inducing additional exposures to the patient as CT-scan associated with the PET. (authors)

  11. Symptomatic portal vein occlusion: treated by interventional radiological techniques

    International Nuclear Information System (INIS)

    Wang Maoqiang; Gu Xiaofang; Guan Jun; Wang Zhongpu; Liu Fengyong; Wang Zhiqiang

    2004-01-01

    Objective: To evaluate the efficacy and safety of the interventional radiological techniques for management of symptomatic portal vein (PV) occlusion. Methods: Nine patients with PV trunk occlusion were treated using interventional procedures. Four patients presented with abdominal pain, distention, and malabsorption; five presented with portal hypertension and repeated bleeding from esophagogastric varices. The etiologic factors were identified in all 9 patients, including post-transplantation of the liver in 2, hepatocellular carcinoma (HCC) associated with PV tumor thrombus in 3, post abdominal operative state in 1, and PV thrombosis in 3 cases. The portal access was established via a percutaneous transhepatic route in 4, and via a transjugular intrahepatic portosystemic shunt ( TIPS) approach in 5 patients. The interventional procedures included stent placement in 4, balloon angioplasty in 6, and catheter directed pharmacologic and mechanical thrombolysis in 7 patients. Results: The technical success was achieved in all cases. No complications related to the procedure occurred. Portal flow was reestablished in all patients after the procedures. Clinical improvement was seen in 3 patients with symptomatic PV thrombosis, characterized by progressive reduction of abdominal pain, distention, and diarrhea. Follow-up time ranged from 4 to 36 months. One patient with HCC died of multiple organs metastases at 11 months after the treatment . One patient died of intraabdominal sepsis and multiple organs failure 12 days after the procedure even though the antegrade flow was re-established in the main trunk of the PV. Patency of the PV trunk was confirmed by follow-up color Doppler ultrasound scan in the rest 7 patients, without recurrence of variceal bleeding or PV thrombus. Conclusions: Interventional minimally invasive procedures, including balloon angioplasty, stent placement, catheter directed local pharmacologic and mechanical thrombolysis, are safe and effective in

  12. Acute Pancreatitis: The Role of Imaging and Interventional Radiology

    International Nuclear Information System (INIS)

    Maher, Michael M.; Lucey, Brian C.; Gervais, Debra A.; Mueller, Peter R.

    2004-01-01

    Acute pancreatitis can manifest as a benign condition with minimal abdominal pain and hyperamylasemia or can have a fulminant course, which can be life-threatening usually due to the development of infected pancreatic necrosis, and multisystem organ failure. Fortunately, 70-80% of patients with acute pancreatitis have a benign self-limiting course. The initial 24-48 hours after the initial diagnosis is usually the period that determines the subsequent course, and for many of the 20-30% of patients who subsequently have a fulminant course, this becomes apparent within this time frame. With reference to long-term outcome following acute pancreatitis, most cases recover without long-term sequelae with only a minority of cases progressing to chronic pancreatitis. In the initial management of acute pancreatitis, assessment of metabolic disturbances and systemic organ dysfunction is critical. However, the advent and continued refinement of cross-sectional imaging modalities over the past two decades has led to a prominent role for diagnostic imaging in assessing acute pancreatitis. Furthermore, these cross-sectional imaging modalities have enabled the development of diagnostic and therapeutic interventional techniques in the hands of radiologists. In this article we review the diagnostic features of acute pancreatitis, the clinical staging systems, complications and the role of imaging. The role of interventional radiology techniques in the management of acute pancreatitis will be discussed as well as potential complications associated with these treatments

  13. Manual of use and accounting of radioactive material and procedures of radiological protection for nuclear medicine

    International Nuclear Information System (INIS)

    Chavez, Miguel

    1997-03-01

    This manual of use and accounting of material radioactive and procedures of radiological safety tries to facilitate workings of protection of material radioactive in services of medicine nuclear, during diagnosis (examinations with x-rays, or those that are made in nuclear medicine), or during the processing of diseases, mainly of the carcinomas (x-ray)

  14. Off label use of devices and drugs in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Zvavanjanja, R.C., E-mail: Rodrick.Zvavanjanja@rlbuht.nhs.uk [Royal Liverpool University Hospital, Liverpool (United Kingdom); Odetoyinbo, T.O.; Rowlands, P.C.; Healey, A.; Abdelsalam, H.; Powell, S.; Evans, J.C.; Hughes, M.L.; Gould, D.A.; McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom)

    2012-03-15

    Aim: To establish how often off-label device and drug use occurs in interventional radiology (IR) in a UK tertiary referral hospital and consider the wider implications for the interventional radiologist. Materials and methods: Prospective data were collected during interventional procedures for 1 working week in a university hospital. Out-of-hours procedures and procedures outside the department were excluded. Operators were asked to record the drugs and devices used, the indication, and method of use. The instructions for use/summary of product characteristics were then studied for each device/drug used to assess if the use was on or off-label. Results: During the study period 52 cases were performed and data were available on 26 cases (50%). In 22 of the 26 cases (84%) there was evidence of off-label use of devices or drugs. Off-label use of drugs included treatment of venous malformations with Fibrovein{sup Copyright-Sign} (sodium tetradecyl sulphate), which is licensed for the treatment of varicose veins in the leg, and intra-arterial injection of heparin, which is licensed for intravenous and subcutaneous use. Off-label device use included placing vascular sheaths in the urinary tract, using angiographic catheters to guide wires in the urinary tract, using sheaths for thrombosuction, reshaping of the tip of most guidewires, and using angioplasty balloons to dislodge the arterial plug at fistula thrombectomy. Conclusion: Off-label device and drugs use is common in a UK tertiary hospital IR department and literature suggests this is common in the wider IR community. There are important clinical and legal implications for off-label use for patients and physicians.

  15. Digitization of medicine: how radiology can take advantage of the digital revolution.

    Science.gov (United States)

    Li, King C; Marcovici, Peter; Phelps, Andrew; Potter, Christopher; Tillack, Allison; Tomich, Jennifer; Tridandapani, Srini

    2013-12-01

    In the era of medical cost containment, radiologists must continually maintain their actual and perceived value to patients, payers, and referring providers. Exploitation of current and future digital technologies may be the key to defining and promoting radiology's "brand" and assure our continued relevance in providing predictive, preventive, personalized, and participatory medicine. The Association of University of Radiologists Radiology Research Alliance Digitization of Medicine Task Force was formed to explore the opportunities and challenges of the digitization of medicine that are relevant to radiologists, which include the reporting paradigm, computational biology, and imaging informatics. In addition to discussing these opportunities and challenges, we consider how change occurs in medicine, and how change may be effected in medical imaging community. This review article is a summary of the research of the task force and hopefully can be used as a stimulus for further discussions and development of action plans by radiology leaders. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  16. Radiological Justification for and Optimization of Nuclear Medicine Practices in Korea

    Science.gov (United States)

    2016-01-01

    Nuclear medicine is a rapidly growing discipline that employs advanced novel hybrid techniques that provide unique anatomical and functional information, as well as targets for molecular therapy. Concomitantly, there has been an increase in the attention paid to medical radiation exposure. A radiological justification for the practice of nuclear medicine has been implemented mainly through referral guidelines based on research results such as prospective randomized clinical trials. The International Commission on Radiological Protection recommends diagnostic reference levels as a practical mechanism to optimize medical radiation exposure in order to be commensurate with the medical purpose. The Korean Society of Nuclear Medicine has been implementing radiological optimization through a survey of the protocols on how each hospital determines the dose of administration of each radiopharmaceutical. In the case of nuclear medicine, radiation exposure of caregivers and comforters of patients discharged after administration of therapeutic radiopharmaceuticals can occur; therefore, optimization has been implemented through written instructions for patients, based on international recommendations. The development of patient-radiation-dose monitoring software, and a national registry and management system of patient-radiation-dose is needed to implement radiological optimization through diagnostic reference levels. This management system must work in agreement with the “Institute for Quality Management of Nuclear Medicine”, and must take into account the medical reality of Korea, such as low medicine fee, in order to implement reasonable radiological justification and optimization. PMID:26908990

  17. Required internship in diagnostic radiology in the fifth year of medicine at Montreal University

    International Nuclear Information System (INIS)

    Saint-Georges, G.; Raymond-Tremblay, D.; Danais, S.; Dussault, R.; Grignon, A.; Lafortune, M.; Saltiel, J.

    1984-01-01

    Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students. (author)

  18. Interventional radiology techniques for the diagnosis of lymphoma or leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, Kevin M.; Hoffer, Fredric A. [Department of Diagnostic Imaging, St. Jude Children' s Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794 (United States); Behm, Frederick G. [Department of Pathology, St. Jude Children' s Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794 (United States); Gow, Kenneth W. [Department of Surgery, St. Jude Children' s Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794 (United States); Hudson, Melissa M.; Sandlund, John T. [Department of Hematology-Oncology, St. Jude Children' s Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794 (United States)

    2002-09-01

    Heading AbstractBackground. Fluid aspiration, percutaneous biopsy, and catheter drainage are standard minimally invasive methods of diagnosing lymphoma or leukemia in adults.Objective. To determine the effectiveness of interventional radiologic techniques in diagnosing specific hematologic malignancies in children.Methods. During a 4-year period, 22 patients (16 male, 6 female; median age, 13 years) underwent 25 percutaneous biopsies, 6 fluid aspirations, 3 catheter drainages, and 1 needle localization for diagnosing suspected hematologic malignancy.Results. For Hodgkin's disease, the procedures yielded 6 true-positive (TP) results, 2 true-negative (TN) results, and 2 false-negative (FN) results; for non-Hodgkin lymphoma (NHL), 14 TP results, 1 TN result, and 3 FN results; and for leukemia, 4 TP results and 3 FN results. Percutaneous biopsies yielded 16 TP results, 3 TN results, and 6 FN results. Aspirations and drainages yielded 8 TP results and 1 FN result. The one needle localization yielded a FN result. Overall sensitivity was 75%{+-}7.3%; specificity, 100%; and accuracy, 77%{+-}7.1%.Conclusion. Percutaneous biopsy of lymphoma is usually diagnostic. Drainage or aspiration of a fluid collection associated with NHL or leukemia is often diagnostic and is less invasive than biopsy. These procedures are minimally invasive and effective for diagnosing pediatric hematologic malignancies. (orig.)

  19. Interventional radiology techniques for the diagnosis of lymphoma or leukemia

    International Nuclear Information System (INIS)

    Garrett, Kevin M.; Hoffer, Fredric A.; Behm, Frederick G.; Gow, Kenneth W.; Hudson, Melissa M.; Sandlund, John T.

    2002-01-01

    Heading AbstractBackground. Fluid aspiration, percutaneous biopsy, and catheter drainage are standard minimally invasive methods of diagnosing lymphoma or leukemia in adults.Objective. To determine the effectiveness of interventional radiologic techniques in diagnosing specific hematologic malignancies in children.Methods. During a 4-year period, 22 patients (16 male, 6 female; median age, 13 years) underwent 25 percutaneous biopsies, 6 fluid aspirations, 3 catheter drainages, and 1 needle localization for diagnosing suspected hematologic malignancy.Results. For Hodgkin's disease, the procedures yielded 6 true-positive (TP) results, 2 true-negative (TN) results, and 2 false-negative (FN) results; for non-Hodgkin lymphoma (NHL), 14 TP results, 1 TN result, and 3 FN results; and for leukemia, 4 TP results and 3 FN results. Percutaneous biopsies yielded 16 TP results, 3 TN results, and 6 FN results. Aspirations and drainages yielded 8 TP results and 1 FN result. The one needle localization yielded a FN result. Overall sensitivity was 75%±7.3%; specificity, 100%; and accuracy, 77%±7.1%.Conclusion. Percutaneous biopsy of lymphoma is usually diagnostic. Drainage or aspiration of a fluid collection associated with NHL or leukemia is often diagnostic and is less invasive than biopsy. These procedures are minimally invasive and effective for diagnosing pediatric hematologic malignancies. (orig.)

  20. Prostate embolization: A new acting field of interventional radiology

    International Nuclear Information System (INIS)

    Kisilevzky, N.; García Mónaco, R.; Peralta, O.; Rabelino, M.; Rosales Arroba, R.; Rodriguez, P.; Ocantos, J.; Martínez, P.F.; Damia, O.

    2014-01-01

    Purposes: To present the initial experience with prostatic embolization as an alternative treatment for benign prostatic hyperplasia (BPH) from a technical perspective to establish the contribution provided by diagnostic imaging. Materials and methods: Sixteen patients with lower urinary tract symptoms due to benign prostatic hyperplasia underwent prostatic embolization. All patients were evaluated with specific questionnaires to determine the severity of symptoms, impact on quality of life and erectile function, ultrasound and MRI of the pelvis, urinary flowmetry and PSA before and 30 days after the procedure. Results: Embolization was successful in all patients; in 10 cases the procedure was performed bilaterally and in six, only one side was embolized. The average time for completion of the procedure was 82 minutes and the average fluoroscopy time was 38.5 minutes. All procedures were performed on an outpatient basis with an average hospital stay of 6.4 hours. The mean contrast medium used was 175 ml. At 30 days there was a mean reduction on prostate volume of 21%. Clinical improvement was characterized by a mean 8-point improvement on IPSS, 2 points on QOL and 4 points on IIEF. The uroflowmetry improved 39% and PSA dropped 26%. No major complications that implied unscheduled hospitalization or performing additional surgical procedures were seen. Minor adverse events were verified in 9 patients. Conclusion: The initial results of prostatic embolization as an alternative treatment for BPH indicate that it is a safe and effective procedure to be consolidated as a new field of action of interventional radiology. (authors) [es

  1. Entrance surface dose in cerebral interventional radiology procedures

    International Nuclear Information System (INIS)

    Barrera-Rico, M.; López-Rendón, X.; Rivera-Ordóñez, C. E.; Gamboa-deBuen, I.

    2012-01-01

    At the Instituto Nacional de Neurología y Neurocirugía (INNN) diagnostic as well as therapeutic procedures of interventional radiology are carried out. Since the procedures can last from some minutes to several hours, the absorbed dose for the patient could increase dangerously. An investigation had begun in order to determine the entrance surface dose (ESD) using 25 thermoluminiscent dosimeters TLD-100 and 8 strips of 15 ×1 cm 2 of Gafchromic XR-QA2 film bound in a holder of 15×15 cm 2 in the posteroanterior (PA) and lateral (LAT) positions during all the procedure. The results show that maximum ESD could be from 0.9 to 2.9 Gy for the PA position and between 1.6 and 2.5 Gy for the lateral position. The average ESD was between 0.7 and 1.3 Gy for the PA position, and from 0.44 to 1.1 Gy for the lateral position in a therapeutic procedure.

  2. Entrance surface dose in cerebral interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Barrera-Rico, M.; Lopez-Rendon, X.; Rivera-Ordonez, C. E.; Gamboa-deBuen, I. [Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, 04510 DF (Mexico); Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, 14269 DF (Mexico); Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, 04510 DF (Mexico)

    2012-10-23

    At the Instituto Nacional de Neurologia y Neurocirugia (INNN) diagnostic as well as therapeutic procedures of interventional radiology are carried out. Since the procedures can last from some minutes to several hours, the absorbed dose for the patient could increase dangerously. An investigation had begun in order to determine the entrance surface dose (ESD) using 25 thermoluminiscent dosimeters TLD-100 and 8 strips of 15 Multiplication-Sign 1 cm{sup 2} of Gafchromic XR-QA2 film bound in a holder of 15 Multiplication-Sign 15 cm{sup 2} in the posteroanterior (PA) and lateral (LAT) positions during all the procedure. The results show that maximum ESD could be from 0.9 to 2.9 Gy for the PA position and between 1.6 and 2.5 Gy for the lateral position. The average ESD was between 0.7 and 1.3 Gy for the PA position, and from 0.44 to 1.1 Gy for the lateral position in a therapeutic procedure.

  3. Need and availability of dentists and specialists in oral medicine and radiology: A survey

    Directory of Open Access Journals (Sweden)

    Amita Aditya

    2014-01-01

    Full Text Available Introduction: The gap between the integration of medical and dental care in our country is quite evident, and requires the attention of both the faculties. Postgraduate training in Oral Medicine and Radiology is available in our country since many years. However, unlike other specialists in dentistry, it is not routine for a medical practitioner to refer patients to a specialist in Oral Medicine and Radiology. An introspection regarding the present situation is essential to improve the accessibility and availability of comprehensive oral healthcare. Objective: This survey was conducted to assess the perceived need and availability of dentists and specialists in Oral Medicine and Radiology by medical practitioners in Pune, Maharashtra. Materials and Methods: A questionnaire was sent by post to 200 randomly selected medical practitioners. Personal interviews were conducted among 41 medical practitioners in private practice and 25 working at a local teaching hospital. Hence, a total of 266 medical practitioners were approached for participation in the study. Results: Ninety-six percent of the practitioners have mentioned seeing patients with oral complaint(s other than toothache in their practice. Thirty-four percent of the medical practitioners referred patients with dental or other oral problems directly to the dentists, 60% referred them after prescribing medicines, whereas, 6% of the medical practitioners treated such patients on their own. Sixty percent referrals were made to a general dental practitioner rather than a dental specialist. Seventy-two percent of them were not even aware of the presence of any Oral Medicine and Radiology specialists in their vicinity or city. Conclusion: Medical practitioners do perceive a need of dental practitioners for referring various oral problems. However, there seems to be little awareness among the medical practitioners regarding the expertise and availability of specialists in Oral Medicine and

  4. the complementary roles of radiology and nuclear medicine

    African Journals Online (AJOL)

    computerised tomography (CT) and magnetic resonance imaging. (MRI). Simultaneously, there has been significant growth in the use of positron emission tomography (PET), sentinel node imaging, targeted radiotherapy and several molecular imaging techniques. Radiology has experienced exponential growth with regard ...

  5. Tele-nuclear medicine | Sabbah | SA Journal of Radiology

    African Journals Online (AJOL)

    SA Journal of Radiology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 18, No 1 (2014) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load ...

  6. Nanotechnology and its Relationship to Interventional Radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

    LENUS (Irish Health Repository)

    Power, Sarah

    2010-09-16

    Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.

  7. Nanotechnology and its relationship to interventional radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

    LENUS (Irish Health Repository)

    Power, Sarah

    2012-02-01

    Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.

  8. Fetal dose in radiology, nuclear medicine and radiotherapy; Dosis fetal en radiodiagnostico, medicina nuclear y radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Rosales, F. J.; Martinez, L. C.; Candela, C.

    2015-07-01

    Sometimes irradiation of the fetus in the mother's womb is inevitable in the field of diagnostic radiology, nuclear medicine and radiotherapy, either through ignorance a priori status of this pregnancy, either because for clinical reasons it is necessary to perform the radiological study or treatment. In the first cases, know the dose at which it has exposed the fetus is essential when assessing the associated risk, while in the second it is when assessing the justification of the test. (Author)

  9. Radiology

    International Nuclear Information System (INIS)

    Edholm, P.R.

    1990-01-01

    This is a report describing diagnostic techniques used in radiology. It describes the equipment necessary for, and the operation of a radiological department. Also is described the standard methods used in radiodiagnosis. (K.A.E.)

  10. Medical intervention in radiological emergencies, formation and training

    International Nuclear Information System (INIS)

    Cardenas H, J.

    2006-01-01

    The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

  11. Analysis of data relative to the update of diagnostic reference levels in radiology and nuclear medicine. 2013-2015 review

    International Nuclear Information System (INIS)

    2016-11-01

    Applying the Order of 24 October 2011 on diagnostic reference levels, departments of radiology and nuclear medicine must send a sample of 'patient' dosimetric data to the IRSN each year. The results of the analysis of dosimetric data performed between the 1 January 2013 and the 31 December 2015 presented in this report should enable the authority to define the needs for updating regulation. This assessment takes place in a national and international context particularly rich and active since the last years. More than 20 years after the official introduction of the DRL concept by ICRP and the first regulation requirements at a European level, the good and the bad sides of the DRLs systems implemented by several countries, including France, has shown the necessity of complementary actions regarding some specific practices (pediatrics, interventional radiology). On one hand, from a national point of view, the current collection and analysis system is highly efficient for evaluation of practices in France and for DRL update ability. On the other hand, as an optimization implementation tool, regarding the lack of professionals involvement, the current system should not be considered as fully effective in radiology. However, when the professionals carry out DRL data collection and analysis, optimization actions are implemented for nearly all the cases. During the 2013-2015 period, professionals involvement in DRLs globally improved but is heterogeneous according to the imaging area considered. The participation of conventional radiology professionals is still low, with less than 30% against about 80% in CT and more than 85% in nuclear medicine. From a dosimetric point of view, the national analysis shows an overall decrease of statistical indicators in radiology, computed tomography and nuclear medicine on which DRLs are indexed. These results lead to proposals for updating reference values for a large number of examinations. In addition to the analysis of data

  12. Report by the work-group on radiation protection in interventional radiology. Recommendations related to the improvement of radiation protection in interventional radiology

    International Nuclear Information System (INIS)

    2010-01-01

    This report aims at proposing recommendations for the improvement of the quality of radiation protection of workers and patients in the field of interventional radiology. These recommendations concern the training of health personnel, the application of the optimization principle to health professionals and patients, dosimetry and the definition of diagnosis reference levels. More particularly, these recommendations concern professions involved in interventional radiology, and take into account the experience of other European Union State members and recommendations made by the IAEA. The authors analyze the equipment, radiological actions, procedures and doses, practitioners, equipment used for radio-guided interventions. They discuss doses received by patients, patient monitoring and radio-induced lesions. Then, they address the role and training of the different interveners in radiation protection, the equipment maintenance issue, and personnel dosimetry and protection

  13. Tele-nuclear medicine | Sabbah | SA Journal of Radiology

    African Journals Online (AJOL)

    This article presents a description of tele-nuclear medicine and, after outlining its history, a wide, representative range of its applications. Tele-nuclear medicine has benefited greatly from technological progress, which for several decades has provided greater data transfer rates and storage capacity at steadily decreasing ...

  14. The clinical practice of interventional radiology: a European perspective.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2009-05-01

    The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management\\'s refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

  15. Meeting Report: 2015 Scientific Meeting of the Pan Arab Interventional Radiology Society

    Directory of Open Access Journals (Sweden)

    Tauqir A. Rana

    2015-10-01

    Full Text Available The second Annual Scientific Meeting of the Pan Arab Interventional Radiology Society (PAIRS, held March 12-14, 2015, was a step above the inaugural edition, and opened new concepts for development.

  16. Adoption of the 16-month American Board of Radiology pathway to dual board certifications in nuclear radiology and/or nuclear medicine for diagnostic radiology residents.

    Science.gov (United States)

    Oates, M Elizabeth; Guiberteau, Milton J

    2014-10-01

    In 2010, the American Board of Radiology (ABR) approved a new 16-month nuclear subspecialty training pathway within a standard 48-month Accreditation Council for Graduate Medical Education (ACGME)-accredited diagnostic radiology (DR) residency available to institutions sponsoring ACGME-accredited nuclear radiology (NR) and/or nuclear medicine (NM) program(s). This accelerated pathway leads to eligibility for dual ABR certifications in DR and NR or in NM by the American Board of Nuclear Medicine (ABNM). The American College of Radiology, in conjunction with the ABR, aimed to understand adoption of this new pathway, barriers to implementation, preferences for subspecialty certification, and competing alternative combined DR/NR/NM training pathways. During 2013-2014, there were 20 ACGME-accredited NR fellowship and 43 ACGME-accredited NM residency programs eligible to adopt this new 16-month pathway. They were surveyed by e-mail correspondence regarding implementation and barriers to implementation, board certification (ABR-NR and ABNM) preferences, and local alternative training pathways. With 100% of the surveys completed, a small cadre of qualifying DR programs (14, 22%) has adopted (9, 14%) or is seriously considering adopting (5, 8%) the 16-month ABR pathway. For most, implementation is problematic with numerous barriers in common. Five (8%) institutions are developing 60-month nontraditional models as alternative routes to ABR-DR/ABR-NR certifications and/or dual ABR/ABNM board certifications. In spite of strategies to promote a shortened training pathway in NR/NM, traditional subspecialty fellowships outside the DR residency remain the dominant pathway leading to ABR subspecialty certification in NR and/or ABNM certification for diagnostic radiologists. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  17. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery).

    Science.gov (United States)

    Magnone, Stefano; Coccolini, Federico; Manfredi, Roberto; Piazzalunga, Dario; Agazzi, Roberto; Arici, Claudio; Barozzi, Marco; Bellanova, Giovanni; Belluati, Alberto; Berlot, Giorgio; Biffl, Walter; Camagni, Stefania; Campanati, Luca; Castelli, Claudio Carlo; Catena, Fausto; Chiara, Osvaldo; Colaianni, Nicola; De Masi, Salvatore; Di Saverio, Salomone; Dodi, Giuseppe; Fabbri, Andrea; Faustinelli, Giovanni; Gambale, Giorgio; Capponi, Michela Giulii; Lotti, Marco; Marchesi, Gianmariano; Massè, Alessandro; Mastropietro, Tiziana; Nardi, Giuseppe; Niola, Raffaella; Nita, Gabriela Elisa; Pisano, Michele; Poiasina, Elia; Poletti, Eugenio; Rampoldi, Antonio; Ribaldi, Sergio; Rispoli, Gennaro; Rizzi, Luigi; Sonzogni, Valter; Tugnoli, Gregorio; Ansaloni, Luca

    2014-03-07

    Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

  18. A pilot study of radiation exposures arising from interventional radiology procedures

    International Nuclear Information System (INIS)

    Pellet, S.; Giczi, F.; Gaspardy, G.; Temesi, A.; Ballay, L.

    2006-01-01

    Full text of publication follows: In the past 25 years, considerable number of new therapeutic procedures have been worked out and adopted in radiology. These interventional procedures are mainly based on angiographic methods. During these procedures the exposure of patients and staff are usually greater than of conventional radiography and fluoroscopy as a consequence of longer fluoroscopy times and great number of cine-radiography. In the latest years radiation-induced skin injuries occurred in some patients. Injuries to physicians and staff performing interventional procedures have also been observed. In our days interventional procedures are widely used and more sophisticated procedures are worked out and adopted. Consequently, there is a need for the protection of the patient and the staff on a higher level. Radiation protection of intervention radiology deserves a distinguish attention. In Hungary interventional radiology were performed in 36 laboratories in 2003. According to statistical data the gross number of interventional radiological procedures were 19442. The most frequently performed procedures were the P.T.C.A., the coronary and ilio-femoral stent implantation and chemo-embolization. In 2004, the National Research Institute for Radiobiology and Radio-hygiene and the National Patient Dose Evaluation Program started a pilot study of radiation exposures arising from interventional radiology procedures. During the study the patient exposure were measured by D.A.P.-meters. The patient skin dose and the staff dose were performed by thermoluminescent chips. In their presentation the authors present the most important results of the study. (authors)

  19. complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

    DEFF Research Database (Denmark)

    Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang

    2017-01-01

    radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement...

  20. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care

    International Nuclear Information System (INIS)

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G.

    2006-01-01

    Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

  1. Reference levels in interventional radiology. S.F.P.M. report nr 32

    International Nuclear Information System (INIS)

    Greffier, Joel; Bigand, Emeline; Etard, Cecile; Hornbeck, Amaury; Salvat, Cecile; Habib-Geryes, Bouchra; Goutain-Majorel, Cynthia; Waryn, Marie-Josephine

    2017-06-01

    Whereas interventional radiology is a medical imagery technique which displays a very large scope of application (cardiology, neurology, oncology, and so on), and as, because of the duration and complexity of some procedures, doses delivered to patients can be high and induce mainly cutaneous deterministic effects, this report aims at the elaboration of reference levels according to a EURATOM directive. It builds up a comprehensive guide which proposes reference levels in terms of scope, of total number of images, of air kerma at the reference point, and of dose-surface-product for 21 different interventional radiology acts in neuroradiology, vascular radiology and osteo-articular radiology such as arteriography embolisation, biliary drainage, vertebro-plasty, and so on. This multi-centric study is based on data gathered from 36 hospital centres. It can help teams to analyse and compare their practices, and to optimise protocols and the relationship between a minimal dose of ionizing radiations and a clinically acceptable image quality

  2. The quality assessment of the interventional radiology publications in Chinese journal of radiology using the randomized controlled trials

    International Nuclear Information System (INIS)

    Gao Xiangtao; Xu Guohui; He Hong; Yan Yaiying; Mao Bing

    2007-01-01

    Objective: To assess the quality of reporting randomized controlled trials published in Chinese journal of radiology from 2000 to 2005. Methods: A manual search was performed and 22 checklists of CONSORT statements and other self-established criteria were applied. Results: Six volumes and 72 issues were investigated. There were total trials of 236 in 2186 literatures, and finally 3 randomized controlled trials (RCTs) (1.27%) were identified. In the 3 RCTs, there were 3 trials with methods of randomization, 1 with endpoints measurement, 1 with multi-centre, but without the prior calculation of sample size, blind methods, statistically probability, participant flow, compliance and negative results. Conclusion: The quality of reporting randomized controlled trials of interventional radiology has been improved, but it did not meet fully the CONSORT statement. (authors)

  3. Collective dose estimation in Portuguese population due to medical exams of diagnostic radiology and nuclear medicine

    International Nuclear Information System (INIS)

    Teles, Pedro; Vaz, Pedro; Paulo, Graciano; Santos, Joana; Pascoal, Ana; Lanca, Isabel; Matela, Nuno; Sousa, Patrick; Carvoeiras, Pedro; Parafita, Rui; Simaozinho, Paula

    2013-01-01

    In order to assess the exposure of the Portuguese population to ionizing radiation due to medical examinations of diagnostic radiology and nuclear medicine, a working group, consisting of 40 institutions, public and private, was created to evaluation the coletive dose in the Portuguese population in 2010. This work was conducted in collaboration with the Dose Datamed European consortium, which aims to assess the exposure of the European population to ionizing radiation due to 20 diagnostic radiology examinations most frequent in Europe (the 'TOP 20') and nuclear medicine examinations. We obtained an average value of collective dose of ≈ 1 mSv/caput, which puts Portugal in the category of countries medium to high exposure to Europe. We hope that this work can be a starting point to bridge the persistent lack of studies in the areas referred to in Portugal, and to enable the characterization periodic exposure of the Portuguese population to ionizing radiation in the context of medical applications

  4. French diagnostic reference levels in diagnostic radiology, computed tomography and nuclear medicine: 2004-2008 Review

    International Nuclear Information System (INIS)

    Roch, P.; Aubert, B.

    2013-01-01

    After 5 y of collecting data on diagnostic reference levels (DRLs), the Nuclear Safety and Radiation Protection French Inst. (IRSN) presents the analyses of this data. The analyses of the collected data for radiology, computed tomography (CT) and nuclear medicine allow IRSN to estimate the level of regulatory application by health professionals and the representativeness of current DRL in terms of relevant examinations, dosimetric quantities, numerical values and patient morphologies. Since 2004, the involvement of professionals has highly increased, especially in nuclear medicine, followed by CT and then by radiology. Analyses show some discordance between regulatory examinations and clinical practice. Some of the dosimetric quantities used for the DRL setting are insufficient or not relevant enough, and some numerical values should also be reviewed. On the basis of these findings, IRSN formulates recommendations to update regulatory DRL with current and relevant examination lists, dosimetric quantities and numerical values. (authors)

  5. French diagnostic reference levels in diagnostic radiology, computed tomography and nuclear medicine: 2004-2008 review.

    Science.gov (United States)

    Roch, P; Aubert, B

    2013-04-01

    After 5 y of collecting data on diagnostic reference levels (DRLs), the Nuclear Safety and Radiation Protection French Institute (IRSN) presents the analyses of this data. The analyses of the collected data for radiology, computed tomography (CT) and nuclear medicine allow IRSN to estimate the level of regulatory application by health professionals and the representativeness of current DRL in terms of relevant examinations, dosimetric quantities, numerical values and patient morphologies. Since 2004, the involvement of professionals has highly increased, especially in nuclear medicine, followed by CT and then by radiology. Analyses show some discordance between regulatory examinations and clinical practice. Some of the dosimetric quantities used for the DRL setting are insufficient or not relevant enough, and some numerical values should also be reviewed. On the basis of these findings, IRSN formulates recommendations to update regulatory DRL with current and relevant examination lists, dosimetric quantities and numerical values.

  6. The Importance of Curriculum-Based Training and Assessment in Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Belli, Anna-Maria, E-mail: anna.belli@stgeorges.nhs.uk [St. George’s Hospital, Department of Radiology (United Kingdom); Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl [Academic Medical Centre, Department of Radiology (Netherlands); Lee, Michael, E-mail: mlee@rcsi.ie [Beaumont Hospital, Department of Radiology (Ireland)

    2013-10-30

    Physician performance and outcomes are being scrutinised by health care providers to improve patient safety and cost efficiency. Patients are best served by physicians who have undergone appropriate specialist training and assessment and perform large numbers of cases to maintain their skills. The Cardiovascular and Interventional Radiological Society of Europe has put into place a curriculum for training in interventional radiology (IR) and a syllabus with an examination, the European Board of Interventional Radiology, providing evidence of attainment of an appropriate and satisfactory skill set for the safe practice of IR. This curriculum is appropriate for IR where there is a high volume of image-guided procedures in vascular and nonvascular organ systems with cross-use of minimally invasive techniques in patients with a variety of disease processes. Other specialties may require different, longer, and more focused training if their experience is “diluted” by the need to master a different skill set.

  7. An observation study of radiation exposure to nurses during interventional radiology procedure

    International Nuclear Information System (INIS)

    Komemushi, Atsushi; Tanigawa, Noboru; Aoki, Atsuko

    2010-01-01

    The purpose of this study was to prospectively measure the level of radiation exposure among nursing staff during interventional radiology procedures. All interventional radiology procedures performed at our institution between April 20 and June 19, 2009 were included in this study. Radiation exposure was measured as the equivalent dose penetrating tissue to a depth of 10 mm using electronic personal dosimeters attached outside (Ha) and inside (Hb) lead aprons. Effective dose (HE) was estimated by calculating from Ha and Hb. In total, data from 68 procedures were included in this study. Four nurses performed 71 nursing cares. The mean Ha was 0.70±1.0 μSv, while the mean Hb was 0.06±0.2 μSv. The mean HE was 0.14±0.3 μSv. The present findings indicate that during interventional radiology procedures, nurses were exposed to very low levels of radiation. (author)

  8. Activity-based cost analysis in catheter-based angiography and interventional radiology

    International Nuclear Information System (INIS)

    Rautio, R.; Keski-Nisula, L.; Paakkala, T.

    2003-01-01

    The aim of this study was to analyse the costs of the interventional radiology unit and to identify the cost factors in the different activities of catheter-based angiographies and interventional radiology. In 1999 the number of procedures in the interventional radiological unit at Tampere University Hospital was 2968; 1601 of these were diagnostic angiographies, 526 endovascular and 841 nonvascular interventions. The costs were analysed by using Activity Based Cost (ABC) analysis. The budget of the interventional unit was approximately 1.8 million Euro. Material costs accounted for 67%, personnel costs for 17%, equipment costs for 14% and premises costs for 2% of this. The most expensive products were endografting of aortic aneurysms, with a mean price of 5291 Euro and embolizations of cerebral aneurysms (4472 Euro). Endografts formed 87.3% of the total costs in endografting and Guglielmi detachable coils accounted for 63.3% of the total costs in embolizations. The material costs formed the majority of the costs, especially in the newest and most complicated endovascular treatments. Despite the high cost of angiography equipment, its share of the costs is minor. In our experience ABC system is suitable for analysing costs in interventional radiology. (orig.)

  9. [Effectiveness of conventional diagnostic radiology and nuclear medicine in the treatment of pain from bone metastases].

    Science.gov (United States)

    Genovese, Eugenio Annibale; Mallardo, Vania; Vaccaro, Andrea; Santagata, Mario; Raucci, Antonio; D'Agosto, Gianfranco; Fontanarosa, Antonio; Schillirò, Francesco

    2013-01-01

    Bone is one of the most common metastasis sites from solid tumors. Bone pain due to metastatic neoplastic growth is due to tumor infiltration and expansion of bone membranes. Treatment of acute and chronic pain represents one of the greatest problems in clinical oncology, requiring a multidisciplinary approach. This review focuses on the effectiveness of conventional diagnostic radiology and nuclear medicine for the detection, management and treatment of pain from bone metastasis.

  10. Radiological accidents balance in medicine; Bilan des accidents radiologiques en medecine

    Energy Technology Data Exchange (ETDEWEB)

    Nenot, J.C.

    1995-12-31

    This work deals with the radiological accidents in medicine. In medicine, the radiation accidents on medical personnel and patients can be the result of over dosage and bad focusing of radiotherapy sealed sources. Sometimes, the accidents, if they are unknown during a time enough for the source to be spread and to expose a lot of persons (in the case of source dismantling for instance) can take considerable dimensions. Others accidents can come from bad handling of linear accelerators and from radionuclide kinetics in some therapies. Some examples of accidents are given. (O.L.). 11 refs.

  11. The Evolution of Diagnostic and Interventional Ultrasound in Sports Medicine.

    Science.gov (United States)

    Finnoff, Jonathan T

    2016-03-01

    Diagnostic and interventional ultrasound is a rapidly evolving field in sports medicine. The use of ultrasound has increased exponentially during the past decades. This imaging modality is appealing to sports medicine physicians because of its broad diagnostic and interventional capabilities. In sports medicine, the indications for diagnostic ultrasound extend well beyond the musculoskeletal realm to include other conditions such as ocular trauma, thoracoabdominal trauma, and cardiac morphology. Thus, the term "sports ultrasound" has been adopted as a more accurate representation of the broad and unique applications of ultrasound in this specialty. Ultrasound-guided procedures also have evolved from the commonly performed joint and tendon sheath injections to include ultrasound-guided surgical procedures. This article will discuss the evolution of diagnostic and interventional ultrasound in sports medicine using a case-based approach to highlight its many new applications. Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  12. Development of a real-time extremity dose monitor for personnel in interventional radiology

    International Nuclear Information System (INIS)

    Ban, Nobuhiko; Kusama, Tomoko; Adachi, Akiko

    2000-01-01

    Protection of personnel in interventional radiology is one of the most important issues of radiological protection in medicine. Fluoroscopically guided interventional procedures require the operation near X-ray beam, which brings a considerable hand exposure to the operators. For the purpose of effectual control of their extremity doses, we have developed a real-time extremity dose monitor which is worn on a strap around the wrist. The monitor consists of a silicon semiconductor detector, thin lithium battery and a waterproof frame with a four-digit LED display. Experiment was carried out to examine a response of the monitor to diagnostic X-rays. A practical test was also performed to evaluate usability in the actual interventional procedures. In the experiment, the extremity dose monitor was placed on an arm phantom and exposed to diagnostic X-rays. Readings of the monitor were compared to those of Capintec PS-033 shallow chamber. The monitor was highly sensitive to diagnostic X-rays. It showed a linear response down to doses of a few tens of microsieverts. For high dose-rate exposure, however, a slight decrease in the response was observed, about 10% of counting loss for 80 kV, 40 mA X-ray at one meter from the focus. With regard to energy dependence, variation was within 20% for 60 to 100 kV X-rays. The monitor showed a good angular response in general, except lateral geometry facing the far side from a detector center. In the practical test, hand exposures of medical staff were measured with the extremity dose monitor. They were also asked to fill in a questionnaire regarding size and weight of the monitor, clarity of the display and usefulness. The subjects consisted of physicians, technicians and nurses who engaged in angiography, PTCD, CT-biopsy, barium enema and so on. The readings of the monitor were less than 1 mSv in most cases while 93 mSv was recorded in an extreme case due to direct-beam exposure. In some cases, TLD rings were used together with the

  13. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

    Science.gov (United States)

    Vano, E; Sanchez, R M; Fernandez, J M

    2015-07-01

    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. Radiological emergency preparedness: a survey of nuclear medicine technologists in the United States.

    Science.gov (United States)

    Van Dyke, Miriam E; McCormick, Lisa C; Bolus, Norman E; Pevear, Jesse; Kazzi, Ziad N

    2013-09-01

    Because of the increasing risk of radiological emergencies, public health agencies and first-response organizations are working to increase their capability of responding. Nuclear medicine technologists (NMTs) have expertise in certain areas, such as radiation safety, radiobiology, decontamination, and the use of radiation detection and monitoring equipment, that could be useful during the response to events that involve radiological materials. To better understand the potential role that NMTs may have in response efforts, a cross-sectional survey was conducted. The survey was sent electronically to the 7,000 members of the Technology Section of the Society of Nuclear Medicine and Molecular Imaging. Eight hundred fifty NMTs responded to the survey, for a response rate of 12.14%. The study queried NMTs across the United States on their knowledge of using radiation detection and monitoring equipment, such as a scintillation γ-cameras, Geiger counters, thyroid probes, well counters, and portal monitors; willingness to participate in response efforts during a nuclear reactor accident, nuclear weapon detonation, or dirty bomb detonation; access to radiation detection and monitoring equipment within their work setting; familiarity with current preparedness guidance and tools provided by the Centers for Disease Control and Prevention and U.S. Department of Health and Human Services; and registration in volunteer initiatives such as the Emergency System for Advance Registration of Volunteer Health Professionals, Metropolitan Medical Response System, and Medical Reserve Corps. Survey results suggest that NMTs are knowledgeable and willing to respond to radiological emergencies, regardless of number of years of work experience. Radiological preparedness training within the last 5 y significantly increases NMTs' willingness to respond and familiarity with current guidance and tools provided by the Centers for Disease Control and Prevention and Department of Health and Human

  15. Interventional radiological treatment of renal transplant complications: A pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Lezzi, Roberto; La, Torre Michele fabio; Santoro, Marco; Dattesi, Robrta; Nestola, Massimiliano; Posa, Alessandro; Romagnoli, Jacopo; CItterio, Franco; Bonomo, Lorenzo [' A. Gemelli' Hospital - Catholic University, Rome (Italy)

    2015-06-15

    Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.

  16. Changes in the American Interventional Radiology Literature: Comparison over a 10-Year Time Period

    International Nuclear Information System (INIS)

    Ray, Charles E.; Gupta, Rajan; Blackwell, John

    2006-01-01

    Purpose. To determine the changes that occurred regarding interventional radiologic research in the major American radiology journals between 1992-1993 and 2002-2003. Methods. Articles published in three major American radiology journals (Journal of Vascular and Interventional Radiology, American Journal of Roentgenology, and Radiology) during two distinct 24-month time periods (1992-1993 and 2002-2003) were evaluated. All articles judged to be pertinent to the interventional radiologic community were included. Investigations included in journal subheadings other than 'interventional' or 'vascular radiology' were included if the emphasis of the article was on a vascular imaging modality or peripheral intervention. Exclusions included: case reports, technical reports, letters to the editor, breast interventions, and primary neurointerventions. Data were collected regarding the affiliations of the primary author (nationality, hospital type, department); primary category of interest of the investigation; funding information; and study design variables. Two-by-two chi-squared statistical analyses were performed comparing the variables from the early and late data sets. Results. A total of 405 articles met the inclusion criteria for the early data set (1992-1993); 488 articles met the inclusion criteria for the late data set (2002-2003). Variables that demonstrated a statistically significant decrease from the early data set to the late data set included: articles in which the primary author was from a department of radiology (91.1% vs. 86.3%; p < 0.025); articles written by a primary author who was American (69.4% vs. 44.6%; p < 0.001); and articles with a primary category of investigation that had a nonvascular intervention focus (22.7% vs. 11.9%; p < 0.001). Variables that demonstrated a statistically significant increase from the early data set to the late data set included primary authors from Western Europe (18.0% vs. 30.1%; p < 0.001) and Asia (6.6% vs. 18.4%; p

  17. Intervention of the army health service in the case of radiological accident in peace time

    International Nuclear Information System (INIS)

    Curet, P.M.; Croq, M.

    2001-01-01

    The Army Health Service has conceived an organisation and has at its disposal the means necessary to answer the consequences of an accident having a radiological type in peace time in the military field. Its intervention area can be extended to the civil medium at the public authorities demand to give assistance. (N.C.)

  18. Study on generic intervention levels for protecting the public in a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    Suzuki, Fabio Fumio

    2003-01-01

    After a nuclear accident or radiological emergency, several social and economical factors shall be considered for the actions to protect the public and to recover the environment. The application of the radiological protection principles on practices in intervention situations may lead to adoption of protective measures disproportional to the involved risk, compromising the resources available to more effective actions. This causes a negative impact on the population and may conduct to discredit about the protective measures and the lost of confidence on the authorities. In this context, the principles of radiological protection for interventions should be studied and analyzed for being adequately applied in accident situations or radiological emergencies that involves the country. These principles are constantly improved and the concept of generic intervention level plays an important role in the decision-making to protect the public. The costs involved to the protective measures for the public in Brazil were studied and cost benefit analysis techniques were applied to estimate the generic intervention levels for public protection applicable in the country. These results were compared to those values internationally recommended, as well to values obtained in a similar study accomplished for Japan. It was also performed a sensibility analysis of the results regarding a value and a simple analysis of the results considering the costs of the several protective measures. (author)

  19. The role of interventional radiology in complications after paediatric ...

    African Journals Online (AJOL)

    Liver transplantation has become an established treatment in both adults and children for end-stage liver disease, acute hepatic failure and certain liver tumours. There is a significant risk of complications after all forms of liver transplantation. The interventional radiologist plays a critical role in the diagnosis and treatment of ...

  20. A survey of nurse staffing levels in interventional radiology units throughout the UK

    International Nuclear Information System (INIS)

    Christie, A.; Robertson, I.

    2016-01-01

    Aim: To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. Materials and methods: A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Results: Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. Conclusion: A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. - Highlights: • A significant disparity exists between the level of nursing support provided in-hours and OOH. • This applies to both the availability of a nurse to scrub and to monitor the patient. • Having a dedicated 24/7 nursing rota is mandatory to providing a deliverable OOH service.

  1. Evaluation of the radiological protection in several departments of nuclear medicine

    International Nuclear Information System (INIS)

    Lopez Bejerano, G.; Jova Sed, L.

    2001-01-01

    For the evaluation of radiation protection, in several departments of nuclear medicine a survey was elaborated and applied that includes mainly: aspects of the licence and compliance with the requirements settled down in this, the program of individual radiological surveillance and their evaluation, functions that it completes the service of radiation protection, training program and the personnel's training, equipment and means of radiation protection, radiological surveillance program of the work areas, characteristics of the installation, radioactive waste management, quality assurance program, relative aspects to radiation protection in the procedures of diagnoses, as well as to pregnant patients and those related with the investigation of accidental medical exposures. The work makes a systematization and discussion of the state of compliance of the radiation protection requirements reflected in the International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources (BSS) and the main recommendations are exposed to achieve in these departments the optimization of the radiation protection. (author)

  2. Virtual anthropology: useful radiological tools for age assessment in clinical forensic medicine and thanatology.

    Science.gov (United States)

    Dedouit, Fabrice; Saint-Martin, Pauline; Mokrane, Fatima-Zohra; Savall, Frédéric; Rousseau, Hervé; Crubézy, Eric; Rougé, Daniel; Telmon, Norbert

    2015-09-01

    Virtual anthropology consists of the introduction of modern slice imaging to biological and forensic anthropology. Thanks to this non-invasive scientific revolution, some classifications and staging systems, first based on dry bone analysis, can be applied to cadavers with no need for specific preparation, as well as to living persons. Estimation of bone and dental age is one of the possibilities offered by radiology. Biological age can be estimated in clinical forensic medicine as well as in living persons. Virtual anthropology may also help the forensic pathologist to estimate a deceased person's age at death, which together with sex, geographical origin and stature, is one of the important features determining a biological profile used in reconstructive identification. For this forensic purpose, the radiological tools used are multislice computed tomography and, more recently, X-ray free imaging techniques such as magnetic resonance imaging and ultrasound investigations. We present and discuss the value of these investigations for age estimation in anthropology.

  3. Status of radiation protection in interventional radiology. Assessment of inspections in 2009 by the ASN

    International Nuclear Information System (INIS)

    2011-01-01

    This report first describes the organization of inspections performed in health institutions, indicates the inspected establishments, the types of fixed installations in interventional radiology, the use of imagery in the operating theatre, and discusses the regulatory arrangements applicable to interventional radiology (in the Public Health Code, in the Labour Code). Then, the report discusses the results of inspections regarding radiation protection in interventional radiology: application of public health code arrangements (justification, patient training in radiation protection, radiological procedures and protocols, patient dosimetry monitoring), application of Labour Code arrangements (designation of the person with expertise in radiation protection, risk assessment and delimitation of monitored and controlled areas, workstation analysis, workers' training in radiation protection, individual protection equipment, workers' dosimetric monitoring, workers' medical monitoring, radiation protection technical controls), significant events, radiation protection in operating theatre. Propositions are stated regarding the differences noticed within or between the health establishments, the methodological and organisational difficulties faced by persons with expertise in radiation protection (PCR), the need of an interdisciplinary team

  4. 76 FR 45825 - Center for Devices and Radiological Health 510(k) Clearance Process; Institute of Medicine Report...

    Science.gov (United States)

    2011-08-01

    ...] Center for Devices and Radiological Health 510(k) Clearance Process; Institute of Medicine Report... Drug Administration (FDA) is requesting comments on the Institute of Medicine (IOM) report entitled... conclusions or recommendations contained within the report. FDA may, in the future, take additional measures...

  5. Sedoanalgesia in interventional radiology; Analgosedierung in der interventionellen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U.; Pfeifer, K.J.; Reiser, M. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Klinische Radiologie; Wagner, P. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Anaesthesiologie und Intensivmedizin; Ambulantes Operationszentrum, Muenchen Pasing (Germany)

    2002-02-01

    Purpose: Development of a save and effective protocol for analgosedation of patients undergoing painful interventional procedures. Material and Methods: In a prospective trial a consecutive series of 72 adult patients underwent analgosedation during painful interventions. A radiologist performed the analgosedation, the patients received a combination of a shortly effective piperidine derivative (Alfentanil [Rapifen {sup trademark} ]; 7.5-15 {mu}g/kg body weight) and Benzodiazepine (midazolam [Dormicum {sup trademark} ]; 20 {mu}g/kg body weight). After pre-procedure oxygenation patients were continuously monitored. Pain and discomfort were scored using an established visual-analog pain score (0-10). A control group (n=24) had received midazolam, pentazocine or fentanyl according to the study protocol. Results: All procedures could be carried out by an interventional radiologist and a nurse and/or technologist only. In 69/72 cases adequate analgosedation could be achieved. Injection of alfentanil was titrated, with a rapid onset and short acting effect of the analgesia. Patients reported an average pain score of 2.6 vs. 4.5 in the control group. Over 55% experienced no or mild pain (score 0-3), in the control group only 8% reached this level. Conclusion: A combination of shortly effective alfentanil and midazolam allows interventional radiologists to perform major procedures alone under effective analgosedation. This medication scheme is superior to the medication upon demand. (orig.) [German] Ziel: Die Entwicklung eines einfach zu handhabenden Protokolls fuer Radiologen zur Analgosedierung bei schmerzhaften interventionellen Eingriffen. Methoden: Prospektiv wurden 72 konsekutive Patienten zusammengefasst, bei denen schmerzhafte interventionelle Eingriffe geplant waren. Die Anlagosedierung erfolgte mit einer Kombinationsmedikation aus kurzwirksamem Piperidinderivat (Alfentanil [Rapifen {sup trademark} ]; 7,5-15 {mu}g/kg KG) und Benzodiazepin (Midazolam [Dormicum {sup

  6. Pediatric interventional radiology with 3D rotational angiography

    Energy Technology Data Exchange (ETDEWEB)

    Racadio, J.M. [Children' s Hospital Medical Center, Cincinnati, OH (United States)

    2004-07-01

    Rotational angiography with three-dimensional reconstruction vastly improves spatial orientation, eliminating guesswork during interventions. The 3D images help to define the anatomy more accurately, particularly in the case of overlapping tortuous anatomy such as that encountered in genitourinary abnormalities. The procedures are performed on a Philips Integris Allura biplane system with two 12'' image intensifiers. Although radiologists are trained to assemble multiple oblique views in their minds, that vision is often hard to convey to a waiting surgeon. The 3D images give a much better impression of the spatial relationships, saving valuable time and giving added security. (orig.)

  7. Radiologic management of haemoptysis. Diagnostic and interventional bronchial arterial embolisation

    Energy Technology Data Exchange (ETDEWEB)

    Ittrich, H.; Adam, G. [Univ. Medical Center Hamburg, Hamburg (Germany). Diagnostic and Interventional Radiology Dept. and Clinic; Klose, H. [Univ. Medical Center Hamburg, Hamburg (Germany). Section Pneumology

    2015-04-15

    Hemoptysis can be a life-threatening pulmonary emergency with high mortality, is symptomatic of an underlying severe pulmonary disease and requires immediate diagnosis and treatment. Diagnostically, bronchoscopy, conventional chest x-ray and contrast-enhanced multislice computed tomography (MSCT) with CT angiography (CTA) provide information regarding the underlying pulmonary disease, bleeding site, the vascular anatomy of the bronchial arteries (BA) and extrabronchial branches, as well a basis for planning of endovascular intervention. Therapeutically, bronchial artery embolization (BAE) is a safe and effective technique in the hands of an experienced interventionist with profound knowledge of the BA anatomy and possible pitfalls as well as experience with first-line therapy of recurrent and massive hemoptysis or as an intervention prior to elective surgery. Recurrent episodes of hemoptysis are not uncommon and require a prompt repeat BAE after exclusion of extrabronchial systemic and pulmonary artery bleeding sources. This review article should give an overview of the history, anatomical and pathophysiological basics and the clinical context of hemoptysis and diagnosis, as well as a survey of management, treatment and results of BAE.

  8. Use of Multimedia tools for Training in Radiation Protection for Interventional Radiology

    International Nuclear Information System (INIS)

    Guibelalde, E.; Vano, E.

    2003-01-01

    The European Commission has published and distributed cost free in the main European languages and interactive CD-ROM for Radiation Protection Training in Interventional Radiology (MARTIR project-Radiation Protection Series N. 119-EC 2002). The CD-ROM allows: a) To select different levels of training; b) To follow a training programme as a regular course (step by step) or looking only for the topics of interest; c) To do some auto evaluation multiple choice questions at the end of the different sections or topics; d) To perform a final examination at the end of the course and to have a certification with the total time dedicated to the training programme and the obtained score in final examination. During 2001 and 2002 the MARTIR material has been distributed for evaluation purpose to different experts and it has been used in different pilot courses. In this paper the experience of using this interactive CD-ROM is discussed. The University Complutense of Madrid offers an optional specific training on Radiation Protection for the students of Medicine during their clinical period (4th to 6th year). About 100 hundred students are enrolled per year, 10% of these students follow the MARTIR CD at home as a pilot course. All of them used the CD at Least during 40 hours, completed the low level step-by-step course and pass the exam (score over 75% for 60 multiple choice questions. 87% of the students after finishing the course stated that this education methodology was very suitable for them. (Author)

  9. Development of real-time radiation exposure dosimetry system using synthetic ruby for interventional radiology

    International Nuclear Information System (INIS)

    Hosokai, Yoshiyuki; Win, Thet Pe; Muroi, Kenzo; Matsumoto, Kenki; Takahashi, Kaito; Usui, Akihito; Saito, Haruo; Kozakai, Masataka

    2017-01-01

    Interventional radiology (IVR) tends to involve long procedures, consequently delivering high radiation doses to the patient. Radiation-induced injuries that occur because of the effect of the high radiation doses are a considerable problem for those performing IVR. For example, skin injuries can include skin erythema if the skin is exposed to radiation doses beyond the threshold level of 2 Gy. One of the reasons for this type of injury is that the local skin dose cannot be monitored in real time. Although there are systems employed to measure the exposure dose, some do not work in real time (such as thermoluminescence dosimeters and fluorescent glass dosimeters), while certain real-time measurement systems that enter the field of view (such as patient skin dosimeters and dosimeters using a nontoxic phosphor) interfere with IVR. However, synthetic ruby has been shown to emit light in response to radiation. The luminous wavelength is 693 nm. It is possible to monitor the radiation dose by detecting the emitted light. However, small synthetic rubies emit a tiny amount of light that is difficult to detect using common systems such as photodiodes. A large enough synthetic ruby to increase the quantity of emitted light would however enter the field of view and interfere with the IVR procedure. Additionally, although a photodiode system could reduce the system size, the data is susceptible to effects from the X-rays and outside temperature. Therefore, use of a sensitive photon counting system as used in nuclear medicine could potentially have a beneficial effect in detecting the weak light signal. A real-time radiation exposure dosimetry system for use in IVR should be sufficiently sensitive, not interfere with the IVR procedure, and ideally have the possibility of development into a system that can provide simultaneous multipoint measurements. This article discusses the development of a realtime radiation exposure dosimetry system for use in IVR that employs a small

  10. Needs-Based Innovation in Interventional Radiology: The Biodesign Process.

    Science.gov (United States)

    Steinberger, Jonathan D; Denend, Lyn; Azagury, Dan E; Brinton, Todd J; Makower, Josh; Yock, Paul G

    2017-06-01

    There are many possible mechanisms for innovation and bringing new technology into the marketplace. The Stanford Biodesign innovation process is based in a deep understanding of clinical unmet needs as the basis for focused ideation and development. By identifying and vetting a compelling unmet need, the aspiring innovator can "derisk" a project and maximize chances for successful development in an increasingly challenging regulatory and economic environment. As a specialty founded by tinkerers, with a history of disruptive innovation that has yielded countless new ways of delivering care with minimal invasiveness, lower morbidity, and lower cost, interventional radiologists are uniquely well positioned to identify unmet needs and develop novel solutions free of dogmatic convention. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Interventional radiology of malignant biliary obstruction complication and treatment

    International Nuclear Information System (INIS)

    Zhai Renyou; Huang Qiang

    2007-01-01

    Intervetional therapy as an important therapeutic method for malignant biliary obstruction has been used extensively, but there still remain some problems worthy for our emphasis and research. We retrospectively reviewed more than 800 patients with malignant obstructive jaundice during 12 years. Indications, contraindications, complications and corresponding treatment methods were studied. Furthermore, discussion including methods of biliary drainage, proper time of stent implantation, methods of anesthesia, usage of antibiotics and haemostat were also carded out. Use of analgesics (pain-suppressal) pre- and post procedure, development of acute pancreatitis and its management, and peri-operative mortality were further investigated in detail. We hope our experiences and lessons would give interventional doctors some help in their career. (authors)

  12. Interventional Pain Procedures in Physical Medicine and Rehabilitation Residencies.

    Science.gov (United States)

    Agarwal, Sanjeev; Cicone, Caitlin; Chang, Philip

    2018-04-01

    Exposure to interventional pain procedures is now a required component of training in physical medicine and rehabilitation residencies as mandated by the Accreditation Council for Graduate Medical Education. Data regarding resident exposure and competency in these procedures remain limited. Objectives were to determine the volume and type of exposure physical medicine and rehabilitation residents have to interventional pain procedures and to obtain faculty-perceived opinions regarding competency of incoming fellows as it pertains to interventional pain management. Online surveys were sent to program directors of physical medicine and rehabilitation residencies and fellowship directors of interventional spine, sports medicine, and pain medicine fellowships. Surveys inquired about educational methods, the volume of procedures in which residents actively participate, and faculty-perceived competency of trainees performing procedures. Thirty-nine residency programs and 27 fellowships responded to the surveys. Of the 39 residencies that responded, there was great variation in the exposure residents receive. Most programs reported that residents have moderate exposure to common procedures such as ultrasound-guided knee injections and lumbar epidural injections. In addition, while most residency program directors report graduates to be "fairly prepared" (33%) to "well prepared" (20.5%) with regard to spine procedures, most fellowship directors (63%) describe incoming fellows to be at the "beginner" level.

  13. [Compulsory internship in diagnostic radiology in the 5th year of medicine at the University of Montreal].

    Science.gov (United States)

    Saint-Georges, G; Raymond-Tremblay, D; Danais, S; Dussault, R; Grignon, A; Lafortune, M; Saltiel, J

    1984-01-01

    Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students.

  14. Fractal analysis in radiological and nuclear medicine perfusion imaging: a systematic review.

    Science.gov (United States)

    Michallek, Florian; Dewey, Marc

    2014-01-01

    To provide an overview of recent research in fractal analysis of tissue perfusion imaging, using standard radiological and nuclear medicine imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and to discuss implications for different fields of application. A systematic review of fractal analysis for tissue perfusion imaging was performed by searching the databases MEDLINE (via PubMed), EMBASE (via Ovid) and ISI Web of Science. Thirty-seven eligible studies were identified. Fractal analysis was performed on perfusion imaging of tumours, lung, myocardium, kidney, skeletal muscle and cerebral diseases. Clinically, different aspects of tumour perfusion and cerebral diseases were successfully evaluated including detection and classification. In physiological settings, it was shown that perfusion under different conditions and in various organs can be properly described using fractal analysis. Fractal analysis is a suitable method for quantifying heterogeneity from radiological and nuclear medicine perfusion images under a variety of conditions and in different organs. Further research is required to exploit physiologically proven fractal behaviour in the clinical setting. • Fractal analysis of perfusion images can be successfully performed. • Tumour, pulmonary, myocardial, renal, skeletal muscle and cerebral perfusion have already been examined. • Clinical applications of fractal analysis include tumour and brain perfusion assessment. • Fractal analysis is a suitable method for quantifying perfusion heterogeneity. • Fractal analysis requires further research concerning the development of clinical applications.

  15. A survey of interventional radiology awareness among final-year medical students in a European country.

    LENUS (Irish Health Repository)

    Leong, Sum

    2009-07-01

    Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract

  16. Evaluation of patient radiation doses using DAP meter in interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Sam [Dept. of Radiological Technology. Shingu University, Sungnam (Korea, Republic of); Yoon, Yong Su [Dept. of Health Sciences, Graduate School of Medical Sciences, Kyushu Univeristy, Kyushu (Japan)

    2017-03-15

    The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipment in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effective of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were 237.7 Gy·cm{sup 2} in TACE, 17.3 Gy·cm{sup 2} in AVF, 114.1 Gy·cm{sup 2} in LE PTA and STENT, 188.5 Gy·cm{sup 2} in TFCA, 383.5 Gy·cm{sup 2} in Aneurysm Coil, 64.6 Gy·cm{sup 2} in PTBD, 64.6 Gy·cm{sup 2} in Biliary Stent, 22.4 Gy·cm{sup 2} in PCN, 4.3 Gy·cm{sup 2} in Hickman, 2.8 Gy·cm{sup 2} in Chemo-port, 4.4 Gy·cm{sup 2} in Perm-Cather, 17.1 Gy·cm{sup 2} in PCD, and 357.9 Gy·cm{sup 2} in Vis, EMB. Dose reference level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipment and procedures in the interventional radiology procedures, further studies and monitoring are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

  17. Diagnostic reference levels and complexity indices in interventional radiology: a national programme

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Cruces, R.; Perez-Martinez, M.; Pastor-Vega, J.M.; Canete, S. [University of Malaga, School of Medicine, Malaga (Spain); Vano, E.; Fernandez-Soto, J.M.; Sanchez-Casanueva, R.; Gallego-Beuter, J.J. [Complutense University, San Carlos Hospital, Medical School, Madrid (Spain); Carrera-Magarino, F.; Moreno-Rodriguez, F.; Moreno-Sanchez, T. [Juan Ramon Jimenez University Hospital, Huelva (Spain); Soler-Cantos, M.M.; Canis-Lopez, M. [Reina Sofia University Hospital, Cordoba (Spain); Hernandez-Armas, J.; Diaz-Romero, F.J. [University Hospital of Canary Islands, Tenerife (Spain); Rosales-Espizua, F.; Lopez-Medina, A.; Gonzalez-de-Garay, M. [Basurto Hospital, Bilbao (Spain); Martin-Palanca, A. [Virgen de la Victoria University Hospital, Malaga (Spain); Gil-Agudo, A.; Zarca-Diaz, M.A.; Zapata-Jimenez, J.C. [General University Hospital, Ciudad Real (Spain); Parra-Osorio, V.; Munoz Ruiz-Canela, J.J.; Moreno-Saiz, C.; Galan-Montenegro, P. [Carlos Haya University Hospital, Malaga (Spain)

    2016-12-15

    To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. The KAP (3rd quartile) in Gy cm{sup 2} for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. (orig.)

  18. Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France

    International Nuclear Information System (INIS)

    Etard, Cecile; Bigand, Emeline; Salvat, Cecile; Vidal, Vincent; Beregi, Jean Paul; Hornbeck, Amaury; Greffier, Joel

    2017-01-01

    A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions. Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm 2 and 11 mins for cerebral angiography, 35 Gy.cm 2 and 16 mins for biliary drainage, 75 Gy.cm 2 and 6 mins for lower limbs arteriography and 70 Gy.cm 2 and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published. This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs. (orig.)

  19. Interventional radiologic placement of tunneled central venous catheters : results and complications in 557 cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chan Kyo; Do, Young Soo; Paik, Chul H. [Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)] (and others)

    1999-05-01

    To evaluate prospectively the results of interventional radiologic placement of tunneled central venous catheters, and subsequent complications. Between April 1997 and April 1998, a total of 557 tunneled central venous catheters were percutaneously placed in 517 consecutive patients in an interventional radiology suite. The indications were chemotherapy in 533 cases, total parenteral nutrition in 23 and transfusion in one. Complications were evaluated prospectively by means of a chart review, chest radiography, central vein angiography and blood/catheter culture. The technical success rate for tunneled central venous catheter placement was 100% (557/557 cases). The duration of catheter placement ranged from 4 to 356 (mean, 112{+-}4.6) days; Hickman catheters were removed in 252 cases during follow-up. Early complications included 3 cases of pneumothorax(0.5%), 4 cases of local bleeding/hematoma(0.7%), 2 cases of primary malposition(0.4%), and 1 case of catheter leakage(0.2%). Late complications included 42 cases of catheter-related infection(7.5%), 40 cases of venous thrombosis (7.2%), 18 cases of migration (3.2%), 5 cases of catheter / pericatheter of occlusion(0.8%), and 1 case of pseudoaneurysm(0.2%). The infection rate and thrombosis rate per 1000 days were 1.57 and 1.50, respectively. The technical success rate of interventional radiologic placement of tunneled central venous catheters was high. In comparison to conventional surgical placement, it is a more reliable method and leads to fewer complications.

  20. Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France

    Energy Technology Data Exchange (ETDEWEB)

    Etard, Cecile [Institut de Radioprotection et de Surete Nucleaire, Fontenay-aux-Roses (France); French Society of Medical Physicists (SFPM), Paris (France); Bigand, Emeline [French Society of Medical Physicists (SFPM), Paris (France); La Timone University Hospital, Department of Radiology, Marseille Cedex (France); Salvat, Cecile [French Society of Medical Physicists (SFPM), Paris (France); Lariboisiere Hospital, Department of Medical Physics and Radiation Protection, Paris (France); Vidal, Vincent [La Timone University Hospital, Department of Radiology, Marseille Cedex (France); French Society of Radiology (SFR) - Interventional Radiology Federation (FRI), Paris (France); Beregi, Jean Paul [French Society of Radiology (SFR) - Interventional Radiology Federation (FRI), Paris (France); Nimes University Hospital, Medical Imaging Group Nimes, Department of Radiology, Nimes (France); Hornbeck, Amaury [French Society of Medical Physicists (SFPM), Paris (France); Trousseau University Hospital, Department of Pediatric Radiology, Paris (France); Greffier, Joel [French Society of Medical Physicists (SFPM), Paris (France); Nimes University Hospital, Medical Imaging Group Nimes, Department of Radiology, Nimes (France)

    2017-10-15

    A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions. Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm{sup 2} and 11 mins for cerebral angiography, 35 Gy.cm{sup 2} and 16 mins for biliary drainage, 75 Gy.cm{sup 2} and 6 mins for lower limbs arteriography and 70 Gy.cm{sup 2} and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published. This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs. (orig.)

  1. A novel combined interventional radiologic and hepatobiliary surgical approach to a complex traumatic hilar biliary stricture

    Directory of Open Access Journals (Sweden)

    Rachel E. NeMoyer

    Full Text Available Introduction: Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. Presentation of case: The patient is a 32-year-old male that developed a hilar stricture as sequelae of a gunshot wound. Due to the complex nature of the stricture and scarring at the porta hepatis a combined interventional radiologic and surgical approach was carried out to approach the hilum of the right and left hepatic ducts. The location of this stricture was found by ultrasound guidance intraoperatively using a balloon tipped catheter placed under fluoroscopy in the interventional radiology suite prior to surgery. This allowed the surgeons to select the line of parenchymal transection for best visualization of the stricture. A left hepatectomy was performed, the internal stent located and the right hepatic duct opened tangentially to allow a side-to-side Roux-en-Y hepaticojejunostomy (a Puestow-like anastomosis. Discussion: Injury to the intrahepatic biliary ductal confluence is rarely fatal, however, the associated injuries lead to severe morbidity as seen in this example. Management of these injuries poses a considerable challenge to the surgeon and treating physicians. Conclusion: Here we describe an innovative multi-disciplinary approach to the repair of this rare injury. Keywords: Combined approach, Interventional radiology, Hepatobiliary surgery, Complex traumatic hilar biliary stricture, Case report

  2. An Internet-Based Medicine Education Intervention: Fourth Graders’ Perspectives

    Directory of Open Access Journals (Sweden)

    Sirpa Kärkkäinen

    2017-04-01

    Full Text Available Health education, which also includes medicine education, promotes social sustainability in society. Through the context of Internet-based intervention, this study reports on fourth graders’ (N = 51, aged 10–11 years perspectives on medicines, their use with common diseases and medicine-related information sources. The study was qualitative by nature. Data was collected in spring 2010, by audio recording students’ group discussions during the study process and group interviews. After intervention, students were well aware of the proper use of medicines and how to find information both on medicines and health issues. The main challenge was finding websites that provide reliable and confidential information. The results of this study raise awareness of a concrete pedagogical approach to health education. The pedagogical approach conducted in the intervention could, to some extent, be transferred to any school setting. This study underlies the promotion of Internet-based health literacy and criteria, for evaluating online health information in the primary school context.

  3. Pilot study of the dose in crystalline lens in the interventional radiology practice

    International Nuclear Information System (INIS)

    Castro, A.; Martinez, A.; Fernandez, A.; Molina, D.; Sanchez, L.; Diaz, A.

    2014-08-01

    The interventional radiology involves considerable exposure levels for the occupationally exposed personnel (OEP). The doses can encompass a wide range of values in dependence of the function that develops the personnel and the complexity of each procedure. In organs like the crystalline lens and skin values can be reached that imply the appearance of deterministic effects if is not fulfilled the appropriate measures of radiological protection. This has been demonstrated through multiple studies, among those that the retrospective study of damages in the crystalline lens and dose has been one of those most commented, known as RELID. The objective of that study was to examine the opacity prevalence in the crystalline lens in workers linked to the interventional cardiology and to correlate it with the occupational exposition. The obtained results contributed to that the ICRP recommend a new limit value of equivalent dose for crystalline lens of 20 mSv in one year. With the objective of analyzing the operational implications, in the radiological surveillance programs that they could originate with the new recommendations was developed a pilot study to evaluate the dose in crystalline lens in the OEP linked to the interventional radiology in a Cuban hospital. For this, an anthropomorphic mannequin RANDO-ALDERSON was used on which thermoluminescent dosimeters were placed below and above of the leaded apron and in different positions at level of the crystalline lens: above, below and to the sides of the leaded lenses that the personnel uses routinely. The mannequin was located on the same positions that occupy the main specialist that execute the procedure, as well as of the nurse to assist him. The measurements were made simulating the more representative procedures about complexity, duration time and exposure rate. The used dosimeters were RADOS model for whole body composed of two thermoluminescent detectors Gr-200 (LiF: Mg, Cu, P) to evaluate personal equivalent dose

  4. Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

    International Nuclear Information System (INIS)

    Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.; Lee, Michael J.

    2000-01-01

    Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived from a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are

  5. Radiological intervention in postoperative complications following liver transplantation; Interventionelle radiologische Verfahren bei postoperativen Komplikationen nach Lebertransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Berger, H. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Staebler, A. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Kunzfeld, A. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Zuelke, C. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany); Anthuber, M. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany); Kraemling, H.J. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany)

    1997-03-01

    Purpose: Postoperative complications contribute significantly to the morbidity and mortality of liver transplant patients. The management of these complications requires a multidisciplinary approach in which interventional radiology plays an integral role. Indications, techniques, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent radiological interventions, including angioplasty (n=20), embolization (n=2), percutaneous drainage (n=11), and biliary interventions (n=19). Results: Nine out of ten arterial stenoses located at the anastomoses (n=8), within the liver (n=1) and in the coeliac trunk (n=1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n=5) provided long-term success only in combination with stent implantation. Portal vein stenoses and chronic thrombosis were treated by balloon dilatation and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante- or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is poor. Conclusion: Interventional radiological procedures are very useful in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, and thus, surgical interventions may be avoided in selected cases. (orig.) [Deutsch] Die komplexe chirurgisch-technische Operation sowie immunologische und ischaemieverursachte Probleme tragen zur relativ hohen Komplikationsrate nach Lebertransplantation bei, die grundsaetzlich organ- bzw. lebensbedrohlich fuer den Patienten sind. Interventionelle radiologische Techniken sind aufgrund ihres minimal-invasiven Charakters in der klinischen Versorgung dieser Komplikationen

  6. Analysis of data related to the update of diagnosis reference levels in radiology and nuclear medicine. Assessment 2009-2010

    International Nuclear Information System (INIS)

    Roch, Patrice; Celier, David

    2012-10-01

    This report presents and comments the results of the analysis of 'patient' dosimetric data which radiology and nuclear medicine establishments had to transmit to the IRSN. The first part concerns conventional radiology and the analysis is made from a general point of view, and then by examination type (in the case of adults and of children). A synthesis of results since 2004 is proposed in terms of transmitted data, of data representativeness, of influence of detection technology on the delivered dose, of evolution of diagnosis reference level. With the same approach, the next parts address scanography examinations and nuclear medicine

  7. Radiological protection in the interventional techniques: experience in the Pain Clinic of the CIMEQ

    International Nuclear Information System (INIS)

    Guerrero C, M. C.; Benitez N, P. P.; Gonzalez G, Y.; Martinez G, A.; Gonzalez R, N.; Sanchez Z, L. R.

    2014-08-01

    The Pain Clinic of the CIMEQ offers treatment to patients with different pathologies, using interventional techniques as the radiology like visual guide to reach the target structure and to apply the election technique. The personnel that carry out these procedures are inserted in the program of radiological surveillance of the institution, reason for which a radiological event could be detected where the main physician responsible of the service was implied. In this work the results of an investigation are presented realized with the objective of to know the causes of the event and to determine the necessary measures to avoid that this repeats again. The investigation was oriented to three fundamental aspects: medical exam of the affected worker; evaluation of the operational procedures from the radiological protection view point; and dosimetric measurements simulating the real conditions of work for which were used ionization chamber, radiometer and PMMA mannequin. As a result of the medical exam was detected that the main physician of the service did not use during the execution of all the procedures the extremities dosimetry and that he presented a radio induced erythema in the right hand, reason for which he was separated of the activity with ionizing radiations, until the conclusion of the investigation. With relationship to the evaluation of the operational procedures from the radiological protection view point, was verified that the medical physician not carried out any collimation of the beam and he was located in the positions where the dose rate reached the maximum values, frequently introducing the hands in the direct beam; that which implied an overexposure of the superior extremities and a not optimized exposure for whole body. This result was proven with the realized experimental measurements, which gave dose estimated values in extremities of the order of the deterministic effects. The investigation facilitated to introduce modifications in the

  8. Occupational exposure in radiology and nuclear medicine departments. Categorization and dosimetric monitoring; Exposition aux rayonnements ionisants des personnels medicaux. Pour une categorisation et une surveillance dosimetrique rationnelles

    Energy Technology Data Exchange (ETDEWEB)

    Cordoliani, Y.S. [Hopital des Armees du Val-de-Grace, Service d' Imagerie Medicale, 75 - Paris (France); Aubert, B. [Institut Gustave Roussy, Service de Physique 94 - Villejuif (France)

    2003-12-01

    Currently, the radiation exposure of the huge majority of radiologic staff in radiology or nuclear medicine departments is very low. These workers are no longer in the 'A category' of the French regulations, which implies annual exposure ranged from 6 to 20 mSv. Most workers of the staff would be categorized into B category (annual exposure ranged from 1 to 6 mSv). In radiology departments, only the interventional radiologists must be categorized 'A' and in nuclear medicine department, only the technicians regularly assigned to injection of radiopharmaceuticals must be categorized 'A'. The modification of the categorization from 'B' to 'A' provides a best dosimetric monitoring: the electronic dosimeters are allocated to a few, really exposed, workers, while passive, three-month-read dosimeters record the very low exposures of the majority of workers. A dosimetric survey of each post, working out the maximal exposure of a permanent worker at this post is the prerequisite of the establishment of this categorization. (author)

  9. Development of experts for radiation emergency medicine. An experience at the National Institute of Radiological Sciences

    International Nuclear Information System (INIS)

    Tatsuzaki, H.; Hachiya, M.

    2016-01-01

    The National Institute of Radiological Sciences has been conducting many training courses on radiation emergency medicine, both for Japanese and foreigners. Medical professionals working in hospitals and first responders who deal with victims have been main participants of these courses for Japanese. Typically, these courses include table top exercises and/or practical drills, which give unique features to our courses, in addition to lectures. Apart from training courses, some medical professionals came to work as a staff member of NIRS for a long term, such as two years, to learn about radiation emergency medicine. Some foreigners also stayed in NIRS as short to middle term visitors to learn about the fields. Courses for foreigners were organized sometimes in cooperation with international organizations. Participants were mainly from Asian countries, and some courses targeted one country. For example, courses for Korean professionals were organized nine times. The NIRS will continue to contribute to human development in radiation emergency medicine with training courses and other methods of education. (author)

  10. Central venous catheter placement by an interventional radiology unit: an australian experience

    International Nuclear Information System (INIS)

    Lee, M. K. S.; Mossop, P. J.; Vrazas, J. I.

    2007-01-01

    The aim of this retrospective study was to analyse the outcomes of central venous catheter (CVC) placement carried out by an interventional radiology unit. A review of our hospital records identified 331 consecutive patients who underwent insertion of a tunnelled or non-tunnelled CVC between January 2000 and December 2004. Key outcome measures included the technical success rate of CVC insertion and the percentage of immediate ( 30 days) complications. A total of 462 CVCs were placed under radiological guidance, with an overall success rate of 98.9%. Immediate complications included one pneumothorax, which was diagnosed 7 days after subclavian CVC insertion, and eight episodes of significant haematoma or bleeding within 24 h of CVC insertion. No cases were complicated by arterial puncture or air embolus. Catheter-related sepsis occurred in 2% of non-tunnelled CVC and 8.9% of tunnelled CVC. The overall incidence of catheter-related sepsis was 0.17 per 100 catheter days. As the demand for chemotherapy and haemodialysis grows with our ageing population, interventional radiology suites are well placed to provide a safe and reliable service for the placement of central venous access devices

  11. Image fusion in open-architecture quality-oriented nuclear medicine and radiology departments

    International Nuclear Information System (INIS)

    Pohjonen, H.

    1997-01-01

    Imaging examinations of patients belong to the most widely used diagnostic procedures in hospitals. Multimodal digital imaging is becoming increasingly common in many fields of diagnosis and therapy planning. Patients are frequently examined with magnetic resonance imaging (MRI), X-ray computed tomography (CT) or ultrasound imaging (US) in addition to single photon (SPET) or positron emission tomography (PET). The aim of the study was to provide means for improving the quality of the whole imaging and viewing chain in nuclear medicine and radiology. The specific aims were: (1) to construct and test a model for a quality assurance system in radiology based on ISO standards, (2) to plan a Dicom based image network for fusion purposes using ATM and Ethernet technologies, (3) to test different segmentation methods in quantitative SPET, (4) to study and implement a registration and visualisation method for multimodal imaging, (5) to apply the developed method in selected clinical brain and abdominal images, and (6) to investigate the accuracy of the registration procedure for brain SPET and MRI

  12. Image fusion in open-architecture quality-oriented nuclear medicine and radiology departments

    Energy Technology Data Exchange (ETDEWEB)

    Pohjonen, H

    1997-12-31

    Imaging examinations of patients belong to the most widely used diagnostic procedures in hospitals. Multimodal digital imaging is becoming increasingly common in many fields of diagnosis and therapy planning. Patients are frequently examined with magnetic resonance imaging (MRI), X-ray computed tomography (CT) or ultrasound imaging (US) in addition to single photon (SPET) or positron emission tomography (PET). The aim of the study was to provide means for improving the quality of the whole imaging and viewing chain in nuclear medicine and radiology. The specific aims were: (1) to construct and test a model for a quality assurance system in radiology based on ISO standards, (2) to plan a Dicom based image network for fusion purposes using ATM and Ethernet technologies, (3) to test different segmentation methods in quantitative SPET, (4) to study and implement a registration and visualisation method for multimodal imaging, (5) to apply the developed method in selected clinical brain and abdominal images, and (6) to investigate the accuracy of the registration procedure for brain SPET and MRI 90 refs. The thesis includes also six previous publications by author

  13. Cost analysis of radiological interventional procedures and reimbursement within a clinic

    International Nuclear Information System (INIS)

    Strotzer, M.; Voelk, M.; Lenhart, M.; Fruend, R.; Feuerbach, S.

    2002-01-01

    Purpose: Analysis of costs for vascular radiological interventions on a per patient basis and comparison with reimbursement based on GOAe(Gebuehrenordnung fuer Aerzte) and DKG-NT (Deutsche Krankenhausgesellschaft-Nebenkostentarif). Material and Methods: The ten procedures most frequently performed within 12 months were evaluated. Personnel costs were derived from precise costs per hour and estimated procedure time for each intervention. Costs for medical devices were included. Reimbursement based on GOAewas calculated using the official conversion factor of 0.114 DM for each specific relative value unit and a multiplication factor of 1.0. The corresponding conversion factor for DKG-NT, determined by the DKG, was 0.168 DM. Results: A total of 832 interventional procedures were included. Marked differences between calculated costs and reimbursement rates were found. Regarding the ten most frequently performed procedures, there was a deficit of 1.06 million DM according GOAedata (factor 1.0) and 0.787 million DM according DKG-NT. The percentage of reimbursement was only 34.2 (GOAe; factor 1.0) and 51.3 (DKG-NT), respectively. Conclusion: Reimbursement of radiological interventional procedures based on GOAeand DKG-NT data is of limited value for economic controlling purposes within a hospital. (orig.) [de

  14. Dosimetry with slow films in Interventional Radiology; Dosimetria con peliculas lentas en Radiologia Intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Ten, J.I.; Guibelalde, E.; Fernandez, J.M.; Canevaro, L.; Ramirez, R.; Vano, E. [Grupo de Fisica Medica. Departamento de Radiologia. Facultad de Medicina. Universidad Complutense de Madrid. Martin Lagos s/n CP 28040, Madrid (Spain)

    1998-12-31

    In this work it is presented a method for evaluation of patients doses in Interventional Radiology (RI). The method proposed in this work allows the simultaneous valoration of the product dose-area (PDA), the dose in the patient skin (DES) and the distribution of the irradiated fields, all of they together with their corresponding dose levels. The latter sometimes can be essential since the possible damages in skin depend not only of the doses, but also the irradiated area. The method has been resulted adequate for to evaluate doses to patients in Interventional Radiology procedures. It was possible to apply it as a routine form seeing that its not interfering significantly in the normal development of the medical intervention. The fundamental advantages of this dosimetric method in relation with the unique PDA measure or with the utilization of TLD is that it provide information about the total irradiated area, distribution and length of fields, collimation and wedge used besides that allow to determine the most irradiated zone. The visualization of the irradiated regions and the length fields utilized suggest the possibility to optimize the realization protocols of the interventional procedure in the cases in which it is considered that the doses have been very elevated. (Author)

  15. Safety and effectiveness of moderate sedation for radiologic non-vascular intervention

    International Nuclear Information System (INIS)

    Kim, Tae-Hoon

    2006-01-01

    The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range:27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-pro- cedural anxiety and intraprocedural pain. The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148 μg. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and FRA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures

  16. Safety and effectiveness of moderate sedation for radiologic non-vascular intervention

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae-Hoon [Dankook University Hospital, Chungju (Korea, Republic of)

    2006-06-15

    The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range:27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-pro- cedural anxiety and intraprocedural pain. The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148 {mu}g. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and FRA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

  17. M2IRAGE: Management of measurements during radiological interventions geographically assisted in the environment

    International Nuclear Information System (INIS)

    Gerphagnon, O.; Roche, H.; Lelache, H.; Guelin, M.; Fauquant, J.M.; Kacenelen, Y.; Armand, Y.

    2010-01-01

    This report presents the M 2 IRAGE software, a data processing tool designed to share radioactivity measurements and to give a schematised view of a radiological situation and of its evolution, while respecting different legal frameworks, notably the obligation to produce a radiological measurement programme. After a simplified recall of the crisis management organisation, the authors describe the M 2 IRAGE software and hardware architecture, the functions of its main modules (presentation of radioprotection information during field intervention, field mission management, data browsing, and data transmission to field teams). While giving some display examples, the authors describe how an event is managed and processed by this tool: event creation, measurement acquisition, aid to decision, team management. They report and discuss the results of a national exercise which took place in September 2009 in Saclay with a prototype version of M 2 IRAGE

  18. Auditing an Online Self-reported Interventional Radiology Adverse Event Database for Compliance and Accuracy.

    Science.gov (United States)

    Burch, Ezra A; Shyn, Paul B; Chick, Jeffrey F; Chauhan, Nikunj R

    2017-04-01

    The purpose of this study was to determine whether auditing an online self-reported interventional radiology quality assurance database improves compliance with record entry or improves the accuracy of adverse event (AE) reporting and grading. Physicians were trained in using the database before the study began. An audit of all database entries for the first 3 months, or the first quarter, was performed, at which point physicians were informed of the audit process; entries for the subsequent 3 months, or the second quarter, were again audited. Results between quarters were compared. Compliance with record entry improved from the first to second quarter, but reminders were necessary to ensure 100% compliance with record entry. Knowledge of the audit process did not significantly improve self-reporting of AE or accuracy of AE grading. However, auditing significantly changed the final AE reporting rates and grades. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. European Community (Radiological and Nuclear Medicine Installations) Regulations, 1998. Statutory Instrument S.I. No. 250 of 1998

    International Nuclear Information System (INIS)

    1998-01-01

    These regulations establish the criteria of acceptability to be met for radiological installations and nuclear medicine installations. The regulations implement the provisions of EC Directive 84/466 Euratom of 3 September 1984 laying down the basic measures for radiation protection of persons undergoing medical examinations or treatment and to provide protection for workers and the general public. (author)

  20. WE-EF-BRD-04: MR in the OR: The Growth and Applications of MRI for Interventional Radiology and Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Fahrig, R. [Stanford University (United States)

    2015-06-15

    MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at: http://sydney.edu.au/medicine/radiation-physics/about-us/disclosures.php.

  1. Assessment of eye lens doses in interventional radiology: a simulation in laboratory conditions

    International Nuclear Information System (INIS)

    Cemusova, Z.; Ekendahl, D.; Judas, L.

    2016-01-01

    As workers in interventional radiology belong to one of the most occupationally exposed groups, methods for sufficiently accurate quantification of their external exposure are sought. The objective of the authors' experiment was to investigate the relations between eye lens dose and H p (10), H p (3) or H p (0.07) values measured with a conventional whole-body personal thermoluminescence dosemeter (TLD). Conditions of occupational exposure during common interventional procedures were simulated in laboratory. An anthropomorphic phantom represented a physician. The TLDs were fixed to the phantom in different locations that are common for purposes of personal dosimetry. In order to monitor the dose at the eye lens level during the exposures, a special thermoluminescence eye dosemeter was fixed to the phantom's temple. Correlations between doses measured with the whole-body and the eye dosemeters were found. There are indications that personnel in interventional radiology do not need to be unconditionally equipped with additional eye dosemeters, especially if an appropriate whole-body dosimetry system has been already put into practice. (authors)

  2. A pilot experience launching a national dose protocol for vascular and interventional radiology

    International Nuclear Information System (INIS)

    Vano, E.; Segarra, A.; Fernandez, J. M.; Ordiales, J. M.; Simon, R.; Gallego, J. J.; Del Cerro, J.; Casasola, E.; Verdu, J. F.; Ballester, T.; Sotil, J.; Aspiazu, A.; Garcia, M. A.; Moreno, F.; Carreras, F.; Canis, M.; Soler, M. M.; Palmero, J.; Ciudad, J.; Diaz, F.; Hernandez, J.; Gonzalez, M.; Rosales, P.

    2008-01-01

    The design of a national dose protocol for interventional radiology has been one of the tasks during the European SENTINEL Coordination Action. The present paper describes the pilot experience carried out in cooperation with the Spanish Society on Vascular and Interventional Radiology (SERVEI). A prospective sample of procedures was initially agreed. A common quality control of the X-ray systems was carried out, including calibration of the air kerma area product (KAP) meters. Occupational doses of the radiologists involved in the survey were also included in the survey. A total of 10 Spanish hospitals with interventional X-ray units were involved. Six hundred and sixty-four patient dose data were collected from 397 diagnostic and 267 therapeutic procedures. Occupational doses were evaluated in a sample of 635 values. The obtained KAP median/mean values (Gy.cm 2 ) for the gathered procedures were: biliary drainage (30.6/68.9), fistulography (4.5/9.8), lower limb arteriography (52.2/60.7), hepatic chemoembolisation (175.8/218.3), iliac stent (45.9/73.2) and renal arteriography (39.1/59.8). Occupational doses (mean monthly values, in mSv) were 1.9 (over apron); 0.3 (under apron) and 4.5 (on hands). With this National experience, a protocol was agreed among the SENTINEL partners to conduct future similar surveys in other European countries. (authors)

  3. The role of interventional radiology in the management of kidney transplant complications

    International Nuclear Information System (INIS)

    Carrafiello, Gianpaolo; Lagana, Domenico; Mangini, Monica; Cafaro, Tamara; Recaldini, Chiara; Genovese, Eugenio; Fugazzola, Carlo; Cuffari, Salvatore

    2005-01-01

    Purpose. To evaluate the role and the effectiveness of interventional radiology in the treatment of renal transplant complications. Materials and methods. From 1996 to 2004 a total of 288 kidney transplants from cadavers were performed in our Institute. The kidney was always collocated in iliac fossa by creating a vascular anastomosis with the external iliac artery and vein; in all cases the ureter was implanted into the recipient bladder. During the follow-up, 34 complications were observed. Twenty-seven complications in 25 patients (20 males and 5 females; age 35-65 years) were treated by a radiologic procedure: 9 renal artery stenosis and 1 native external iliac artery stenosis (by PTA), 5 ureteral obstructions (by nephrostomy and ureteral stenting), 8 ureteral leaks (by nephrostomy, in 2 cases associated to ureteral stenting) and 4 limphoceles (by percutaneous ultrasound-guided catheter drainage). Results. Primary technical success was obtained in 20/27 cases (74%). Success was obtained with a second interventional procedure in 3/27 cases, 2 limphoceles and 1 ureteral fistula (secondary technical success: 85.2%), with a clinical final success in 23/27 cases (85.2%). We observed a peri-procedural complication rate of 3.7% (1 renal artery post-PTA dissection during a restenosis treatment). Four cases (1 renal arterial post-PTA dissection, 1 ureteral obstructions, 1 ureteral leak and llimphocele) needed a surgical correction (14.8%). Conclusions. Interventional radiology is the first therapeutic approach to treat renal transplant complications. It shows good technical and clinical results and a low complication rate. Surgery had to be considered only if minimally invasive procedures are infeasible or ineffective [it

  4. The Value of Digital Personal Dosemeters in Angiography/Interventional Radiology: Preliminary Experience

    International Nuclear Information System (INIS)

    Casey, M.; Malone, D.E.

    2001-01-01

    New interventional procedures tend to involve longer screening times than were hitherto used in radiology. A careful audit of technique and shielding facilities needs to be performed to ensure that patient and operator doses are optimised. This paper explores the use of digital dosemeters to evaluate operator dose. Equipment related parameters, e.g. screening time, dose-area-product readings, were not found to be strongly correlated to operator dose. The real time display on the electronic dosemeter is a non-intrusive indicator of the efficacy of operator protection strategies. (author)

  5. Analysis of dose to crystalline in Interventional radiology: a purpose of one case

    International Nuclear Information System (INIS)

    Carrera M, F.; Moreno R, F.; Velazquez M, F.; Manzano M, F.J.; Moreno S, T.

    1998-01-01

    The present work shows the dose values to crystalline for the personnel which works in interventional radiology procedures. It was took data of 436 studies with a total of 2,133.4 minutes in fluoroscopy and 19,563 images. It was showed dose values to crystalline in three situations: without blinding, with blinding of 0.25 and 0.50 mm Pb and by type of study: fluoroscopy, graphie and total. The dose means and ranges to patient for each of these studies also are detailed. (Author)

  6. Yttrium-90 hepatic radioembolization: clinical review and current techniques in interventional radiology and personalized dosimetry.

    Science.gov (United States)

    Tong, Aaron K T; Kao, Yung Hsiang; Too, Chow Wei; Chin, Kenneth F W; Ng, David C E; Chow, Pierce K H

    2016-06-01

    In recent years, yttrium-90 ((90)Y) microsphere radioembolization has been establishing itself as a safe and efficacious treatment for both primary and metastatic liver cancers. This extends to both first-line therapies as well as in the salvage setting. In addition, radioembolization appears efficacious for patients with portal vein thrombosis, which is currently a contraindication for surgery, transplantation and transarterial chemoembolization. This article reviews the efficacy and expanding use of (90)Y microsphere radioembolization with an added emphasis on recent advances in personalized dosimetry and interventional radiology techniques. Directions for future research into combination therapies with radioembolization and expansion into sites other than the liver are also explored.

  7. How can interventions for inhabitants be justified after a nuclear accident? An approach based on the radiological protection system of the international commission on radiological protection

    International Nuclear Information System (INIS)

    Takahara, Shogo; Homma, Toshimitsu; Yoneda, Minoru; Shimada, Yoko

    2016-01-01

    Management of radiation-induced risks in areas contaminated by a nuclear accident is characterized by three ethical issues: (1) risk trade-off, (2) paternalistic intervention and (3) individualization of responsibilities. To deal with these issues and to clarify requirements of justification of interventions for the purpose of reduction in radiation-induced risks, we explored the ethical basis of the radiological protection system of the International Commission on Radiological Protection (ICRP). The ICRP's radiological protection system is established based on three normative ethics, i.e. utilitarianism, deontology and virtue ethics. The three ethical issues can be resolved based on the decision-making framework which is constructed in combination with these ethical theories. In addition, the interventions for inhabitants have the possibility to be justified in accordance with two ways. Firstly, when the dangers are severe and far-reaching, interventions could be justified with a sufficient explanation about the nature of harmful effects (or beneficial consequences). Secondly, if autonomy of intervened-individuals can be promoted, those interventions could be justified. (author)

  8. Awareness of interventional radiology among patients referred to the interventional radiology department: a survey of patients in a large Canadian community hospital.

    Science.gov (United States)

    Baerlocher, Mark O; Asch, Murray R; Puri, Gaurav; Vellahottam, Andrew; Myers, Andy; Andrews, Karen

    2007-05-01

    To quantify the level of knowledge about interventional radiology (IR) among patients referred for an IR procedure and to develop recommendations on how to increase public awareness of IR. Paper surveys were prospectively administered to consecutive patients scheduled to undergo an IR procedure at a community hospital. The study was terminated at the accrual of 100 completed surveys. Totals of 28% and 6% knew generally the job of a diagnostic radiologist and interventional radiologist, respectively, and 6% had heard of the field of IR before their referral (despite 21% having undergone a procedure previously). Before their arrival in the IR department, 87% had not received any information about IR. Three percent, 0%, 4%, 82%, and 82% had heard about uterine artery embolization, radiofrequency ablation, vertebroplasty, biopsy (any type), and angioplasty, respectively. After the procedures, 84% had a clearer view of what interventional radiologists do, but 98% believed that most others did not know what IR was. When asked how best to educate the public about IR, the responses were: unsure (39%), other (19%), pamphlets (12%), information from physicians (9%), television (8%), and Internet (7%). Overall, the mean satisfaction rate was 8.8 (with 0 representing the minimum and 10 representing the maximum), and 97% would choose IR over surgery for future treatments. These data quantify and strongly support the views that (1) even among patients specifically referred to IR for a procedure, the majority of people are unaware of what the field is or may offer; and (2) most patients were satisfied with their IR experience. Six results-based recommendations are made to increase public awareness about IR.

  9. Nutritional interventions for Alzheimer's prevention: a clinical precision medicine approach.

    Science.gov (United States)

    Schelke, Matthew W; Hackett, Katherine; Chen, Jaclyn L; Shih, Chiashin; Shum, Jessica; Montgomery, Mary E; Chiang, Gloria C; Berkowitz, Cara; Seifan, Alon; Krikorian, Robert; Isaacson, Richard Scott

    2016-03-01

    Alzheimer's disease (AD) is a major source of morbidity and mortality, with the disease burden expected to rise as the population ages. No disease-modifying agent is currently available, but recent research suggests that nutritional and lifestyle modifications can delay or prevent the onset of AD. However, preventive nutritional interventions are not universally applicable and depend on the clinical profile of the individual patient. This article reviews existing nutritional modalities for AD prevention that act through improvement of insulin resistance, correction of dyslipidemia, and reduction of oxidative stress, and discusses how they may be modified on the basis of individual biomarkers, genetics, and behavior. In addition, we report preliminary results of clinical application of these personalized interventions at the first AD prevention clinic in the United States. The use of these personalized interventions represents an important application of precision medicine techniques for the prevention of AD that can be adopted by clinicians across disciplines. © 2016 New York Academy of Sciences.

  10. Recommendations for equipment requirements and specifications for digital and interventional radiology: Dosimetric aspects

    International Nuclear Information System (INIS)

    Suliman, I.I.; Zoetelief, J.

    2002-01-01

    The recognition of radiation induced injuries from fluoroscopically guided interventional procedures has resulted in the current demand for development of recommendations and standards to limit dose to both patients and staff. This paper outlines the recommendations drafted within the framework of European Project DIMOND III. The actual work involves survey and review of national and international documents as well as scientific publications in areas relevant to the digital and/or interventional radiology with an aim of developing recommendations for equipment requirements and specifications for digital and interventional radiology. A pilot study of experimental investigations in at least three hospitals will be conducted to test the requirements and the specifications, the result of which will be presented. The recommendations are expected to provide an effective means of dose reduction to both patients and staff while maintaining image quality adequate for the specific diagnosis or interventional procedure. Different components of x-ray systems that have direct impact on patient and staff doses have been considered. Where necessary a compromise between patient dose and image quality has been made. The dosimetric aspects of the recommendations propose detailed descriptions and limits to dosimetric information relevant to patient and staff doses. International recommendations on maximum patient entrance surface dose rate vary in the range from 25 to 65 mGy.min -1 for normal mode fluoroscopy. Maximum image intensifier or image receptor input dose rate around 0.1 Gy min -1 at a distance 30 cm from the image intensifier input surface has been generally recommended. Maximum fluoroscopic dose rate in air must not exceed 50 mGy.min -1 at a location depending on the configuration e.g. for undertable x-ray tube at 10 mm from the patient support on the patient side of the support. The use of pulsed fluoroscopy or low dose fluoroscopy is proposed as good options to minimize

  11. Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

    Science.gov (United States)

    Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette

    2017-03-20

    In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr -1 . The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

  12. Characteristics of the development of the radiological situation resulting from the accident, intervention levels and countermeasures

    International Nuclear Information System (INIS)

    Belyaev, S.T.; Demin, V.F.; Kutkov, V.A.; Bariakhtar, V.G.; Petriaev, E.P.

    1996-01-01

    Great efforts have been made in the frame of the national and international research programs to get complete data on the radioactive releases, environmental contamination and radiological situation resulted from the Chernobyl accident. Beginning from the first publication (IAEA meeting, August 1986) these data have been considerably improved and added. The most important change of them with their influence on the decision making in the mitigation activity and the current situation is described and analyzed. The national and international regulatory documents at the moment of the accident were neither complete nor perfect in some necessary aspects especially in respect to the countermeasures at the intermediate and long-term phases. New documents have been worked out during the intervention activity. From 1986 series of documents were developed on the national and international levels. These documents are considered and analyzed in the context of their practical implementation and by the modern experience and research results. The history of countermeasures adopted on the different intervention phases are described. These documents mainly establish intervention levels in terms of averted doses and regulate only radiation protection. They don't content any intervention levels in terms of residual doses and risk, which are necessary for regulation of social and health protection of population suffered from the accident. Other restriction for the optimal regulation comes from use of the effective dose for establishing intervention levels. These and other respective aspects are discussed

  13. The role of interventional radiology and imaging in pancreatic islet cell transplantation

    International Nuclear Information System (INIS)

    Dixon, S.; Tapping, C.R.; Walker, J.N.; Bratby, M.; Anthony, S.; Boardman, P.; Phillips-Hughes, J.; Uberoi, R.

    2012-01-01

    Pancreatic islet cell transplantation (PICT) is a novel treatment for patients with insulin-dependent diabetes who have inadequate glycaemic control or hypoglycaemic unawareness, and who suffer from the microvascular/macrovascular complications of diabetes despite aggressive medical management. Islet transplantation primarily aims to improve the quality of life for type 1 diabetic patients by achieving insulin independence, preventing hypoglycaemic episodes, and reversing hypoglycaemic unawareness. The islet cells for transplantation are extracted and purified from the pancreas of brain-stem dead, heart-beating donors. They are infused into the recipient's portal vein, where they engraft into the liver to release insulin in order to restore euglycaemia. Initial strategies using surgical access to the portal vein have been superseded by percutaneous access using interventional radiology techniques, which are relatively straightforward to perform. It is important to be vigilant during the procedure in order to prevent major complications, such as haemorrhage, which can be potentially life-threatening. In this article we review the history of islet cell transplantation, present an illustrated review of our experience with islet cell transplantation by describing the role of imaging and interventional radiology, and discuss current research into imaging techniques for monitoring graft function.

  14. Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

    International Nuclear Information System (INIS)

    Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio Júnior; Goldman, Suzan Menasce

    2015-01-01

    The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers

  15. Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

    Energy Technology Data Exchange (ETDEWEB)

    Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio Júnior; Goldman, Suzan Menasce [Universidade Federal de São Paulo, São Paulo, SP (Brazil)

    2015-07-01

    The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers.

  16. Interventional techniques in medicine and radioprotection; Les techniques interventionnelles en medecine et radioprotection

    Energy Technology Data Exchange (ETDEWEB)

    Le Guen, B.; Bar, O.; Benderitter, M.; Bourguignon, M.; Chevillard, S.; Gauron, Ch.; Lallemand, J.; Lombard, J.; Maccia, C.; Sapoval, M.; Bernier, M.O.; Pirard, Ph.; Jacob, S.; Donadille, L.; Aubert, B.; Clairand, I.; Mozziconacci, J.G.; Brot, A.M.; Jarrige, V.; Huet, Ch.; Marchal, C.; Martin, M.; Bar, O.; Degrange, J.P.; Livarek, B.; Menechal, Ph.; Sapoval, M.; Pellerin, O.

    2009-07-01

    This document gathers the slides of the available presentations given during this conference day. Nineteen presentations are assembled in the document and deal with: 1 - Interventional radiology: why is it developing? (M. Sapoval); 2 - exposure particularities in interventional radiology (O. Bar); 3 - doses received by organs in interventional cardiology (C. Maccia); 4 - Patients exposure: description of cumulated exposure of patients treated in interventional cardiology (M.O. Bernier); 5 - 2004 inquiry to dermatologists about post-interventional radiology radio-dermatitis (P. Pirard); 6 - exposure and risks to operators (S. Jacob); 7 - dosimetric evaluation techniques and results about interventional imaging operators' extremities (L. Donadille and F. Merat); 8 - bibliographic study of doses received by operators with non-protected organs (B. Aubert); 9 - ORAMED European project: optimization of operational dosimeter uses in interventional radiology (I. Clairand); 10 - reference levels and dosimetric evaluation of patients (C. Maccia); 11 - optimization in coronary angioplasty (J.G. Mozziconacci, A.M. Brot and V. Jarrige); 12 - dosimetry in medical over-exposure situation (C. Huet); 13 - significant radioprotection events in interventional radiology declared to the Nuclear Safety Authority (ASN) - status and experience feedback (C. Marchal); 14 - interventional radiology and unwanted effects (M. Benderitter); 15 - global analyses and new exposure indicators in human epidermis cells (M. Martin); 16 - radioprotection regulations and training (O. Bar); 17 - zoning and workplace analysis in interventional cardiology (J.P. Degrange); 18 - guide of good clinical practices: example of interventional cardiology (B. Livarek); 19 - how to encourage the radioprotection optimization in interventional radiology: the ASN's point of view (P. Menechal). (J.S.)

  17. Proposal of a radiological protection inspection technique for nuclear medicine facilities

    International Nuclear Information System (INIS)

    Mendes, Leopoldino da Cruz Gouveia; Fonseca, Lea Mirian Barbosa da; Carvalho, Antonio Carlos Pires

    2004-01-01

    The main objective of this study is to implement an impartial and efficient inspection method for a correct and secure use of ionizing radiation in nuclear medicine. The radiological protection model was tested in 113 nuclear medicine services (NMS) all over Brazil, following a biannual analysis schedule (1996, 1998, 2000 and 2002). In the analytical process, we adopted the methodology of assigning different importance levels to each of 82 features, based on the risk factors established by the 'Comissao Nacional de Energia Nuclear' (CNEN) and on the International Atomic Energy Agency (IAEA) recommendations. A feature was considered a radioprotection fault when in nonconformity with the rules mentioned above, and was imparted a grade. The sum of those grades, classified the NMS in one of the three different ranges, as follows: operating without restriction - 100 points and below; operating with restriction - between 100 and 300 points; temporary shutdown - above 300 points. Permission for the second group to carry on operation should be attached to a defined and restricted period of time (6 to 12 months), considered enough for the NMS to solve the problems and submit to a new evaluation. The NMS's classified in the third group are supposed to go back into operation only after compliance with all the pending radioprotection requirements. Until the next regular evaluation, a multiplication factor 2 n was applied to the recalcitrant NMS's, where n is the number of unwilling occurrences. The previous establishment of those items of radioprotection, with their respective grades, excluded subjective and personal values in the judgement and technical evaluation of the institutions. (author)

  18. Radiological protection and the exposure of animals as patients in veterinary medicine.

    Science.gov (United States)

    Pentreath, R J

    2016-06-01

    It is apparent that most of the techniques that make use of ionising radiation in human medical practices are now being applied in veterinary medicine. Steps are being taken by the IAEA to provide guidance for humans involved in such practices, but there appears to be no international initiative that considers the protection or welfare of the animal as a patient. There is therefore a risk that the deliberate exposure of an animal, particularly in the therapeutic application of radiation, could do more harm than good. In the light of recent developments in dosimetric modelling and the application of known effects of radiation on different types of animals, for the purposes of the protection of biota in an environmental context, it is argued that it would be sensible now to start a serious consideration of this issue. Some suggestions are made with regard to a number of areas that could be considered further, both specifically and with regard to the field of radiological protection as a whole.

  19. Scene setting: Criteria for acceptability and suspension levels in diagnostic radiology, nuclear medicine and radiotherapy

    International Nuclear Information System (INIS)

    Malone, J.; Faulkner, K.; Christofides, S.; Lillicrap, S.; Horton, P.

    2013-01-01

    The EC (European Commission) Directive on radiation protection of patients requires that Criteria for Acceptability of Equipment in Diagnostic Radiology, Nuclear Medicine and Radiotherapy be established throughout the member states. This paper reviews the background to this requirement and to its implementation in practice. It notes parallel requirements in the EC medical devices directive and International Electrotechnical Commission standards. It is also important to be aware and that both sets of requirements should ideally be harmonised due to the global nature of the equipment industry. The paper further reviews the type of criteria that can be well applied for the above purposes, and defines qualitative criteria and suspension levels suitable for application. Both are defined and relationships with other acceptance processes are considered (including acceptance testing at the time of purchase, commissioning and the issue of second-hand equipment). Suspension levels are divided into four types, A, B, C and D, depending on the quality of evidence and consensus on which they are based. Exceptional situations involving, for example, new or rapidly evolving technology are also considered. The publication and paper focuses on the role of the holder of the equipment and related staff, particularly the medical physics expert and the practitioner. Advice on how the criteria should be created and implemented and how this might be coordinated with the supplier is provided for these groups. Additional advice on the role of the regulator is provided. (authors)

  20. PACS for surgery and interventional radiology: Features of a Therapy Imaging and Model Management System (TIMMS)

    International Nuclear Information System (INIS)

    Lemke, Heinz U.; Berliner, Leonard

    2011-01-01

    Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the 'image-centric world view' of the classical PACS technology is complemented by an IT 'model-centric world view'. Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

  1. Estimate of the exposition to the ionizing radiation of the medical veterinarians and its assistants in radiology examinations veterinary medicine

    International Nuclear Information System (INIS)

    Lima, G.; Braz, D.; Lopez, R.; Mauricia, C.; Barroso, R.

    2006-01-01

    The absorbed ionizing radiation outside of the permissible limits, can cause biological damages e, therefore it must necessarily be monitored. The dosimetry thermoluminescent is a technique very used to detect expositions in operators, therefore they are sensible crystals the ionizing radiation and allows to evaluate if the dose of radiation is or not below of the restriction levels. In scientific literature many information do not exist on the exposition of a medical veterinarian, with this do not have many data of the individual monitoring of these workers, becoming the work it important for posterior studies. Ahead of this, it was carried through measured of the doses, using the thermoluminescence dosemeters LiF: Mg, Cu, P (TLD-100 H) in the position of the crystalline lens, thyroid, hand and thorax, in three clinics of radiology veterinary medicine, different, having the objective to determine the dose distribution that the workers of radiology veterinary medicine are submitted in one day of work. (authors)

  2. Estimate of the exposition to the ionizing radiation of the medical veterinarians and its assistants in radiology examinations veterinary medicine

    Energy Technology Data Exchange (ETDEWEB)

    Lima, G.; Braz, D.; Lopez, R. [Rio de Janeiro Univ. Federal, COPPE (Brazil); Mauricia, C. [Rio de Janeiro Univ. Federal, Instituto de Radioprotecao e Dosimetria (Brazil); Barroso, R. [Rio de Janeiro Univ. Federal, Universidade Estadual do Rio de Janeiro (Brazil)

    2006-07-01

    The absorbed ionizing radiation outside of the permissible limits, can cause biological damages e, therefore it must necessarily be monitored. The dosimetry thermoluminescent is a technique very used to detect expositions in operatorserefore they are sensible crystals the ionizing radiation and allows to evaluate if the dose of radiation is or not below of the restriction levels. In scientific literature many information do not exist on the exposition of a medical veterinarian, with this do not have many data of the individual monitoring of these workers, becoming the work it important for posterior studies. Ahead of this, it was carried through measured of the doses, using the thermoluminescence dosemeters LiF: Mg, Cu, P (TLD-100 H) in the position of the crystalline lens, thyroid, hand and thorax, in three clinics of radiology veterinary medicine, different, having the objective to determine the dose distribution that the workers of radiology veterinary medicine are submitted in one day of work. (authors)

  3. Hospital Organization and Importance of an Interventional Radiology Inpatient Admitting Service: Italian Single-Center 3-Year Experience

    International Nuclear Information System (INIS)

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-01-01

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p < 0.05). The results of the 3-year activity show that the activation of a COUIR with an inpatient admitting service, and the better organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of Euro 1,009,095.35. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  4. The nuclear medicine department in the emergency management plan: a referent structure for the nuclear and radiological risks

    International Nuclear Information System (INIS)

    Barat, J.L.; Ducassou, D.; Lesgourgues, P.; Zamaron, S.; Boulard, G.

    2006-01-01

    Each french public or private hospital has to establish guidelines for an immediate response to mass casualties (Emergency Management Plan or 'White' Plan). For a nuclear accident or terrorist attack, the staff of the Nuclear Medicine Department may be adequately prepared and equipped. This paper presents the nuclear and radiological risks section of the final draft of the White Plan developed at Bordeaux University Hospital. (author)

  5. Using the Monte Carlo technique to calculate dose conversion coefficients for medical professionals in interventional radiology

    International Nuclear Information System (INIS)

    Santos, W.S.; Carvalho Jr, A.B.; Hunt, J.G.; Maia, A.F.

    2014-01-01

    The objective of this study was to estimate doses in the physician and the nurse assistant at different positions during interventional radiology procedures. In this study, effective doses obtained for the physician and at points occupied by other workers were normalised by air kerma-area product (KAP). The simulations were performed for two X-ray spectra (70 kVp and 87 kVp) using the radiation transport code MCNPX (version 2.7.0), and a pair of anthropomorphic voxel phantoms (MASH/FASH) used to represent both the patient and the medical professional at positions from 7 cm to 47 cm from the patient. The X-ray tube was represented by a point source positioned in the anterior posterior (AP) and posterior anterior (PA) projections. The CC can be useful to calculate effective doses, which in turn are related to stochastic effects. With the knowledge of the values of CCs and KAP measured in an X-ray equipment, at a similar exposure, medical professionals will be able to know their own effective dose. - Highlights: ► This study presents a series of simulations to determine scatter-dose in IR. ► Irradiation of the worker is non-uniform and a part of his body is shielded. ► With the CCs it is possible to estimate the occupational doses in the CA examination. ► Protection of medical personnel in IR is an important issue of radiological protection

  6. Transition in occupational radiation exposure monitoring methods in diagnostic and interventional radiology

    International Nuclear Information System (INIS)

    Loennroth, N.; Hirvonen-Kari, M.; Timonen, M.; Savolainen, S.; Kortesniemi, M.

    2008-01-01

    Radiation exposure monitoring is a traditional keystone of occupational radiation safety measures in medical imaging. The aim of this study was to review the data on occupational exposures in a large central university hospital radiology organisation and propose changes in the radiation worker categories and methods of exposure monitoring. An additional objective was to evaluate the development of electronic personal dosimeters and their potential in the digitised radiology environment. The personal equivalent dose of 267 radiation workers (116 radiologists and 151 radiographers) was monitored using personal dosimeters during the years 2006-2010. Accumulated exposure monitoring results exceeding the registration threshold were observed in the personal dosimeters of 73 workers (59 radiologists' doses ranged from 0.1 to 45.1 mSv; 14 radiographers' doses ranged from 0.1 to 1.3 mSv). The accumulated personal equivalent doses are generally very small, only a few angiography radiologists have doses >10 mSv per 5 y. The typical effective doses are -1 and the highest value was 0.3 mSv (single interventional radiologist). A revised categorisation of radiation workers based on the working profile of the radiologist and observed accumulated doses is justified. Occupational monitoring can be implemented mostly with group dosimeters. An active real-time dosimetry system is warranted to support radiation protection strategy where optimisation aspects, including improving working methods, are essential. (authors)

  7. Effective dose to patients in interventional vascular radiology in Malaga and Tenerife

    International Nuclear Information System (INIS)

    Ruiz Cruces, R.; Perez Martinez, M.; Diez de los Rios Delgado, A.; Hernandez Armas, J.; Garcia-Granados, J.; Diaz Romero, F.J.

    1997-01-01

    The objective of the research is to estimate the effective dose that patients receive during the procedure of interventional vascular radiology screening using a digital system. The effective dose is the best indicator of radiological risks. A plane ionization camera is used to estimate dose per surface area (Gy/square cm). By means of the method described in the NRPB R-262 report, projections were selected which adjust to the field irradiated in each of the procedures analysed. The product values of the dose surface and effective dose has been 75.7 Gy/cm 2 and 10.5 mSv for abdominal angiography; 29.0 Gy/cm 2 and 7.6 mSv for arteriographic diagnosis of the inferior members; 104.5 Gy/cm 2 and 23.6 mSv for gall drainage; 90.5 Gy/cm 2 and 21.5 mSv for varicoceles, and 39.5 Gy/cm 2 and 9.6 mSv for nephrostomas

  8. Review the past and look forward the future: in celebration of 20 anniversary of(Chinese Society of Interventional Radiology)

    International Nuclear Information System (INIS)

    Li Linsun

    2010-01-01

    This paper aims to make a brief review of the Chinese Society of Interventional Radiology in the past 20 years since it was established and to put forward some personal suggestions. The article will mainly describe the following contents: (1) to make suggestions to set up a standard organization of Chinese Interventional Society; (2) to demand interventional radiologist to be a real clinical doctor, to take care of their own patients for full course, to practice all kinds of minimally-invasive therapy; (3) to improve the ability of scientific research work; (4) to perfect the system of education, training and promotion in interventional radiology field; (5) to strengthen the special team of interventional radiologists; (6) to raise the academic level and status of the 'Journal of Interventional Radiology'; (7) to heighten the quality of academic activity and to intensify the organization system of interventional discipline; (8) to correctly deal with the competition between different subjects; and (9) to improve and perfect our own interventional job.(authors)

  9. Radiation risk management during fluoroscopy for interventional pain medicine physicians.

    Science.gov (United States)

    Broadman, Lynn M; Navalgund, Yeshvant A; Hawkinberry, Denzil W

    2004-02-01

    Because of serious radiographic-induced skin injuries that may have been caused by the inappropriate use of fluoroscopy during the performance of radiograph-guided invasive procedures, the US Food and Drug Administration (FDA) issued an advisory in 1994 suggesting that the key to preventing such unfortunate mishaps may be physician education, training, and credentialing in the safe operation of fluoroscopic equipment. The purpose of this article is to familiarize the interventional pain medicine physician with the physics of ionizing radiation and how to limit patient exposure through the optimum setting of tube current and voltage, the use of limited beam-on time, tight collimation, and the elimination of the nonessential use of the magnification mode on a fluoroscopy unit. In addition, the use of personal protection equipment and the knowledge needed to interpret the personal exposure record of each practitioner is discussed. All of this information will assist the interventional pain medicine physician in meeting the recommended FDA training and credentialing requirements.

  10. Correlações técnicas e ocupacionais da radiologia intervencionista Occupational and technical correlations of interventional radiology

    Directory of Open Access Journals (Sweden)

    Edvaldo de Souza

    2008-12-01

    Full Text Available A radiologia diagnóstica é a área da física médica relacionada ao uso de raios X para a obtenção de informações anatômicas e funcionais do corpo humano. As técnicas associadas a essa área utilizam tubos de raios X como fontes de radiação, filmes para o registro das informações, sistemas de monitoração por televisão e equipamentos que digitalizam as imagens utilizando computadores. Os equipamentos de fluoroscopia são considerados fontes artificiais de radiação ionizante e são utilizados para a realização de exames e procedimentos nas doenças vasculares. O objetivo deste estudo foi analisar criticamente os métodos de proteção em relação à radiação emitida pela fluoroscopia utilizados pelos profissionais que lidam com a radiologia intervencionista no ambiente hospitalar. Foi realizada uma análise crítica das atitudes de proteção tomadas pelos profissionais engajados nos procedimentos da radiologia intervencionista a partir da revisão bibliográfica realizada em livros-textos e em revistas periódicas indexadas no MEDLINE, nas línguas portuguesa, inglesa, francesa e espanhola, no período de 1966 a 2005, conforme os princípios e as normas de segurança de proteção radiológica norteadas pela Portaria 453/98 do Ministério da Saúde e a norma da Comissão Nacional de Energia Nuclear NN-3.01 do Ministério da Ciência e Tecnologia.Diagnostic radiology is a field of physical medicine that uses X rays to obtain functional and anatomical information on the human body. The techniques associated to this area use X ray tubes as radiation sources, films to record information, and monitoring systems using television and computers for the digitalization of images. Fluoroscopic equipment is considered as artificial springs of ionizing radiation and is used in diagnostic exams and procedures of vascular illnesses. The objective of this study was to critically analyze the protection methods regarding the radiation

  11. Finger doses during interventional radiology: The value of flexible protective gloves

    International Nuclear Information System (INIS)

    Vehmas, T.

    1991-01-01

    Finger doses of radiologists and assistants during 19 interventional radiological procedures were measured with thermoluminescent dosimeters (TLDs), and two types of flexible protective gloves were compared with each other. There were considerable differences in doses between different sites of TLDs on fingers. The exact site of TLDs on hands/fingers should thus be reported in papers. Both gloves were also irradiated through an Alderson phantom and the attenuation values were measured. The gloves with slightly greater attenuation proved to be significantly less comfortable to use. Wearing flexible protective gloves did not lengthen screening times as compared to a previous study in the same department. Various aspects of using such gloves are discussed. The attenuation values of gloves reported by the manufacturers may not apply under all clinical circumstances. (orig.) [de

  12. Use of digital dosemeters for supporting staff radiation safety in paediatric interventional radiology suites.

    Science.gov (United States)

    McNeil, Sarah M; Lai, Priscilla; Connolly, Bairbre L; Gordon, Christopher L

    2013-12-01

    Modern-day interventional radiology (IR) procedures impart a wide range of occupational radiation doses to team members. Unlike thermoluminescent badges, digital dosemeters provide real-time dose readings, making them ideal for identifying different components during IR procedures, which influence staff radiation safety. This study focused solely on paediatric IR (PIR) cases. Digital dosemeters measured the impact of imaging modality, shielding, patient and operator specific factors, on the radiation dose received during various simulated and real live PIR procedures. They recorded potential dose reductions of 10- to 100-fold to each staff member with appropriate use of shielding, choice of imaging method, staff position in the room and complex interplay of other factors. The digital dosemeters were well tolerated by staff. Results highlight some unique radiation safety challenges in PIR that arise from dose increases with magnification use and close proximity of staff to the X-ray beam.

  13. Monte Carlo calculations for reporting patient organ doses from interventional radiology

    Science.gov (United States)

    Huo, Wanli; Feng, Mang; Pi, Yifei; Chen, Zhi; Gao, Yiming; Xu, X. George

    2017-09-01

    This paper describes a project to generate organ dose data for the purposes of extending VirtualDose software from CT imaging to interventional radiology (IR) applications. A library of 23 mesh-based anthropometric patient phantoms were involved in Monte Carlo simulations for database calculations. Organ doses and effective doses of IR procedures with specific beam projection, filed of view (FOV) and beam quality for all parts of body were obtained. Comparing organ doses for different beam qualities, beam projections, patients' ages and patient's body mass indexes (BMIs) which generated by VirtualDose-IR, significant discrepancies were observed. For relatively long time exposure, IR doses depend on beam quality, beam direction and patient size. Therefore, VirtualDose-IR, which is based on the latest anatomically realistic patient phantoms, can generate accurate doses for IR treatment. It is suitable to apply this software in clinical IR dose management as an effective tool to estimate patient doses and optimize IR treatment plans.

  14. StarClose Vascular Closure Device: Prospective Study on 222 Deployments in an Interventional Radiology Practice

    International Nuclear Information System (INIS)

    Imam, Atique; Carter, Ranjana M. S.; Phillips-Hughes, Jane; Boardman, Philip; Uberoi, Raman

    2007-01-01

    The StarClose device (Abbott Vascular Devices; Abbott Laboratories, Redwood City, CA) utilizes an externally placed Nitinol clip to achieve arterial closure following femoral artery puncture. The objectives of this study were to assess the efficacy and complications of the StarClose device in patients undergoing interventional radiological procedures. Preprocedural clotting status, pulse and blood pressure, severity of vessel calcification, sheath size, and time to deployment were recorded. Postdeployment complications immediately postprocedure, at 1 h, at 2 h, and at 1 week were recorded. A duplex scan was performed in the first 10 patients to assess any immediate vascular complications. Deployments were successful in 96% achieving immediate hemostasis. Mean deployment time was 48 s. There were no major complications. The StarClose device was found to have a high technical and clinical efficacy

  15. Radiation load of the extremities and eye lenses of the staff during selected interventional radiology procedures

    International Nuclear Information System (INIS)

    Nikodemova, Denisa; Trosanova, Dominika

    2010-01-01

    The Slovak Medical University in Bratislava is involved in the ORAMED (Optimization of Radiation Protection for Medical Staff) research project, aimed at developing a unified methodology for a more accurate assessment of professional exposure of interventional radiology staff, with focus on extremity and eye lens dosimetry in selected procedures. Three cardiac procedures and 5 angiography examinations were selected: all technical parameters were monitored and the dose equivalent levels were measured by TL dosimetry at 9 anatomic sites of the body. Preliminary results were obtained for the radiation burden of the eyes and extremities during digital subtraction angiography of the lower limbs, collected from 7 hospital departments in partner EU states. Correlations between the evaluated data and the influence of some parameters are shown

  16. Use of digital dosemeters for supporting staff radiation safety in paediatric interventional radiology suites

    International Nuclear Information System (INIS)

    McNeil, S. M.; Lai, P.; Connolly, B. L.; Gordon, C. L.

    2013-01-01

    Modern-day interventional radiology (IR) procedures impart a wide range of occupational radiation doses to team members. Unlike thermoluminescent badges, digital dosemeters provide real-time dose readings, making them ideal for identifying different components during IR procedures, which influence staff radiation safety. This study focused solely on paediatric IR (PIR) cases. Digital dosemeters measured the impact of imaging modality, shielding, patient and operator specific factors, on the radiation dose received during various simulated and real live PIR procedures. They recorded potential dose reductions of 10-to 100-fold to each staff member with appropriate use of shielding, choice of imaging method, staff position in the room and complex interplay of other factors. The digital dosemeters were well tolerated by staff. Results highlight some unique radiation safety challenges in PIR that arise from dose increases with magnification use and close proximity of staff to the X-ray beam. (authors)

  17. Proceedings of the 5. Latin American Congress of Ultrasound in Medicine and Biology; Seminar of the Inter American College of Radiology - Abstracts

    International Nuclear Information System (INIS)

    1991-01-01

    The works about general radiology, radiotherapy, obstetrics, gynecology, internal medicine and echo-ophthalmology are presented in these congresses. Imaging procedures, including computerized tomography, ultrasonography, scintiscanning, magnetic resonance and X radiation are also described. (C.G.C.)

  18. Provision of out-of-hours interventional radiology services in Scotland

    International Nuclear Information System (INIS)

    Zealley, I.A.; Gordon, T.J.; Robertson, I.; Moss, J.G.; Gillespie, I.N.

    2012-01-01

    Aim: To evaluate the availability of out-of-hours (OOH) interventional radiology (IR) services in Scotland and discuss implications for service redesign. Materials and methods: Data were gathered via a survey conducted by telephone/e-mail interview. The setting was hospitals in Scotland with acute medical and/or surgical beds. The interviewees were consultant interventional radiologists representing each of the 14 geographical Health Boards in Scotland. Results: Three of the 14 geographical Health Boards provided a formal, prospectively planned OOH IR service in at least one hospital. Fourteen of the 34 acute hospitals provided an in-hours IR service, which includes endovascular haemorrhage control. Eight of the 34 acute hospitals had formal, prospectively planned on-call IR arrangements, 12 had an ad-hoc service, and 20 transferred patients to other facilities. Thirty-eight of the 223 consultant radiologists in Scotland were able to perform endovascular haemorrhage control procedures: only 18 of these 38 (47%) were included in on-call rotas. A further 42 radiologists were able to perform nephrostomy and a further 61 were able to perform abscess drainage. Eighty-two radiologists did not perform any interventional procedures. Conclusions: The provision of OOH IR services in Scotland is limited and available resources, both skills and equipment, are being underutilized. These data will be used to inform a process of OOH IR service redesign in Scotland.

  19. Risk of bleeding associated with interventional musculoskeletal radiology procedures. A comprehensive review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Foremny, Gregory B.; Jose, Jean; Subhawong, Ty K. [University of Miami Miller School of Medicine, Department of Radiology, Jackson Memorial Hospital, Miami, FL (United States); Pretell-Mazzini, Juan [University of Miami Miller School of Medicine, Department of Orthopaedic Surgery-Division of Musculoskeletal Oncology, Miami, FL (United States)

    2015-05-01

    This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient's particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures. (orig.)

  20. Risk of bleeding associated with interventional musculoskeletal radiology procedures. A comprehensive review of the literature

    International Nuclear Information System (INIS)

    Foremny, Gregory B.; Jose, Jean; Subhawong, Ty K.; Pretell-Mazzini, Juan

    2015-01-01

    This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient's particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures. (orig.)

  1. Interventional Radiological Treatment of Perihepatic Vascular Stenosis or Occlusion in Pediatric Patients After Liver Transplantation

    International Nuclear Information System (INIS)

    Uller, Wibke; Knoppke, Birgit; Schreyer, Andreas G.; Heiss, Peter; Schlitt, Hans J.; Melter, Michael; Stroszczynski, Christian; Zorger, Niels; Wohlgemuth, Walter A.

    2013-01-01

    Purpose: Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients. Methods: Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated. Results: Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days). Conclusion: Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown

  2. Touchless interaction with software in interventional radiology and surgery: a systematic literature review.

    Science.gov (United States)

    Mewes, André; Hensen, Bennet; Wacker, Frank; Hansen, Christian

    2017-02-01

    In this article, we systematically examine the current state of research of systems that focus on touchless human-computer interaction in operating rooms and interventional radiology suites. We further discuss the drawbacks of current solutions and underline promising technologies for future development. A systematic literature search of scientific papers that deal with touchless control of medical software in the immediate environment of the operation room and interventional radiology suite was performed. This includes methods for touchless gesture interaction, voice control and eye tracking. Fifty-five research papers were identified and analyzed in detail including 33 journal publications. Most of the identified literature (62 %) deals with the control of medical image viewers. The others present interaction techniques for laparoscopic assistance (13 %), telerobotic assistance and operating room control (9 % each) as well as for robotic operating room assistance and intraoperative registration (3.5 % each). Only 8 systems (14.5 %) were tested in a real clinical environment, and 7 (12.7 %) were not evaluated at all. In the last 10 years, many advancements have led to robust touchless interaction approaches. However, only a few have been systematically evaluated in real operating room settings. Further research is required to cope with current limitations of touchless software interfaces in clinical environments. The main challenges for future research are the improvement and evaluation of usability and intuitiveness of touchless human-computer interaction and the full integration into productive systems as well as the reduction of necessary interaction steps and further development of hands-free interaction.

  3. Development of a calibration methodology for instruments used to interventional radiology quality control

    International Nuclear Information System (INIS)

    Miranda, Jurema Aparecida de

    2009-01-01

    Interventional radiology is the technique where X radiation images are used as a tool in the conduction of diagnostic or/and therapeutic procedures. The exposition times are long for both procedures, diagnostic and therapeutic, may cause serious injuries in the patient, and also contribute to the dose of the clinical staff. In Brazil there are not yet well established rules to determine the doses and to make the dosimetry in fluoroscopic beams. There is great interest in this study, in relation to the beam quality, the half-value-layer, and others parameters. In this work a Medicor Neo Diagnomax clinical X ray generator, fluoroscopy mode, was used to develop a calibration methodology for instruments used in interventional radiology quality control. One plane parallel ionization chamber PTW was used as monitor. The ionization chambers recommended for fluoroscopy measurements had been evaluated and calibrated in relation to the IPEN Calibration Laboratory reference ionization chamber. The RQR3, RQR5 and RQR7 radiation qualities and the specific ones for fluoroscopy, RQC3, RQC5 and RQC7, were established following the norm IEC 61267. All beams characteristics were determined. Ionization chambers positioning system and the acrylic phantoms to the entrance and exit doses determination were developed and constructed. The results obtained show air kerma rates of 4.5x10 -3 , 1.2x10 -2 and 1.9x10 -2 Gy/min for RQC3, RQC5 and RQC7 respectively. Tests with and without the collimation just after the monitor chamber, were carried out and the results showed a difference of +5.5%, +0.6% e + 0.8%, confirming the importance of the collimation use in these interventionist procedures. (author)

  4. Enhancing interventional radiology training in Canada: creating new choices for medical students and residents. Current training options in the United States

    International Nuclear Information System (INIS)

    Baerlocher, M.O.; Collingwood, P.; Becker, G.J.

    2005-01-01

    Vascular interventional radiology (VIR) faces both a current and even greater projected shortage of VIR specialists and VIR researchers. Three new residency programs were introduced in the United States within the past 6 years that may have a dramatic impact on the subspecialty: 1) the 6-year Diagnostic and Interventional Radiology Enhanced Clinical Training and Certification (DIRECT) pathway, 2) the 6-year clinical pathway for Vascular and Interventional Radiology, and 3) the 5-year ABR Holman research pathway. In this paper, we introduce these 3 programs, the relevant issues they create and affect, and the relevancy for Canadian radiology training programs. (author)

  5. Bone metastases: assessment of therapeutic response through radiological and nuclear medicine imaging modalities.

    Science.gov (United States)

    Vassiliou, V; Andreopoulos, D; Frangos, S; Tselis, N; Giannopoulou, E; Lutz, S

    2011-11-01

    Radiological and nuclear medicine imaging modalities used for assessing bone metastases treatment response include plain and digitalised radiography (XR), skeletal scintigraphy (SS), dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and PET/CT. Here we discuss the advantages and disadvantages of these assessment modalities as evident through different clinical trials. Additionally, we present the more established response criteria of the International Union Against Cancer and the World Health Organization and compare them with newer MD Anderson criteria. Even though serial XR and SS have been used to assess the therapeutic response for decades, several months are required before changes are evident. Newer techniques, such as MRI or PET, may allow an earlier evaluation of response that may be quantified through monitoring changes in signal intensity and standard uptake value, respectively. Moreover, the application of PET/CT, which can follow both morphological and metabolic changes, has yielded interesting and promising results that give a new insight into the natural history of metastatic bone disease. However, only a few studies have investigated the application of these newer techniques and further clinical trials are needed to corroborate their promising results and establish the most suitable imaging parameters and evaluation time points. Last, but not least, there is an absolute need to adopt uniform response criteria for bone metastases through an international consensus in order to better assess treatment response in terms of accuracy and objectivity. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  6. Benefits of an automatic patient dose registry system for interventional radiology and cardiology at five hospitals of the Madrid area

    International Nuclear Information System (INIS)

    Fernandez-Soto, J.M.; Vano, E.; Sanchez, R.M.; Ten, J.I.; Espana, M.; Pifarre, X.

    2015-01-01

    The purpose of this article is to present the results of connecting the interventional radiology and cardiology laboratories of five university hospitals to a unique server using an automatic patient dose registry system (Dose On Line for Interventional Radiology, DOLIR) developed in-house, and to evaluate its feasibility more than a year after its introduction. The system receives and stores demographic and dosimetric parameters included in the MPPS DICOM objects sent by the modalities to a database. A web service provides a graphical interface to analyse the information received. During 2013, the system processed 10 788 procedures (6874 cardiac, 2906 vascular and 1008 neuro interventional). The percentages of patients requiring clinical follow-up due to potential tissue reactions before and after the use of DOLIR are presented. The system allowed users to verify in real-time, if diagnostic (or interventional) reference levels are fulfilled. (authors)

  7. Interventional radiology simulation and measurement of patient doses; Simulacion en radiologia intervencionista y medida de dosis a pacientes

    Energy Technology Data Exchange (ETDEWEB)

    Herraiz Lablanca, M. d.; Diaz Romero, F.; Hernandez Armas, J.

    2011-07-01

    In this paper we propose a method of work to calculate the effective dose in any interventional radiology procedure using an Alderson Rando anthropomorphic phantom and dosimeters TLD 100 chip. We applied this method in the case of biliary drainage and allowed us to establish the dose value corresponding reference in the Hospital Universitario de Canarias (HUC).

  8. Lean manufacturing and Toyota Production System terminology applied to the procurement of vascular stents in interventional radiology.

    Science.gov (United States)

    de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Wintzer, Christian; Collettini, Federico; Kloeters, Christian; Hamm, Bernd; Teichgräber, Ulf K

    2011-08-01

    OBJECTIVES: To apply the economic terminology of lean manufacturing and the Toyota Production System to the procurement of vascular stents in interventional radiology. METHODS: The economic- and process-driven terminology of lean manufacturing and the Toyota Production System is first presented, including information and product flow as well as value stream mapping (VSM), and then applied to an interdisciplinary setting of physicians, nurses and technicians from different medical departments to identify wastes in the process of endovascular stent procurement in interventional radiology. RESULTS: Using the so-called seven wastes approach of the Toyota Production System (waste of overproducing, waiting, transport, processing, inventory, motion and waste of defects and spoilage) as well as further waste characteristics (gross waste, process and method waste, and micro waste), wastes in the process of endovascular stent procurement in interventional radiology were identified and eliminated to create an overall smoother process from the procurement as well as from the medical perspective. CONCLUSION: Economic terminology of lean manufacturing and the Toyota Production System, especially VSM, can be used to visualise and better understand processes in the procurement of vascular stents in interventional radiology from an economic point of view.

  9. Diagnostic and interventional radiology workload in acute pancreatitis in an ITU/HDU setting

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Y.Y. [Department of Radiology, Manchester Royal Infirmary, Manchester (United Kingdom); O' Shea, S. [Department of Radiology, Manchester Royal Infirmary, Manchester (United Kingdom); Lee, S.H. [Department of Radiology, Manchester Royal Infirmary, Manchester (United Kingdom)]. E-mail: stephen.lee@cmmc.nhs.uk

    2006-01-15

    AIM: To determine the impact on diagnostic and interventional radiology services when imaging patients with severe pancreatitis on intensive therapy (ITU) and high-dependency units (HDU) in a tertiary referral centre. MATERIAL AND METHODS: One hundred and sixty-nine patients admitted to ITU/HDU over a 9-year period (1996-2004) with severe acute pancreatitis were reviewed. There were 109 admissions to the ITU with length of stay of 0.2-81.6 days (mean 19.7 days) and 92 admissions to the HDU with length of stay of 0.4-12.8 days (mean 4.9 days). RESULTS: One hundred and seventy-nine computed tomography (CT) and 199 ultrasound (US) examinations were performed on the ITU patients in whom interventional procedures were required in 24% of patients undergoing CT examinations and in 32% of patients undergoing US. Sixty-two CT and 60 US examinations were performed in the HDU patients. The percentage of interventional procedures performed in HDU patients was similar to that in ITU patients, i.e., 18% CT-guided and 35% US-guided. The proportion of patients that underwent investigations and interventions has gradually increased over the period of the study. Inpatient mortalities were 29% and 5.4%, respectively, in ITU and HDU patients. CONCLUSIONS: This study demonstrates the huge input and increasing workload undertaken by radiologists when managing patients with severe acute pancreatitis in an ITU/HDU setting. We believe this is partly due to the implementation of the British Society of Gastroenterology (BSG) guidelines on management of acute pancreatitis and partly due to the more intensive non-surgical management offered to patients being referred into a specialist tertiary referral unit.

  10. Pediatric radiology

    International Nuclear Information System (INIS)

    Kirkpatrick, J.A. Jr.

    1985-01-01

    Computed tomography has made possible the excellent and basic work having to do with the characteristics of the trachea, its caliber, shape, and length in children. Another group of articles has to do with interventional pediatric radiology. This year there were a number of articles of which only a sample is included, dealing with therapeutic procedures involving drainage of abscesses, angioplasty, nephrostomy, therapeutic embolization, and the removal of esophageal foreign bodies. Obviously, there is no reason to think that techniques developed for the adult may not be applicable to the infant or child; also, there is no reason to believe that processes peculiar to the child should not be amenable to intervention, for instance, use of embolization of hepatic hemangioma and transluminal balloon valvuloplasty for pulmonary valvular stenosis. Among the reports and reviews, the author would add that sonography remains a basic imaging technique in pediatric radiology and each year its application broadens. For example, there is an excellent article having to do with sonography of the neonatal and infant hip and evaluation of the inferior vena cava and the gallbladder. Nuclear medicine continues to play a significant role in diagnosis, which is featured in two articles concerned with problems of the hip

  11. Staff extremity doses in interventional radiology. Results of the ORAMED measurement campaign

    International Nuclear Information System (INIS)

    Nikodemová, D.; Brodecki, M.; Carinou, E.; Domienik, J.; Donadille, L.; Koukorava, C.; Krim, S.; Ruiz-López, N.; Sans-Merce, M.; Struelens, L.; Vanhavere, F.; Zaknoune, R.

    2011-01-01

    The introduction of interventional radiology (IR) procedures in the 20th century has demonstrated significant advantages over surgery procedures. As a result, their number is continuously rising in diagnostic, as well as, in therapy field and is connected with progress in highly sophisticated equipment used for these purposes. Nowadays, in the European countries more than 400 fluoroscopically guided IR procedures were identified with a 10–12% increase in the number of IR examinations every year (). Depending on the complexity of the different types of the interventions large differences in the radiation doses of the staff are observed. The staff that carries out IR procedures is likely to receive relatively high radiation doses, because IR procedures require the operator to remain close to the patient and close to the primary radiation beam. In spite of the fact that the operator is shielded by protective apron, the hands, eyes and legs remain practically unshielded. For this reason, one of the aims of the ORAMED project was to provide a set of standardized data on extremity doses for the personnel that are involved in IR procedures and to optimize their protection by evaluating the various factors that affect the doses. In the framework of work package 1 of the ORAMED project the impact of protective equipment, tube configuration and access routes were analyzed for the selected IR procedures. The position of maximum dose measured is also investigated. The results of the extremity doses in IR workplaces are presented in this study together with the influence of the above mentioned parameters on the doses. -- Highlights: ► We present a set of data on extremity doses for staff in selected interventional radiology procedures. ► We studied the influence of different parameters. ► The measured doses are analyzed according to the operators skill,his position during work, tube configuration, etc. ► Maximum doses recorded for all types of embolisation, in all

  12. Applying a structured innovation process to interventional radiology: a single-center experience.

    Science.gov (United States)

    Sista, Akhilesh K; Hwang, Gloria L; Hovsepian, David M; Sze, Daniel Y; Kuo, William T; Kothary, Nishita; Louie, John D; Yamada, Kei; Hong, Richard; Dhanani, Riaz; Brinton, Todd J; Krummel, Thomas M; Makower, Joshua; Yock, Paul G; Hofmann, Lawrence V

    2012-04-01

    To determine the feasibility and efficacy of applying an established innovation process to an active academic interventional radiology (IR) practice. The Stanford Biodesign Medical Technology Innovation Process was used as the innovation template. Over a 4-month period, seven IR faculty and four IR fellow physicians recorded observations. These observations were converted into need statements. One particular need relating to gastrostomy tubes was diligently screened and was the subject of a single formal brainstorming session. Investigators collected 82 observations, 34 by faculty and 48 by fellows. The categories that generated the most observations were enteral feeding (n = 9, 11%), biopsy (n = 8, 10%), chest tubes (n = 6, 7%), chemoembolization and radioembolization (n = 6, 7%), and biliary interventions (n = 5, 6%). The output from the screening on the gastrostomy tube need was a specification sheet that served as a guidance document for the subsequent brainstorming session. The brainstorming session produced 10 concepts under three separate categories. This formalized innovation process generated numerous observations and ultimately 10 concepts to potentially to solve a significant clinical need, suggesting that a structured process can help guide an IR practice interested in medical innovation. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  13. The consent process in interventional radiology: the role of specialist nurses

    International Nuclear Information System (INIS)

    Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F.

    2004-01-01

    AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased

  14. Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

    International Nuclear Information System (INIS)

    Illing, R.O.; Ingham Clark, C.L.; Allum, C.

    2010-01-01

    Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

  15. Interventional radiology in the diagnosis, management, and follow-up of pseudoaneurysms.

    LENUS (Irish Health Repository)

    Keeling, A N

    2009-01-01

    Arterial wall disruption, as a consequence of inflammation\\/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.

  16. Provision of out-of-hours interventional radiology services in the London Strategic Health Authority

    Energy Technology Data Exchange (ETDEWEB)

    Illing, R.O., E-mail: rowland@doctors.org.u [University College London Hospitals NHS Foundation Trust, 235 Euston Road, London NW1 2BU (United Kingdom); Ingham Clark, C.L.; Allum, C. [Whittington Hospital NHS Trust, London (United Kingdom)

    2010-04-15

    Aim: To review the provision of out-of-hours interventional radiology (IR) services in the London Strategic Health Authority (SHA). Materials and methods: All 29 acute hospitals in the London SHA were contacted between November 2008 and January 2009. A questionnaire based on the Royal College of Radiologists (RCR) guidelines assessed the provision of out-of-hours IR services. An 'ad-hoc' service was defined as on-call provision where not all the radiologists could perform intervention: If IR was required out of hours, an interventionalist came in when off-duty or the patient was transferred. Results: Seventeen out of the 29 (59%) hospitals provided ad-hoc out-of-hours services, eight (28%) provided a 24-hour rota, and four (14%) provide no out-of-hours cover. No ad-hoc service had formal transfer arrangements to a centre providing a 24 h service. Only two hospitals providing a 24 h service had six radiologists on the rota. Conclusion: Strategic planning for out-of-hours IR across London is recommended. This is likely to be welcomed by the hospitals involved, allowing informal arrangements to be formalized, and collaboration to provide comprehensive regional networks, provided appropriate funding is made available. A national audit is recommended; it is unlikely these findings are unique to London.

  17. Radiological protection optimization derived from radiation induced lesions in interventional cardiology finding

    International Nuclear Information System (INIS)

    Vano, E.; Arranz, L.; Sastre, J.M.; Ferrer, N.

    1997-01-01

    Interventional Cardiology is one of the specialties in which patients are submitted to the greatest radiation doses with x ray systems used for diagnostic purposes and then, it is also a specialty of high occupational radiation risk. In the last years, several cases of radiation induced lesions produced on patients derived of new complex interventional procedures have been described. As consequence, different rules for avoiding this kind of incidents have been recommended by International Organisations and regulatory Bodies. Nevertheless it has been devoted relatively few attention to the evaluation of the occupational risks that inevitably are also high in these facilities. In this work, some cases of radioinduced skin lesions produced on patients submitted to cardiac ablation procedures are described. Radiological protection considerations of interest for the regulatory Bodies are made, that permit to minimize the probability of these incidents, in what to the X-rays equipment is referred as well as to the operation procedures and level of radiation protection training of the medical specialists. (author)

  18. The consent process in interventional radiology: the role of specialist nurses

    Energy Technology Data Exchange (ETDEWEB)

    Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F. E-mail: derrick.martin@smtr.nhs.uk

    2004-03-01

    AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased.

  19. Preoperative Chemotherapy for Gastric Cancer: Personal Interventions and Precision Medicine

    Science.gov (United States)

    Xu, Wei; Beeharry, Maneesh K.; Yan, Min; Zhu, Zhenggang

    2016-01-01

    In spite of the declining incidence of gastric cancer (GC) in recent years, the mortality rate is still high. The asymptomatic nature and nonspecific clinical manifestations combined with the lack of efficient screening programs delay the diagnosis of GC. Therefore, the prevalence of advanced gastric cancer (AGC) has prompted the need for aggressive and intensive treatment options. Among the various treatment options for AGC, surgery is still the mainstay. However, the efficacy of surgery alone is not established. Results from multiple randomized controlled trials suggest that preoperative chemotherapy is promising intervention for the treatment and management of AGC. The main objective of neoadjuvant chemotherapy is to downstage or control micrometastasis in resectable tumor before surgery. On the other hand, conversion chemotherapy refers to surgical treatment aiming at R0 resection after chemotherapy for originally nonresectable or marginally resectable tumors. Nevertheless, preoperative chemoradiotherapy is considered beneficial for AGC patients. Over the last few decades, the combination of chemotherapy and targeted therapy prior to surgery demonstrated great results for the treatment of AGC. The rapid developments in genomics and proteomics have heralded the era of precision medicine. The combination of preoperative chemotherapy and precision medicine may enhance survival in AGC patients. PMID:28105420

  20. Joint CDRH (Center for Devices and Radiological Health) and state quality-assurance surveys in nuclear medicine: Phase 2 - radiopharmaceuticals

    International Nuclear Information System (INIS)

    Hamilton, D.R.; Evans, C.D.

    1986-08-01

    The report discusses survey results on aspects of the quality assurance of radio-pharmaceuticals from 180 nuclear-medicine facilities in the United States. Data were collected from facilities in 8 states. Demographic information about nuclear-medicine operations and quality-assurance programs was gathered by state radiation-control-program personnel. The data collected from the survey show an incomplete acceptance of quality-assurance practices for radiopharmaceuticals. Most of the facilities in the survey indicated that, because an inferior radiopharmaceutical was prepared so infrequently, they did not believe it was cost-effective to perform extensive quality-assurance testing. The Center for Devices and Radiological Health hopes that the information from the survey will stimulate nuclear-medicine professionals and their organizations to encourage appropriate testing of all radiopharmaceuticals

  1. Proceedings of the 1. National Forum of Science and Technology on Health; 13. Brazilian Congress on Biomedical Engineering; 4. Brazilian Congress of Physicists on Medicine; Brazilian Meeting on Biology and Nuclear Medicine; Brazilian Meeting on Radiological Protection

    International Nuclear Information System (INIS)

    Costa, E.T.; Martins, H.L.; Muehlen, S.S.; Rockman, T.M.B.

    1992-01-01

    This 1. National Forum of Science and Technology on Health presents works of several scientific institutions, including topics on bioengineering; modelling and simulation; sensors and transducers; ultrasonic on medicine; instrumentation processing of signs and medical images; biomedical informatics and clinical software; engineering of rehabilitation; bio-materials and bio-mechanical; clinical engineering; in vivo and in vitro nuclear medicine; radioisotope production and utilization; radiology; radiology protection and dosimetry; radiotherapy; evaluation of technology on health and education. (C.G.C.)

  2. Experimental method for calculation of effective doses in interventional radiology; Metodo experimental para calculo de dosis efectivas en radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Herraiz Lblanca, M. D.; Diaz Romero, F.; Casares Magaz, O.; Garrido Breton, C.; Catalan Acosta, A.; Hernandez Armas, J.

    2013-07-01

    This paper proposes a method that allows you to calculate the effective dose in any interventional radiology procedure using an anthropomorphic mannequin Alderson RANDO and dosimeters TLD 100 chip. This method has been applied to an angio Radiology procedure: the biliary drainage. The objectives that have been proposed are: to) put together a method that, on an experimental basis, allows to know dosis en organs to calculate effective dose in complex procedures and b) apply the method to the calculation of the effective dose of biliary drainage. (Author)

  3. Study on Generic Intervention Levels for Protecting the Public in a Nuclear Accident or Radiological Emergency

    International Nuclear Information System (INIS)

    Suzuki, E. F.; Sordi, G. M. A. A.; Rodrigues, D. L.

    2004-01-01

    Large amounts of radioactive material can be released to the environment in a nuclear accident or radiological emergency. In these cases, social and economical factors should be considered in the actions for protecting the public and to recover the environment, as these actions may affect not only the exposed individuals but also the society as a whole, because of the social impact and high costs. In 1994, the International Atomic Energy Agency, IAEA, published the radiological protection principles for intervention criteria in accident situations involving radioactive materials, as well as numeric values for the generic intervention levels, GIL, for the main countermeasures for protecting the public. These GIL values were selected to achieve broadly the maximum net benefit in many accident situations and, nowadays, those principles still represent the international consensus about this matter. On the other hand, the economic differences between countries can lead the optimization process to get GIL values that are quite different from those recommended. In this context, the monetary value of unit collective averted dose, called alpha-value, is a key element for the determination of the GIL. In this work, the method recommended by the IAEA, based on the human capital approach, was used to estimate the alpha-value for Brazil and the value of US$ 3268 per person-sievert was obtained, considering the year 2000 prices. The per capita costs of the countermeasures for protecting the public, as sheltering, evacuation, temporary relocation and permanent resettlement, were estimated and the cost-benefit analysis technique was applied to estimate the respective GIL applicable in the country. Some of the results for the GILs were smaller than those internationally recommended, even the alpha-value being about six times lower than the alpha-value considered by the IAEA. These results were discussed and they were also compared to values estimated by a similar study accomplished

  4. White paper of the European Society of Radiology (ESR) and the European Association of Nuclear Medicine (EANM) on multimodality imaging

    International Nuclear Information System (INIS)

    Gourtsoyiannis, Nicholas; McCall, Iain; Reiser, Maximilian; Silberman, Bruno; Bischof Delaloye, Angelika; Carrio, Ignacio; Cuocolo, Alberto; Knapp, Wolfram

    2007-01-01

    New multimodality imaging systems bring together anatomical and molecular information and require the competency and accreditation of individuals from both radiology and nuclear medicine. This paper sets out the positions and aspirations of the European Society of Radiology (ESR) and the European Association of Nuclear Medicine (EANM) working together on an equal and constructive basis for the future benefit of both specialties. ESR and EANM recognise the importance of coordinating working practices for multimodality imaging systems and that undertaking the radiology and nuclear medicine components of imaging with hybrid systems requires different skills. It is important to provide adequate and appropriate training in the two disciplines in order to offer a proper service to the patient using hybrid systems. Training models are proposed with the overall objective of providing opportunities for acquisition of special competency certification in multimodality imaging. Both organisations plan to develop common procedural guidelines and recognise the importance of coordinating the purchasing and management of hybrid systems to maximise the benefits to both specialties and to ensure appropriate reimbursement of these examinations. European multimodality imaging research is operating in a highly competitive environment. The coming years will decide whether European research in this area manages to defend its leading position or whether it falls behind research in other leading economies. Since research teams in the member states are not always sufficiently interconnected, more European input is necessary to create interdisciplinary bridges between research institutions in Europe and to stimulate excellence. ESR and EANM will work with the European Institute for Biomedical Imaging Research (EIBIR) to develop further research opportunities across Europe. European Union grant-funding bodies should allocate funds to joint research initiatives that encompass clinical research

  5. White paper of the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) on multimodality imaging

    International Nuclear Information System (INIS)

    Bischof Delaloye, Angelika; Carrio, Ignasi; Cuocolo, Alberto; Knapp, Wolfram; Gourtsoyiannis, Nicholas; McCall, Iain; Reiser, Maximilian; Silberman, Bruno

    2007-01-01

    New multimodality imaging systems bring together anatomical and molecular information and require the competency and accreditation of individuals from both nuclear medicine and radiology. This paper sets out the positions and aspirations of the European Association of Nuclear Medicine (EANM) and the European Society of Radiology (ESR) working together on an equal and constructive basis for the future benefit of both specialties. EANM and ESR recognise the importance of coordinating working practices for multimodality imaging systems and that undertaking the nuclear medicine and radiology components of imaging with hybrid systems requires different skills. It is important to provide adequate and appropriate training in the two disciplines in order to offer a proper service to the patient using hybrid systems. Training models are proposed with the overall objective of providing opportunities for acquisition of special competency certification in multimodality imaging. Both organisations plan to develop common procedural guidelines and recognise the importance of coordinating the purchasing and management of hybrid systems to maximise the benefits to both specialties and to ensure appropriate reimbursement of these examinations. European multimodality imaging research is operating in a highly competitive environment. The coming years will decide whether European research in this area manages to defend its leading position or whether it falls behind research in other leading economies. Since research teams in the Member States are not always sufficiently interconnected, more European input is necessary to create interdisciplinary bridges between research institutions in Europe and to stimulate excellence. EANM and ESR will work with the European Institute for Biomedical Imaging Research (EIBIR) to develop further research opportunities across Europe. European Union grant-funding bodies should allocate funds to joint research initiatives that encompass clinical research

  6. The Introduction of an Undergraduate Interventional Radiology (IR) Curriculum: Impact on Medical Student Knowledge and Interest in IR

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, M. [Bradford Royal Infirmary, Department of Radiology, Bradford Teaching Hospital Foundation Trust (United Kingdom); Shaygi, B. [Royal Devon and Exeter Hospital, Interventional Radiology Department (United Kingdom); Asadi, H., E-mail: asadi.hamed@gmail.com; Thanaratnam, P.; Pennycooke, K.; Mirza, M.; Lee, M., E-mail: mlee@rcsi.ie [Beaumont Hospital, Interventional Radiology Service, Department of Radiology (Ireland)

    2016-04-15

    IntroductionInterventional radiology (IR) plays a vital role in modern medicine, with increasing demand for services, but with a shortage of experienced interventionalists. The aim of this study was to determine the impact of a recently introduced IR curriculum on perception, knowledge, and interest of medical students regarding various aspects of IR.MethodsIn 2014, an anonymous web-based questionnaire was sent to 309 4th year medical students in a single institution within an EU country, both before and after delivery of a 10-h IR teaching curriculum.ResultsSeventy-six percent (236/309) of the respondents participated in the pre-IR module survey, while 50 % (157/309) responded to the post-IR module survey. While 62 % (147/236) of the respondents reported poor or no knowledge of IR compared to other medical disciplines in the pre-IR module survey, this decreased to 17 % (27/157) in the post-IR module survey. The correct responses regarding knowledge of selected IR procedures improved from 70 to 94 % for venous access, 78 to 99 % for uterine fibroid embolization, 75 to 97 % for GI bleeding embolization, 60 to 92 % for trauma embolization, 71 to 92 % for tumor ablation, and 81 to 94 % for angioplasty and stenting in peripheral arterial disease. With regard to knowledge of IR clinical roles, responses improved from 42 to 59 % for outpatient clinic review of patients and having inpatient beds, 63–76 % for direct patient consultation, and 43–60 % for having regular ward rounds. The number of students who would consider a career in IR increased from 60 to 73 %.ConclusionDelivering an undergraduate IR curriculum increased the knowledge and understanding of various aspects of IR and also the general enthusiasm for pursuing this specialty as a future career choice.

  7. The ICRU (International Commission on Radiation Units and Measurements): Its contribution to dosimetry in diagnostic and interventional radiology

    International Nuclear Information System (INIS)

    Wambersie, A.; Zoetelief, J.; Menzel, H. G.; Paretzke, H.

    2005-01-01

    The ICRU (International Commission on Radiation Units and Measurements was created to develop a coherent system of quantities and units, universally accepted in all fields where ionizing radiation is used. Although the accuracy of dose or kerma may be low for most radiological applications, the quantity which is measured must be clearly specified. Radiological dosimetry instruments are generally calibrated free-in-air in terms of air kerma. However, to estimate the probability of harm at low dose, the mean absorbed dose for organs is used. In contrast, at high doses, the likelihood of harm is related to the absorbed dose at the site receiving the highest dose. Therefore, to assess the risk of deterministic and stochastic effects, a detailed knowledge of absorbed dose distribution, organ doses, patient age and gender is required. For interventional radiology, where the avoidance of deterministic effects becomes important, dose conversion coefficients are generally not yet developed. (authors)

  8. The Future of Radiology

    Directory of Open Access Journals (Sweden)

    Alexander R. Margulis

    2011-07-01

    Full Text Available It has been my good fortune to live and practice radiology during a long period of momentous change – to see the transformation of the discipline from a supportive service into a mainstream, essential branch of clinical medicine. I remember wearing red goggles to adapt my vision before performing fluoroscopy; observing the horrible, now thankfully obsolete, practice of ventriculography, which was considered advanced neuroradiology; and performing other, now rarely prescribed procedures, such as double-contrast barium enemas and intravenous pyelography. Witnessing the beginnings of interventional radiology, I suggested its name in an editorial. I also had the good fortune to see the introduction of computed tomography (CT and a technology first known as nuclear magnetic resonance imaging. Together with fellow members of a committee of the American College of Radiology and editors of prestigious radiological journals, I took part in changing the name of the latter modality to MRI, freeing it from threatening implications. Looking back on these experiences, one lesson stands out above all: Innovation and transformation never cease. Looking forward, it is clear that radiology, along with the rest of medicine, is now undergoing further momentous changes that will affect the future of all those already practicing as well as those yet to start their careers.

  9. Functional phlebology. Phlebography, function studies, interventional radiology. Funktionelle Phlebologie. Phlebographie, Funktionstests, interventionelle Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Weber, J.; May, R.; Biland, L.; Endert, G.; Gottlob, R.; Justich, E.; Luebcke, P.; Mignon, G.; Moltz, L.; Partsch, H.; Petter, A.; Ritter, H.; Soerensen, R.; Widmer, L.K.; Widmer, M.T.; Zemp, E.

    1990-01-01

    The book presents a complete survey of the problems occurring in the venous system of the legs, pelvis, and abdomen. The material is arranged in the following main chapters: (1) Introduction to the phlebology of the low-pressure system in the lower part of the body; (2) Phlebographic methods; (3) Instrumented function studies and methods; (4) Pathologic findings; (5) Diagnostic methods and vein therapy; (6) Interventional radiology; (7) Expert opinions on venous lesions including insurance aspects. The first chapter encompasses a section briefly discussing the available instrumented diagnostic imaging methods. In view of the novel imaging methods, namely digital subtraction phlebology, sonography, CT and MRI, the classical phlebography remains the gold standard, so to speak: all currently available phlebographic methods for imaging the venes in the legs, pelvis and abdomen are explained and comparatively evaluated. Instrumented function tests such as Doppler effect ultrasound testing, plethysmography, peripheral and central phlebodynamometry (venous pressure measurement) are analysed for their diagnostic value and as alternative or supplementing techniques in comparison to phlebology. (orig./MG) With 843 figs., 101 tabs.

  10. The Role of Interventional Radiology in the Diagnosis and Management of Male Impotence

    International Nuclear Information System (INIS)

    Spiliopoulos, Stavros; Shaida, Nadeem; Katsanos, Konstantinos; Krokidis, Miltiadis

    2013-01-01

    Erectile dysfunction (ED) is defined as the persistent inability to reach or maintain penile rigidity enough for sexual satisfaction. Nearly 30% of the men between ages 40 and 70 years are affected by ED. A variety of pathologies, including neurological, psychological, or endocrine disorders and drug side effects, may incite ED. A commonly identified cause of ED is vascular disease. Initial diagnostic workup includes a detailed physical examination and laboratory tests. Whilst duplex ultrasound is considered the first-line diagnostic modality, intra-arterial digital subtraction angiography is still considered the “gold standard” for the diagnosis of arteriogenic impotence. Percutaneous endovascular treatment may be offered in patients with vasculogenic ED that has failed to respond to oral medical therapy as an alternative to penile prosthesis or open surgical repair. In arteriogenic ED balloon angioplasty of the aorto-iliac axis, and in veno-occlusive ED, percutaneous venous ablation using various embolization materials has been reported to be safe and to improve sexual performance. Recently, the ZEN study investigated the safety and feasibility of drug-eluting stents for the treatment of arteriogenic ED attributed to internal pudendal artery stenosis with promising preliminary results. This manuscript highlights the role of interventional radiology in the diagnosis and minimally invasive treatment of male impotence

  11. The Role of Interventional Radiology in the Diagnosis and Management of Male Impotence

    Energy Technology Data Exchange (ETDEWEB)

    Spiliopoulos, Stavros [Patras University Hospital, Department of Radiology (Greece); Shaida, Nadeem [Cambridge University Hospitals NHS Trust, Addenbrooke' s University Hospital, Department of Radiology (United Kingdom); Katsanos, Konstantinos [Guy' s and St Thomas' NHS Trust, Department of Radiology (United Kingdom); Krokidis, Miltiadis, E-mail: mkrokidis@hotmail.com [Cambridge University Hospitals NHS Trust, Addenbrooke' s University Hospital, Department of Radiology (United Kingdom)

    2013-10-15

    Erectile dysfunction (ED) is defined as the persistent inability to reach or maintain penile rigidity enough for sexual satisfaction. Nearly 30% of the men between ages 40 and 70 years are affected by ED. A variety of pathologies, including neurological, psychological, or endocrine disorders and drug side effects, may incite ED. A commonly identified cause of ED is vascular disease. Initial diagnostic workup includes a detailed physical examination and laboratory tests. Whilst duplex ultrasound is considered the first-line diagnostic modality, intra-arterial digital subtraction angiography is still considered the 'gold standard' for the diagnosis of arteriogenic impotence. Percutaneous endovascular treatment may be offered in patients with vasculogenic ED that has failed to respond to oral medical therapy as an alternative to penile prosthesis or open surgical repair. In arteriogenic ED balloon angioplasty of the aorto-iliac axis, and in veno-occlusive ED, percutaneous venous ablation using various embolization materials has been reported to be safe and to improve sexual performance. Recently, the ZEN study investigated the safety and feasibility of drug-eluting stents for the treatment of arteriogenic ED attributed to internal pudendal artery stenosis with promising preliminary results. This manuscript highlights the role of interventional radiology in the diagnosis and minimally invasive treatment of male impotence.

  12. Optimization of radiation protection in diagnostic and interventional radiology: Which is the future?

    International Nuclear Information System (INIS)

    Tsapaki, V.

    2012-01-01

    As quoted in the latest UNSCEAR 2008 report: 'it appears that the world is entering another period of major technological changes, where the impact of these changes on the population dose worldwide in the future will be difficult to predict'. It is more than true that in this fast changing world and immense technological advances, especially in the medical sector, scientists run a marathon to be able to follow the new techniques that are continuously introduced for the benefit of the patient. Almost half of the radiation to the population in diagnostic radiology arises due to CT and interventional techniques. More and more medical specialties as well as other professions (nurses, technicians, managers, etc.) are currently being introduced into the term 'radiation safety culture' and 'optimization'. Some of these stakeholders were not aware of these expressions and were never trained or educated on these subjects. Each of these specialties should therefore be approached in a different way, indicating and underlining the specific roles of the experts, in order to persuade them to include radiation safety in their every day clinical routine. Below, some of these issues are identified and possible ways to move forward in the future are suggested. (author)

  13. Simulators in catheter-based interventional radiology: training or computer games?

    International Nuclear Information System (INIS)

    Gould, D.A.; Kessel, D.O.; Healey, A.E.; Johnson, S.J.; Lewandowski, W.E.

    2006-01-01

    Training in interventional radiology (IR) relies on a traditional apprenticeship; to protect patients, expert supervision is mandatory until knowledge, attitudes and practical skills have been certified as satisfactory. However, the current quality of IR training is threatened by reduced time for trainees to learn, as well as a loss of basic diagnostic, training cases to non-invasive imaging. At the same time, IR techniques are becoming a focus of interest to a range of other clinical specialities. To address this training shortfall there is a need to develop novel training alternatives such as simulator models. Few simulator models in any medical field have been successfully validated to show improved clinical skills in treating patients. To date no endovascular simulator has met this standard. A good simulator must be based around key performance measures (metrics) derived from careful analysis of the procedure to be replicated. Metrics can be determined by trained psychologists from a direct analysis of the content of the job or task to be tested. The identification of these critical measures of performance is a complex process which must be tailored to a training curriculum to be effective. Simulators based on flawed metrics will invariably lead to unsatisfactory assessment. It follows that simulator development must involve the statutory licensing authorities. Equally it is essential that we do not assume that training on a particular simulator will correlate with the ability to perform the task in the real world. This 'transfer of training' must be rigorously proven by validation studies

  14. Comparison of patient doses in interventional radiology procedures performed in two large hospitals in Greece

    International Nuclear Information System (INIS)

    Papageorgiou, E.; Tsapaki, V.; Tsalafoutas, I. A.; Maurikou, E.; Kottou, S.; Orfanos, A.; Karidas, G.; Fidanis, T.; Zafiriadou, E.; Neofotistou, V.

    2007-01-01

    Purpose of the study was to determine patient doses in the most common interventional radiology (IR) procedures performed in two large Greek hospitals. A total of 164 patients who underwent 4 types of IR procedures were studied. Fluoroscopy time, total exposure time, number of frames, number of runs, radiation field size, and cumulative dose-area product (DAP) were recorded. The median DAP values for carotid arteriography and lower limb arteriography were 66 and 123 Gy cm 2 for hospital 'A' and 21 and 49 Gy cm 2 for hospital 'B'. For the cerebral arteriographies performed in hospital 'A', the median DAP was 116 Gy cm 2 while for the hepatic embolizations performed in hospital 'B', it was 104 Gy cm 2 . The DAP values observed in hospital 'A' for carotid arteriography and lower limb arteriography were almost three times than those of hospital 'B'. From the data analysis, it is evident that dose optimization in hospital 'A' should be pursued through revision of the techniques used. (authors)

  15. A Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) in Radiology.

    Science.gov (United States)

    Spalluto, Lucy B; Spottswood, Stephanie E; Deitte, Lori A; Chern, Alexander; Dewey, Charlene M

    2017-06-01

    Women are under-represented in the field of radiology, occupy a minority of leadership positions, and, at our institution, have not achieved the same level of academic success as their male counterparts. Consequently, the authors designed, implemented, and evaluated the Leadership Intervention to Further the Training of Female Faculty (LIFT-OFF) program to (1) improve access to opportunities for women's faculty development and advancement, and (2) improve clarification of expectations about the role and path of advancement. LIFT-OFF was developed based on the results of a needs assessment survey. The results generated 14 priority topics, which served as the basis for educational modules conducted by expert speakers. Module effectiveness was assessed with pre- and postsurveys to elicit participant knowledge about the targeted subject matter. A formative program evaluation was performed at the completion of year 1 of 2 to assess outcomes and impacts to date. Seventeen of 55 (31%) educational module post-survey questions demonstrated a statistically significant (P leadership positions. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  16. Examination of types of exposure and management methods for nurses in interventional radiology

    International Nuclear Information System (INIS)

    Mori, Hiroshige; Fujii, Tomonori; Koshida, Kichiro; Ichikawa, Katsuhiro

    2007-01-01

    Although a large number of studies have been done on exposure to operators and doctors during interventional radiology (IVR), there have been very few reports on nurses. This study was carried out to clarify the situation regarding exposure for nurses, and provides examples of how to estimate and manage. We measured space dose-rate distributions with an ionization survey meter, and personal exposure dose by a small fluorescent grass dosimeter (Dose Ace). The experimental results disclosed that there tended to be two types of exposure depending on the task performed. Head and neck (collar level) were associated with the highest exposure dose, which was observed in nurses assisting operators. Alternatively, knees showed the highest exposure dose, which was observed in nurses observing and assisting the patient. When estimation of skin equivalent exposure at the knees is needed, it can be calculated by using the value measured at the collar level. Furthermore, in estimating exposure dose, the directional and energy characteristics of personal dosimeters should be considered adequate. For radiation management, a circular protective sheet can be placed around the patient's lower area and a protective screen near the patient's head, and basic and practical education can be given. We concluded that these are highly useful for the personal monitoring of nurses engaged in IVR. (author)

  17. Analysis and assessment of the detriment in interventional radiology using biological dosimetry methods

    International Nuclear Information System (INIS)

    Montoro, A.; Almonacid, M.; Villaescusa, J.I.; Barquinero, J.F.; Rodriguez, P.; Barrios, L.; Verdu, G.; Ramos, M.

    2006-01-01

    Interventional radiologist and staff members usually are exposed to high levels of scattered radiation. As a result, the exposition to radiation procedures can produce detrimental effects that we would have to know. Effective dose is the quantity that better estimates the radiation risk. For this study we have realized an estimation of the radiological detriment to exposed workers of the Hospital la Fe de Valencia. For it, have been used physical doses registered in detectors T.L.D., and doses estimated by biological dosimetry in lymphocytes of peripheral blood. There has been estimated for every case the probability of effect of skin cancer and of non-solid cancers (leukaemia, lymphoma and myeloma), being compared with the baseline probability of natural effect. Biological doses were obtained by extrapolating the yield of dicentrics and translocations to their respective dose -effect curves. The discrepancies observed between physically recorded doses and biological estimated doses indicate that workers did not always wear their dosimeters or the dosimeters were not always in the radiation field. Cytogenetic studies should be extended to more workers to assess the risk derived from their occupational exposure. (authors)

  18. Analysis and assessment of the detriment in interventional radiology using biological dosimetry methods

    Energy Technology Data Exchange (ETDEWEB)

    Montoro, A.; Almonacid, M.; Villaescusa, J.I. [Hospital Univ. la Fe de Valen cian, Servicio de Proteccion Radiologica, Valencia (Spain); Barquinero, J.F.; Rodriguez, P. [Universitat Autonom a de Barcelona, Servicio de Dosimetria Biologica, Unidad de Antropologia, Departamento de Biologia Animal, Vegetal y Ecologia., Barcelona (Spain); Barrios, L. [Universidad Autonoma de Barcelona, Dept. de Biologia Celular y Fisiologia. Unidad de Biologia Celular, Barcelona (Spain); Verdu, G.; Ramos, M. [Universidad Politecnica de Valencia, Dept. de Ingenieria Quimica y Nuclear, Valencia, (Spain)

    2006-07-01

    Interventional radiologist and staff members usually are exposed to high levels of scattered radiation. As a result, the exposition to radiation procedures can produce detrimental effects that we would have to know. Effective dose is the quantity that better estimates the radiation risk. For this study we have realized an estimation of the radiological detriment to exposed workers of the Hospital la Fe de Valencia. For it, have been used physical doses registered in detectors T.L.D., and doses estimated by biological dosimetry in lymphocytes of peripheral blood. There has been estimated for every case the probability of effect of skin cancer and of non-solid cancers (leukaemia, lymphoma and myeloma), being compared with the baseline probability of natural effect. Biological doses were obtained by extrapolating the yield of dicentrics and translocations to their respective dose -effect curves. The discrepancies observed between physically recorded doses and biological estimated doses indicate that workers did not always wear their dosimeters or the dosimeters were not always in the radiation field. Cytogenetic studies should be extended to more workers to assess the risk derived from their occupational exposure. (authors)

  19. Estimation of personal dose based on the dependent calibration of personal dosimeters in interventional radiology

    International Nuclear Information System (INIS)

    Mori, Hiroshige; Koshida, Kichiro; Ichikawa, Katsuhiro

    2007-01-01

    The purpose of present study is, in interventional radiology (IVR), to elucidate the differences between each personal dosimeter, and the dependences and calibrations of area or personal dose by measurement with electronic dosimeters in particular. We compare space dose rate distributions measured by an ionization survey meter with the value measured by personal dosimeter: an optically stimulated luminescence, two fluoroglass, and two electronic dosimeters. Furthermore, with electronic dosimeters, we first measured dose rate, energy, and directional dependences. Secondly, we calibrated the dose rate measured by electronic dosimeters with the results, and estimated these methods with coefficient of determination and Akaike's Information Criterion (AIC). The results, especially in electronic dosimeters, revealed that the dose rate measured fell by energy and directional dependences. In terms of methods of calibration, the method is sufficient for energy dependence, but not for directional dependence, because of the lack of stable calibration. This improvement poses a question for the future. The study suggested that these dependences of the personal dosimeter must be considered when area or personal dose is estimated in IVR. (author)

  20. [Vascular interventional radiology: a fundamental procedure for the management of paediatric trauma].

    Science.gov (United States)

    Bordón Cabrera, E; Laín, A; Gander, R; Pérez Lafuente, M; Díez Miranda, I; Fontecha, C G; Seidler, L; Delgado, I; Cañadas Palazón, S; Lloret, J

    2016-01-25

    The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques. In the reported study period 16 patients underwent VIR procedures. Medium age was 13 years (5-17). The most frequent lesion mechanism was traffic accident (8 out of 17) and 93,75% were blunt traumas. Findings on initial Computed Tomography were 12 contrast blushes and 2 absences of arterial flow. In 2 cases the contrast blush appeared 48 hours after the accident. Arteriography allowed us to localize the bleeding vessels in all the cases, performing selective or supraselective renal (7), pelvic (5), hepatic (3), splenic (1) and intercostal (1) embolization. One patient required an endoprothesis for renal revascularization. Two cases needed additional surgical procedures (2 nephrectomies) because of complete section of the renal artery (1) and disruption of the ureteropelvic junction (1). One case required hemofiltration in relation to rhabdomyolysis. In our experience VIR is a valuable diagnostic and therapeutic procedure for the management of paediatric trauma patients, with high effectiveness and a low complication rate.

  1. Radiation protection in interventional radiology: survey results of attitudes and use.

    Science.gov (United States)

    Lynskey, G Emmett; Powell, Daniel K; Dixon, Robert G; Silberzweig, James E

    2013-10-01

    To assess attitudes of interventional radiologists toward personal radiation protection and the use of radiation protection devices. Invitations to an anonymous online survey that comprised eight questions focused on operator attitudes toward radiation protection devices were sent via e-mail to the active membership of the Society of Interventional Radiology (SIR): a total of 3,158 e-mail invitations. A single reminder e-mail was sent. There were 504 survey responders (16% response rate). Reported radiation safety device use included lead apron (99%), thyroid shield (94%), leaded eyeglasses (54%), ceiling-suspended leaded shield (44%), rolling leaded shields (12%), ceiling-suspended/rolling lead-equivalent apron (4%), radiation-attenuating sterile surgical gloves (1%), and sterile lead-equivalent patient-mounted drape (4%). Reasons commonly cited for not using certain devices were comfort (eyewear), ease of use (mounted shields), and lack of availability (rolling/hanging shields and patient-mounted shields). Interventionalists have an array of tools from which to choose for personal radiation protection; however, for a variety of reasons related to lack of availability or choice, these tools are not universally employed. Further study may be of value to clarify why comfort was cited most often as the primary barrier to the use of protective eyewear and difficulty of use was cited as the primary barrier to use of mounted shields (despite reporting that concern for radiation-induced injury to the eye is paramount). It may also be of interest to further study why certain devices with demonstrable protection effects are not readily available, such as rolling/hanging and patient-mounted shields. © SIR, 2013.

  2. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    International Nuclear Information System (INIS)

    Uberoi, Raman; Tapping, Charles Ross; Chalmers, Nicholas; Allgar, Victoria

    2013-01-01

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate ( 9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter placement so that we are better able to advise patients. There is a significant learning curve associated with IVC filter insertion, and when a filter is placed with the intention of removal, procedures should be in place to avoid the patient being lost to follow-up

  3. The radiological protection in the nuclear medicine practice; La proteccion radiologica en la practica de medicina nuclear

    Energy Technology Data Exchange (ETDEWEB)

    Maldonado M, H., E-mail: hmaldonado@cnsns.gob.m [Comision Nacional de Seguridad Nuclear y Salvaguardias, Dr. Barragan No. 779, Col. Narvarte, 03020 Mexico D. F. (Mexico)

    2010-09-15

    The nuclear medicine practice dates of the 1950 years, in this work the achievements reached as regards radiological protection are shown, although even lack a lot to make, the doses for the occupationally exposed personnel have decreased with lapsing of the years, thanks to the perception of the nuclear physicians to improve the administration techniques of the radioactive material, the decrease of administered activity and the unit doses use among the most remarkable advances. The changes in the equipment s technology to quantify the activity to administer, detection systems and image formation have demanded the development of the new professionals of the nuclear medicine that allows give protection to the patient. This improvement needs to consolidate with the appropriate normative development, the involved personnel qualification and the methods and procedures actualization to improve the protection of the occupationally exposed personnel, the public, the environment and the patient. (Author)

  4. Radiological protection and routinary controls of an activimeter with a cesium and barium sources in an nuclear medicine center

    International Nuclear Information System (INIS)

    Morales L, M.E.

    2006-01-01

    In the present work the results when carrying out the routine controls in a Deluxe Isotope (Calibrator II) equipment, with some sources of Cesium 137 and Barium 133, in a Nuclear Medicine Center that operates from the year 1983 in a modern one construction inside the Institute of Neoplastic Illnesses (INEN) are shown. Taking in account the Radiological Protection measures to verify if the equipment responds to the personnel's demands in the measurements of activities of the diverse radionuclides that are used in different types of exams that are carried out in this Nuclear Medicine Center are the objectives of this work. This Center was equipped initially with donated equipment by the International Atomic Energy Agency (IAEA) with those that it develops assistance, educational works and of research, giving services to patients of the INEN and other public and private medical centers. (Author)

  5. Radiological interventions in inflammatory bowel disease; Interventionelle Verfahren bei entzuendlichen Darmerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Krolak, C.; Rock, C.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen (Germany)

    2003-01-01

    Abscesses, fistulas,hemorrhages and stenoses are common complications of inflammatory bowel diseases.This study provides an overview on various methods of radiological intervention and the clinical usefulness of these methods is analyzed. The success rate of percutaneous abscess drainage (PAD), embolisation of hemorrhages and dilatation of bowel stenoses is reviewed and current literature is adressed.Success rate is defined in terms of cure rate and need for subsequent surgery. After PAD, surgery can be avoided during the observation period in about 50% of patients with abscesses due to Crohn's disease and diverticulitis.Preoperative PAD reduces the degree of invasiveness and thus the risk of surgery.Abscess recurrence is found with the same frecuency following surgery or PAD.Bowel dilatation can be performed both with radiological and with endoscopic guidance.Embolisation of GI-hemorrhage is technically feasible, but the indication should be limited to strictly selected cases. In treating abscesses and fistulas associated with Crohn's disease and diverticulitis, PAD is a valuable treatment option.Embolisation or dilatation are restricted to rare cares. (orig.) [German] Fragestellung Abszesse, Fisteln, Blutungen und Darmstenosen sind typische Komplikationen entzuendlicher Darmerkrankungen. Es werden verschiedene radiologisch-interventionelle Verfahren vorgestellt und ihre Wertigkeit fuer die Behandlung geprueft.Methodik Unter Beruecksichtigung der neueren Literatur werden der Erfolg der perkutanen Abszessdrainage (PAD) hinsichtlich der Ausheilung und Notwendigkeit einer folgenden OP, die perkutane Embolisation und die Dilatation von Darmstenosen bewertet.Ergebnisse Die PAD vermeidet bei 50% der Patienten mit Morbus Crohn und bei 20% der Patienten mit Divertikulitis eine OP im kurzfristigen Verlauf.Die PAD verringert die Invasivitaet einer nachfolgenden OP.Rezidivabszesse treten nach PAD und OP gleich haeufig auf.Die Dilatation entzuendlicher Darmstenosen

  6. Utilisation and outcomes following the introduction of an interventional radiology day unit

    International Nuclear Information System (INIS)

    Makris, G.C.; Shaida, N.; Pyneeandee, R.; Shaw, A.; See, T.C.

    2016-01-01

    Aim: To assess the utilisation of an interventional radiology day unit (RDU), the rates of on-time discharges, the financial performance of the unit, and finally, the patient satisfaction rates. Materials and methods: Data regarding the unit utilisation, discharge times, and complications were retrospectively collected for the first 2 years of operation of the unit (1 April 2013 to 1 January 2015). In addition, monitoring the activity going through the RDU and applying a contribution margin to the freed-up beds measured the financial performance. The data were provided by the finance department of the hospital. Satisfaction survey questionnaires were sent randomly by post to 100 patients who had been previously admitted to the RDU. Results: During the study period, 3019 patients were admitted to the RDU, comprising 1426 during the first year and 1513 during the second. On average, 5.6 patients were discharged from the RDU on every working day during the first year and 7.1 patients during the second (21% increase in the discharge rate). Given the 8-hour working time configuration of the unit, a realistic 80% utilisation rate of the RDU's seven beds could free a total of 1400 inpatient bed days over a full year. The cost of delivering these episodes of care was reduced by approximately 50%. From the financial data, it was estimated that the RDU managed to achieve a total of £393,000 in savings for the Trust for the financial year 2013–2014. The return rate of the patient satisfaction survey was 40%. All patients were satisfied with their overall RDU experience. Conclusion: The RDU has brought significant benefits for patients and the Trust without compromises in safety or quality. - Highlights: • Radiology Day units can improve workflow through improved efficiency. • RDUs can decrease the treatment-related costs mainly by reducing the need for unnecessary overnight hospitalisation. • They appear to be welcome by the patients with excellent feedback so

  7. Deepening the reform of medical education, strengthening the training of reserve specialists in interventional radiology: a profound rethinking based on a survey of medical students

    International Nuclear Information System (INIS)

    Ren Chongyang; Di Zhenhai; Li Linsun

    2010-01-01

    Although the interventional radiology, a rapidly expanding medical specialty, has already been widely popularized and generally accepted for many years, it is still facing lots of challenges and turf wars, such as the brain drain, understaffed and the gap between the old and the young. This article attempts to analyze the reasons through investigating the current teaching situation of interventional radiology in medical colleges and finding out the undergraduates' attitude to interventional radiology, in order to explore possible paths for solving the imbalance between supply and demand of qualified personnel. (authors)

  8. Medical intervention in radiological emergencies, formation and training; Intervencion medica en emergencias radiologicas, formacion y adiestramiento

    Energy Technology Data Exchange (ETDEWEB)

    Cardenas H, J. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba)]. e-mail: cardenas@cphr.edu.cu

    2006-07-01

    The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

  9. American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine.

    Science.gov (United States)

    Finnoff, Jonathan T; Hall, Mederic M; Adams, Erik; Berkoff, David; Concoff, Andrew L; Dexter, William; Smith, Jay

    2015-02-01

    The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilisation is by non-radiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases and hydrodissections. Critically review the literature related to the accuracy, efficacy and cost-effectiveness of ultrasound-guided injections (USGIs) in major, intermediate and small joints; and soft tissues. Systematic review of the literature. USGIs are more accurate than landmark-guided injections (LMGIs; strength of recommendation taxonomy (SORT) Evidence Rating=A). USGIs are more efficacious than LMGIs (SORT Evidence Rating=B). USGIs are more cost-effective than LMGIs (SORT Evidence Rating=B). Ultrasound guidance is required to perform many new procedures (SORT Evidence Rating=C). The findings of this position statement indicate there is strong evidence that USGIs are more accurate than LMGI, moderate evidence that they are more efficacious and preliminary evidence that they are more cost-effective. Furthermore, ultrasound-guided (USG) is required to perform many new, advanced procedures and will likely enable the development of innovative USG surgical techniques in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Professional development for radiographers and post graduate nurses in radiological interventions: Building teamwork and collaboration through drama.

    Science.gov (United States)

    Lundén, M; Lundgren, S M; Morrison-Helme, M; Lepp, M

    2017-11-01

    The rapid development within Interventional Radiology presents new challenges. Hybrid operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic resonance imaging and other techniques. This means that several disciplines and professionals need to work in new constellations creating a multidisciplinary team around the patient. In accordance with this development, higher professional education must provide new pedagogic strategies to successfully address the knowledge expected in today's complex working life. To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to foster team work and collaboration in the field of radiography and learning. A qualitative approach, closely related to Ethnography, was utilized. The Drama Workshop utilising Forum Theatre created a dynamic learning environment and enabled the participants from three professions to understand each other's priorities better. The use of drama within health care education allows the students to take different roles in order to find the best way to co-operate. Forum Theatre is a useful learning medium in order to promote teamwork and collaboration in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to engage the participants at a deeper level and to experience various communication strategies and how the outcome changed depending on the approach. This can lead to improved teamwork and collaboration. Copyright © 2017 The College of Radiographers. All rights reserved.

  11. Percutaneous transgastric interventional radiology-operated duodenoscopy for the identification of duodenal perforation and Graham patch dehiscence

    Directory of Open Access Journals (Sweden)

    Ravi Nara Srinivasa, MD

    2017-12-01

    Full Text Available Patients with a Roux-en-Y gastric bypass may be challenging diagnostic and therapeutic dilemmas for gastroenterologists and endoscopists due to anatomic considerations. Pancreaticobiliary limb pathology is particularly difficult to diagnose from standard endoscopic approaches as it often requires double balloon enteroscopy. Percutaneous access and gastrostomy placement into the gastric remnant, however, is a commonly performed procedure by interventional radiology. This report describes the identification of duodenal perforation and Graham patch dehiscence in the pancreaticobiliary limb of a patient with a prior Roux-en-Y gastric bypass who had failed traditional endoscopic measures, using transgastric remnant interventional duodenoscopy and confirmed with methylene blue injection into a periduodenal abscess.

  12. Patient dose assessment in various Interventional radiology and cardiology procedures in Algeria (IAEA regional project results)

    International Nuclear Information System (INIS)

    Khelassi-Toutaoui, Nadia; Merad, Ahmed; Toutaoui, A.E.K.; Bairi, Souad

    2008-01-01

    Full text: Purpose: To evaluate patient doses in Interventional Radiology (IR) and Cardiology (IC) procedures in Algeria, within the framework of an International Atomic Energy Agency (IAEA) regional project on radiation protection of patients and medical exposure control (RAF 9033). Materials and Methods: Three public hospitals (CHU Bab el Oued, CHU Parnet and CHU Mustapha) and one specialised Cardiology Service (Clinique Maouche) were chosen for the study. For Maximum Skin Dose (MSD) evaluation, gafchromic films XR type R were used, placed on patient's back before the procedure. The Dose Area Product (DAP) and MSD were measured in 57 IR and IC procedures, either diagnostic or therapeutic. Results: The results revealed large variations in MSD (0.06-3.3 Gy) and DAP (5.5-332 mGycm 2 ). Mean MSD was 0.227 Gy in cerebral angiography, 0.202 Gy in coronary angiography, 1.162 Gy in Percutaneus Transluminal Coronary Angioplasty (PTCA) and 0.128 in abdominal angiography. The correlation of DAP and MSD was significant (r = 0.7). The correlation was DAP and fluoroscopy time was also significant (r = 0.8). Conclusion: The highest MSD values were found in PTCA which is a therapeutic procedure. Two PTCAs out of the 57 procedures measured in total had MSD over the threshold of 2 Gy for deterministic effects (MSD 1 = 3.0 Gy and MSD 2 3.3 Gy). The large variations in MSD reveal the need to continuously monitor patient doses in IR and IC procedures with special emphasis in PTCA procedure. (author)

  13. Hybrid treatment combining emergency surgery and intraoperative interventional radiology for severe trauma.

    Science.gov (United States)

    Kataoka, Yuichi; Minehara, Hiroaki; Kashimi, Fumie; Hanajima, Tasuku; Yamaya, Tatsuhiro; Nishimaki, Hiroshi; Asari, Yasushi

    2016-01-01

    To evaluate the efficacy of hybrid treatment combining emergency surgery and intraoperative interventional radiology (IVR) for severe trauma. The records of 63 severely injured patients who underwent concurrent emergency surgery and IVR at our emergency centre from 1999 through 2013 were retrospectively reviewed. Mobile digital subtraction angiography device was used in the operating room when performing IVR. Patients undergoing hybrid treatment combining intraoperative IVR and emergency surgery (intraoperative IVR group) were compared with those undergoing IVR in the angiography suite before or after emergency surgery (control group). Thirteen patients underwent hybrid treatment (intraoperative IVR group). Of these 13 patients, 7 underwent treatment for abdominal organ injuries, and 6 for multiregional injuries. Emergency operations were laparotomy (n=12), thoracotomy (n=1), craniotomy (n=1), and haemostasis of the lower extremities (n=1). Five patients underwent damage control surgery. IVR included transarterial embolisation (n=12), endovascular stent or stent-graft placement (n=2), and embolisation of a portal vein by laparotomy (n=2). The mean ISS was 40. The actual overall survival rate was 85%, and the probability of survival (Ps) was 62%. The control group included 45 patients. Five patients who met exclusion criteria were not included in the control group. Age, ISS, RTS, Ps, pH and base excess on arrival, and blood transfusion volume during operation and IVR did not differ significantly between the groups. Total time during operation and IVR was significantly shorter in the intraoperative IVR group than in the control group (229 [SD 72]min vs. 355 [SD 169]min; p=0.007). The mortality were 15 (95% CI 2-45) % in the intraoperative IVR group vs. 36 (95% CI 22-51) % in the control group. Hybrid treatment combining emergency surgery and intraoperative IVR can be a novel treatment strategy for severe trauma, and it will improve patient outcomes due to reduction

  14. Identifying the Learning Curve for Uterine Artery Embolisation in an Interventional Radiological Training Unit

    Energy Technology Data Exchange (ETDEWEB)

    Das, Raj, E-mail: rajdas@nhs.net, E-mail: raj.das@stgeorges.nhs.uk; Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Wang, Haofan, E-mail: wwhhff123@gmail.com; Belli, Anna-Maria, E-mail: anna.belli@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom)

    2015-08-15

    AimA clear understanding of operator experience is important in improving technical success whilst minimising patient risk undergoing endovascular procedures, and there is the need to ensure that trainees have the appropriate skills as primary operators. The aim of the study is to retrospectively analyse uterine artery embolisation (UAE) procedures performed by interventional radiology (IR) trainees at an IR training unit analysing fluoroscopy times and radiation dose as surrogate markers of technical skill.MethodsTen IR fellows were primary operator in 200 UAE procedures over a 5-year period. We compared fluoroscopy times, radiation dose and complications, after having them categorised according to three groups: Group 1, initial five, Group 2, >5 procedures and Group 3, penultimate five UAE procedures. We documented factors that may affect screening time (number of vials employed and use of microcatheters).ResultsMean fluoroscopy time was 18.4 (±8.1), 17.3 (±9.0), 16.3 (±8.4) min in Groups 1, 2 and 3, respectively. There was no statistically significant difference between these groups (p > 0.05) with respect to fluoroscopy time or radiation dose. Analysis after correction for confounding factors showed no statistical significance (p > 0.05). All procedures were technically successful, and total complication rate was 4 %.ConclusionUAE was chosen as a highly standardised procedure followed by IR practitioners. Although there is a non-significant trend for shorter screening times with experience, technical success and safety were not compromised with appropriate Consultant supervision, which illustrates a safe construct for IR training. This is important and reassuring information for patients undergoing a procedure in a training unit.

  15. Psychological intervention in medical preparedness and response to nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Lei, Cuiping; Liu, Ying

    2008-01-01

    Full text: Although the incidence rate of nuclear or radiological accident and their terror attack is very low, their influence is tremendous because of the unexpected of their occurrence and uncertainty of their damage degree. An attack involving the release of radiation will create uncertainty, fear, and terror. Therefore, the management of acute psychological and behavioral responses is likely to be as important and challenging as the treatment of radiation-related injuries and illnesses. In this paper, we introduce the principle of psychological intervention at the preparation stage and during and after emergency. At the preparation stage, people should be educated by various means to prevent them from the impact of accident. When accident happens, effective action should be taken immediately to reduce the psychological influence. Special groups such as children and pregnant women must be considered. Furthermore, we analyze the symptom of different groups including victims, the public and responders and put forward the methods to prevent and treat psychological damage. After radiation accident, victims who have been exposed or anticipate possible exposure may experience feelings of vulnerability, anxiety, and lack of control. The most important element is providing good medical care. Moreover, communication between patients and their family is very important too. The public in the affected community is likely to be anxious and terrified. Trusted and informed leadership should be assigned to give psychological support in counselling center established at monitoring and evacuation centers. Government must be honest in communication with public and media. Responders have to perform their duty under stressful condition. Some of them are unable to deal with such stress could develop mental health problems such as post traumatic stress disorder, substance abuse or depression. Protective clothing and dosimeters must be provided to ensure responders' safety. Moreover

  16. National survey of patient and staff doses in interventional radiology - first results

    International Nuclear Information System (INIS)

    Borisova, R.; Vassileva, J.

    2008-01-01

    The purpose of this work, is to present the first results from the National study of patient and staff doses in interventional radiology. Up to the present moment, 6 X-ray units and 12 examinations have been included in the study - 6 diagnostic and 6 therapeutic. The following information was recorded for each examination: type and complexity of the procedure, patient data, procedure parameters (frame rate, fluoroscopy time), patient dose (kerma-area product, P KA ) and staff dose (dose of the eye lens of the operator). P KA was directly recorded from the X-ray unit reading, or measured with externally mounted kerma-area product meters DIAMENTOR E2 and DIAMENTOR M4 KDK (PTW, Freiburg). The eye lens dose was measured with an EDD-30 (UNFORS, Sweden) electronic dosimeters with a solid state detector. The mean values of the measured parameters for each of the procedures were compared with the European reference levels; the comparison revealed a great potential for patient dose reduction in clinical practice. Patient exposure is influenced by a series of factors such as the type, complexity and duration of the procedure, patient characteristics (weight, height, age and condition of blood vessels, etc.), skill and radiation protection knowledge of the operator, and the type, technical parameters and condition of the X-ray unit, ad well as the operation modes employed during the procedure. He contemporary digital X-ray units offer an opportunity for dose decrease provided that their various operation modes are known and optimally used by the physician. Additionally, the practical skills of the clinicians in the field of radiation protection, and their awareness with respect to the patient dose should be increased. (authors)

  17. Positive psychology in psychological interventions in rehabilitation medicine.

    Science.gov (United States)

    Majani, Giuseppina

    2011-01-01

    Human beings have always tackled their problems and the adversities of life by drawing on their own resources, resilience, and values, and yet the focus on pathology has effectively long dominated the cognitive approach of psychologists to ill-being. Psychological interventions in rehabilitation medicine were formed around the codification and containment of the ill-being, in an almost surgical or antibiotic sense of "correcting" the negativity: identifying and removing or combating the ill-being, or, if possible, its sources; the distance to be covered was from negativity to zero: absence of ill-being as a synonym for well-being. But what makes a 20-year-old tetraplegic look to the future? Where does someone who has been waiting for heart transplant for one, two or three years find the strength to carry on while living on 18 drugs and no more than two little bottles of water a day? In its use in the context of health care, positive psychology is that part of psychology that takes on the task--among others--of deciphering the mechanisms through which it becomes possible to adapt to a chronic illness. But not only. Positive psychology also offers the opportunity to systematise knowledge concerning the possibility of overreaching the distance from negativity to zero, of going beyond, of nourishing positivity, enriching and improving oneself, despite the presence of an organic disease or a disability. Positive psychotherapy does not negate painful or unpleasant experiences, but encourages the use of resources to understand weaknesses and it is contributing substantially to drawing our attention back to optimism, courage, positive emotions, flexibility, creativity, faith, hopes, honesty, perseverance, flourishing and on their relationships with physical health. A different language from the one that years of pragmatism have accustomed us to. If positive psychology can help our patients to see, through the pain, anger and fear, something that makes their life still

  18. Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know—Part I: Standard Post-procedural Instructions and Follow-Up Care

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: Bedros.Taslakian@nyumc.org; Sridhar, Divya [NYU Langone Medical Center, Department of Radiology, Interventional Radiology Section (United States)

    2017-04-15

    Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

  19. Cardiovascular and Interventional Radiological Society of Europe Commentary on the Treatment of Chronic Cerebrospinal Venous Insufficiency

    International Nuclear Information System (INIS)

    Reekers, J. A.; Lee, M. J.; Belli, A. M.; Barkhof, F.

    2011-01-01

    , who are directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population.

  20. Implementation of Ray Safe i2 System for staff dose measuring in interventional radiology

    International Nuclear Information System (INIS)

    Gershan, Vesna; Atsovska, Violeta

    2013-01-01

    Interventional radiology procedures usually delivered the highest radiation dose to the patients as well as to medical personal. Beside another factors like patient size, fluoroscopy time, machine calibration etc., a good clinical practice has strong effects to staff and patient’s radiation dose. Materials and methods: In August 2012, a Ray Safe i2 system was installed in a private hospital in Skopje. The main purpose of this dosimetry system is to provide real time indication for the current exposure level of the medical personal. Knowing that, the staff has prerequisites to adjust their behavior to minimize unnecessary exposure like changing distance from exposed volume, C-ram angulations, field of view etc. and on this way to develop a good clinical practice. The Ray Safe i2 system is consisted by ten digital dosimeters, two dock stations, real time display, dose viewer and dose manager software. During interventional procedures, each involved staff wears dosimeter which measures and records X-Ray exposure every second and transfer the data wirelessly to the real time display. Color indication bars (green, yellow, red) represents the intensity of the currently received exposure, whereas green zone indicates < 0.2 mSv/h, yellow zone from 0.2 to 2 mSv/h and red zone indications from 2 to 20 mSv/h. Additionally, accumulated dose per individual is displayed next to the color indication bars. By using the software, information about personal dose history, such as annual dose, dose per particular session, hour, day or week, can be viewed and analyzed. Results: In this work it was found that staff accumulated doses were constantly increased over time, but reported number of procedures does not correspond to this tendency. Our assumption is that there is a misleading between reported number and actual performed procedures. Doctor1 received 55 times more dose than Doctor2 and Nurse1 received 11 to 3 times more dose than another Nurses. It was found a correlation of R2

  1. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    LENUS (Irish Health Repository)

    Reekers, J A

    2011-02-01

    , who are directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population.

  2. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    Energy Technology Data Exchange (ETDEWEB)

    Uberoi, Raman, E-mail: raman.Uberoi@orh.nhs.uk; Tapping, Charles Ross [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom); Chalmers, Nicholas [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Allgar, Victoria [University of York, Hull and York Medical School (United Kingdom)

    2013-12-15

    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter

  3. Medicine and ionizing rays: a help sheet in analysing risks in exo-buccal dental radiology

    International Nuclear Information System (INIS)

    Gauron, C.

    2009-01-01

    This document proposes a synthesis of useful knowledge for radioprotection in the case of exo-buccal dental radiology. In the first part, several aspects are considered: the concerned personnel, the course of treatment procedures, the hazards, the identification of the risk associated with ionizing radiation, the risk assessment and the determination of exposure levels, the strategy to control the risks (reduction of risks, technical measures concerning the installation or the personnel, teaching and information, prevention and medical monitoring), and risk control assessment

  4. Training project on Radiological Protection in medicine. Use of new technologies

    International Nuclear Information System (INIS)

    Ruis-Cruces, R.; Perez-Martinez, M.; Pastor Vega, J. M.; Diez de los Rios Delgado, A.

    2003-01-01

    Radiological protection training addressed to physicians should start during the teaching graduate and postgraduate studies, and a third phase only for those physicians using X rays and radioactive sources in diagnosis and treatment of diseases. To show a training project addressed to the teaching graduate students based on the new technologies, such as web online and interactive CD-ROM. Development of a web-online including information in.pdf (adobe acrobat) format and additional tools (as data bases, videos, news and class meetings, FAQ, tutorials). Moreover, we propose to development an interactive CD-ROM which will be used as a practical tool to complete the obligatory subject on radiological protection in the University of Malaga (Spain). We show the preliminary phase of the project. The web-online is being developed with the Microsoft FrontPage software. The first version of the CR-ROM is being developed in html format. These tools based on new technologies will be a very important support for radiological protection training, which is recommended by International Organizations (EC Report R116 and IAE Action Plan 2002-2006). (Author) 4 refs

  5. Development of double dosimetry algorithm for assessment of effective dose to staff in interventional radiology

    International Nuclear Information System (INIS)

    Kim, Ji Young

    2011-02-01

    Medical staff involving interventional radiology(IR) procedures are significantly exposed to the scatter radiation because they stand in close proximity to the patient. Since modern IR techniques are often very complicated and require extended operation time, doses to IR workers tend to increase considerably. In general, the personal dose equivalent at 10 mm depth, H p (10), read from one dosimeter worn on the trunk of a radiation worker is assumed to be a good estimate of the effective dose and compared to the dose limits for regulatory compliance. This assumption is based on the exposure conditions that the radiation field is broad and rather homogeneous. However, IR workers usually wear protective clothing like lead aprons and thyroid shield which allow part of the body being exposed to much higher doses. To solve this problem, i.e. to adequately estimate the effective doses of IR workers, use of double dosimeters, one under the apron and one over the apron where unshielded part of the body exposed, was recommended. Several algorithms on the interpretation of the two dosimeter readings have been proposed. However, the dosimeter weighting factors applied to the algorithm differ significantly, which quests a question on the reliability of the algorithm. Moreover, there are some changes in the process of calculating the effective dose in the 2007 recommendations of the International Commission on Radiological Protection(ICRP): changes in the radiation weighting factors, tissue weighting factors and the computational reference phantoms. Therefore, this study attempts to set a new algorithm for interpreting two dosimeter readings to provide a proper estimate of the effective dose for IR workers, incorporating those changes in definition of effective dose. The effective doses were estimated using Monte Carlo simulations for various practical conditions based on the vogel reference phantom and the new tissue weighting factors. A quasi-effective dose, which is

  6. Development of double dosimetry algorithm for assessment of effective dose to staff in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young

    2011-02-15

    Medical staff involving interventional radiology(IR) procedures are significantly exposed to the scatter radiation because they stand in close proximity to the patient. Since modern IR techniques are often very complicated and require extended operation time, doses to IR workers tend to increase considerably. In general, the personal dose equivalent at 10 mm depth, H{sub p}(10), read from one dosimeter worn on the trunk of a radiation worker is assumed to be a good estimate of the effective dose and compared to the dose limits for regulatory compliance. This assumption is based on the exposure conditions that the radiation field is broad and rather homogeneous. However, IR workers usually wear protective clothing like lead aprons and thyroid shield which allow part of the body being exposed to much higher doses. To solve this problem, i.e. to adequately estimate the effective doses of IR workers, use of double dosimeters, one under the apron and one over the apron where unshielded part of the body exposed, was recommended. Several algorithms on the interpretation of the two dosimeter readings have been proposed. However, the dosimeter weighting factors applied to the algorithm differ significantly, which quests a question on the reliability of the algorithm. Moreover, there are some changes in the process of calculating the effective dose in the 2007 recommendations of the International Commission on Radiological Protection(ICRP): changes in the radiation weighting factors, tissue weighting factors and the computational reference phantoms. Therefore, this study attempts to set a new algorithm for interpreting two dosimeter readings to provide a proper estimate of the effective dose for IR workers, incorporating those changes in definition of effective dose. The effective doses were estimated using Monte Carlo simulations for various practical conditions based on the vogel reference phantom and the new tissue weighting factors. A quasi-effective dose, which is

  7. Interventions promoting the acceptance and uptake of generic medicines: a narrative review of the literature.

    Science.gov (United States)

    Babar, Z U D; Kan, S W; Scahill, S

    2014-09-01

    The objective of this paper was to undertake a narrative review of the literature regarding strategies and interventions promoting the acceptance and uptake of generic medicines. A literature search was performed between November 2011 and January 2012 to identify published full text original research articles documenting interventions to promote the use of generic medicines. Keywords used were: "generic medicine", "generic drug", "intervention", "promotion", "acceptance", "uptake", "generic/therapeutic substitution" and their related root words. The electronic databases comprised of Embase (1980 - present), Google, Google Scholar, Medline (1948 - present), PubMed, Science Direct, Scopus, Springer Link and The Cochrane Library. An interpretative narrative synthesis was undertaken and emergent themes analysed and reported. Eighteen studies were included in the final analysis. There were seven main themes which including; education, financial incentives, advertising to promote generic medicines, free generic medicine trials, administrative forms and medicines use review (MUR). These themes were further classified into subthemes. Education was subdivided into consumer and physician education. Financial incentives included the influence of financial incentives on both consumers and physicians. The subthemes in the financial incentives category included the changes in co-payment for consumers, reward payment for physicians and fund-holding schemes. Advertising included the sub-themes of print media and the use of anthropomorphic images, while free generic medicines trial was made up of free vouchers for generic medicines and generic medicines sampling system. The studies have mixed results; some interventions in some settings were useful, while others were not. Not all interventions consistently improved the uptake of generic medicines. There was limited literature available and further work is required to develop a range of interventions to support the uptake of generic

  8. Analysis on quality controls and radiological protection in nuclear medicine: 20 years of experience

    International Nuclear Information System (INIS)

    Ferrer, N.; Arranz, L.; Sastre, J.M.

    1998-01-01

    This work shows inspection and changes made to performance protocols during 20 years in which the Nuclear Medicine Service has been operating at this Hospital, in reference to new clinical techniques introduced and requirements made by the Spanish legislation

  9. Adverse effects of immunotherapy. Clinical aspects, radiological and nuclear medicine results; Unerwuenschte Wirkungen der Immuntherapie. Klinik, radiologische und nuklearmedizinische Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Widmann, G.; Plaickner, J.; Jaschke, W. [Medizinische Universitaet Innsbruck, Universitaetsklinik fuer Radiologie, Innsbruck (Austria); Nguyen, V.A. [Medizinische Universitaet Innsbruck, Universitaetsklinik fuer Dermatologie, Venerologie und Allergologie, Innsbruck (Austria)

    2017-10-15

    The increasing use of immunotherapy in oncology increases the need for radiologic evaluation of frequent and severe immune-related adverse events. Determination of the incidence and manifestation of radiologic and nuclear medicine findings of immune-related adverse events. Literature review of clinical and imaging findings of immune-related adverse events induced by the immune checkpoint inhibitors ipilimumab, nivolumab and pembrolizumab. Findings are illustrated with pictorial examples and contrasted to other relevant differential diagnoses. The most frequent imaging manifestations are colitis, hepatitis, pancreatitis, hypophysitis, pneumonitis, arthritis and sarcoid-like lymphadenopathy. Severe to life-threatening complications may result from colitis, pneumonitis and hypophysitis. A clear differentiation from other autoimmune diseases and discrimination of immune-related and infectious pulmonary findings can be very difficult and need close multidisciplinary collaboration. Knowledge of clinical and imaging findings of adverse events induced by immunotherapy is essential for timely and adequate therapeutic decisions. In addition to staging and follow-up imaging, identification and monitoring of immune-related adverse events adds to the radiologic responsibility in oncologic care. (orig.) [German] Mit zunehmendem Einsatz von Immuntherapien in der Onkologie steigt die Bedeutung der radiologischen Beurteilung haeufiger und schwerwiegender immunbedingter Nebenwirkungen. Inzidenz und Manifestation radiologischer und nuklearmedizinischer Befunde der immunbedingten Nebenwirkungen. Literaturuebersicht zu Klinik und bildgebenden Befunden immunbedingter Nebenwirkungen der Immuncheckpointinhibitoren Ipilimumab, Nivolumab und Pembrolizumab. Veranschaulichung mit Bildbeispielen und Gegenuebergestellung mit anderen relevanten Differenzialdiagnosen. Die haeufigsten bildgebenden Manifestationen sind Kolitis, Hepatitis, Pankreatitis, Hypophysitis, Pneumonitis, Arthritis und die

  10. How to operate a university institute as a radiological emergency service?; Comment faire fonctionner un institut universitaire en service d'intervention radiologique?

    Energy Technology Data Exchange (ETDEWEB)

    Besancon, A.; Bochud, F. [Institut de radiophysique, Centre hospitalier universitaire vaudois et Universite de Lausanne (Switzerland)

    2011-07-15

    The Institute of Radiation Physics (IRA) is attached to the Department of Medical Radiology at the Vaud University Hospital Center (CHUV) in Lausanne. The Institute's main tasks are strongly linked to the medical activities of the Department: radiotherapy, radiodiagnostics, interventional radiology and nuclear medicine. The Institute also works in the fields of operational radiation protection, radiation metrology and radioecology. In the case of an accident involving radioactive materials, the emergency services are able to call on the assistance of radiation protection specialists. In order to avoid having to create and maintain a specific structure, both burdensome and rarely needed, Switzerland decided to unite all existing emergency services for such events. Thus, the IRA was invited to participate in this network. The challenge is therefore to integrate a university structure, used to academic collaborations and the scientific approach, to an interventional organization accustomed to strict policies, a military-style command structure and 'drilled' procedures. The IRA's solution entails mobilizing existing resources and the expertise developed through professional experience. The main asset of this solution is that it involves the participation of committed collaborators who remain in a familiar environment, and are able to use proven materials and mastered procedures, even if the atmosphere of an accident situation differs greatly from regular laboratory routines. However, this solution requires both a commitment to education and training in emergency situations, and a commitment in terms of discipline by each collaborator in order to be integrated into a response plan supervised by an operational command center. (authors)

  11. Lessons learned in radiology

    International Nuclear Information System (INIS)

    Goodenough, D.J.

    2001-01-01

    The paper reviews aspects of the history of radiology with the goal of identifying lessons learned, particularly in the area of radiological protection of the patient in diagnostic and interventional radiology, nuclear medicine and radiotherapy. It is pointed out that since the days of Roentgen there has been a need not only to control and quantify the amount of radiation reaching the patient but also to optimize the imaging process to offer the greatest diagnostic benefit within allowable levels of patient dose. To this end, in diagnostic radiology, one finds the development of better films, X rays tubes, grids, screens and processing techniques, while in fluoroscopy, one sees the increased luminance of calcium tungstate. In interventional radiology, one finds an improvement in catheterization techniques and contrast agents. In nuclear medicine, the development of tracer techniques into modern cameras and isotopes such as technetium can be followed. In radiotherapy, one sees the early superficial X rays and radium sources gradually replaced with radon seeds, supervoltage, 60 Co and today's linear accelerators. Along with the incredible advances in imaging and therapeutic technologies comes the growing realization of the potential danger of radiation and the need to protect the patient (as well as physicians, ancillary personnel and the general population) from unnecessary radiation. The important lesson learned is that we must walk a tightrope, balancing the benefits and risks of any technology utilizing radiation to produce the greatest benefits at the lowest acceptable risk. The alternative techniques using non-ionizing radiation will have to be considered as part of the general armamentarium for medical imaging whenever radiation consequences are unacceptable. (author)

  12. Diagnostic medicine: A comprehensive ABCDE algorithm for accurate interpretation of radiology and pathology images and data.

    Science.gov (United States)

    Zioga, Christina A; Destouni, Chariklia T

    2015-01-01

    A pathway to the procedure of interpreting radiology images or pathology slides is presented. This simplified mnemonic can be used as a memory aid determining the order in which diagnosis should be approached. First, before we place the radiology image in front of the lightbox or the slide under the microscope we have to be sure that it is adequately labelled and prepared (Correct). It is also necessary to have or gather all available information concerning the patient and if possible his full medical history (A, Available Information). Once we come across the image, two fundamental questions should be answered: which part of the body does the image concern and-where applicable-if the image is adequate (B, Body). Next, we proceed to answer if we have a neoplastic tissue or not (C, Cancer). We then either form a differential diagnosis list or we reach to a final diagnosis (D, Diagnosis), which is followed by the writing of the report (E, Exhibit). These series of steps followed as an ad hoc procedure by most specialists, are important in order to achieve a complete and clear diagnosis and report, which is intended to support optimal clinical practice. This ABCDE concept is a generic standard approach which is not limited to specific specimens and can lead to faster diagnosis with less mistakes.

  13. The reporting quality assessment of complex interventions' articles in traditional chinese medicine.

    Science.gov (United States)

    Wu, Meng; Hu, Jingqing; Liu, Biaoyan

    2013-01-01

    Objective. To realize the current situation and problems of complex interventions' clinical trials. Methods. Searching at Chinese Journal Integrated Traditional and Western Medicine and Journal of Traditional Chinese Medicine from 2007 to 2012 by hand, we identified complex interventions' articles, and then we used the proposed criteria of complex interventions and CONSORT FOR TCM to evaluate. Results. All data is presented as counts with percentages and details in tables. Conclusion. Our evaluation presented that complex interventions have many defects: the selection of the intervention's components lacks rationale, complex interventions were short of fundamental researches, components' interactions were ambiguous, and the advantages of complex interventions were not mentioned. Furthermore, explanation of sample size, blind, quality control, ethical approval, and inform consent were neglected in different degrees.

  14. Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications.

    Science.gov (United States)

    Taslakian, Bedros; Sridhar, Divya

    2017-09-01

    Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.

  15. Assessment of radiological safety of some new diagnostic agents used in nuclear medicine investigations

    International Nuclear Information System (INIS)

    Gupta, M.M.; Nagaratnam, A.

    1993-01-01

    Effective dose estimations have been carried out for some newer technetium-99m labelled diagnostic agents employed for myocardial and regional cerebral perfusion studies. Mean absorbed doses due to these preparations were taken from published literature. Effective dose was calculated by multiplying mean absorbed dose to an organ or tissue by the value of tissue weighting factor assigned to that organ or tissue in the recommendations of the international Commission on Radiological Protection and integrating over all organs or tissues of interest. The process was repeated considering revised values of tissue weighting factors as recommended recently. A method for approximate effective dose calculation is described in cases where complete data on mean absorbed dose or tissue weighting factor for an organ or tissue are not available. Revised values of tissue weighting factor normally result in a lowering of estimated effective doses due to these radiopharmaceuticals. It was also demonstrated that additional total stochastic risk will only be marginal. (author)

  16. Evaluation of an intervention to improve skills in diagnostic radiology of rural physicians over one year in four rural hospitals.

    Directory of Open Access Journals (Sweden)

    Tienan Feng

    Full Text Available BACKGROUND: Primary health care and patient triage are two basic functions of rural hospitals. As a routine test, the diagnostic radiology is still unavailable in some rural hospitals in China. Therefore, high-level hospitals are often the first choice of rural residents when they feel unwell. It brings serious social problems. This study was designed to propose an on-the-job drilling schema with integration of practical medical recordings and experienced radiological doctors as tutors to improve skills in diagnostic radiology of rural physicians. METHODS: The information technology was used to help the contact between rural doctors and tutors. In a longitudinal pre/post-test control study design, a cohort of 20 young physicians, each of whom was working in a rural hospital and had a work experience less than two years, were established as the trial group over one year. Another 20 similar counterparts were established as the control group. Participants' performances were evaluated in four categories at five-time point (TP. RESULTS: The trial group significantly outscored the control group on the style of writing at the second TP (d = 2.28; on the accuracy of the image description at final TP (d = 1.11; on the accuracy of the diagnosis at the fourth TP (d = 3.62; and on the correct treatment selection at the third TP (d = 6.45. The aspects with the most improvement were the accuracies of the diagnosis and the treatment selection. CONCLUSION: This study provided the detailed evidences that applying the on-the-job drilling schema has a significant effect on the skills improvement in diagnostic radiology of rural physicians. It was also concluded that the educational intervention based on practical cases was better than that only based on didactic slides presentation.

  17. Top 3: Differential diagnosis in radiology. A case-based training book; Top 3 Differenzialdiagnosen in der Radiologie. Ein fallbasiertes Trainingsbuch

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, William T. Sr. [Cincinnati Univ., OH (United States)

    2011-07-01

    The case-based training book on differential diagnosis in radiology includes the following chapters: (1) Heart and thorax. (2) Gastrointestinal tract. (3) Urogenital tract. (4) Musculoskeletal system. (5) Head and neck. (6) Central nervous system. (7) Pediatric radiology. (8) Sonography. (9) Prenatal imaging. (10) Vascular and interventional radiology. (11) Nuclear medicine. (12) Mammary gland imaging. (13) X-ray and CT classics.

  18. Report About a New Standard for Radiation Protection Training of Intervention Persons. In the Case of Radiological emergency Situations

    International Nuclear Information System (INIS)

    Geringer, T.; Steurer, A.; Schmitzer, C.

    2004-01-01

    In autumn 2003 the Austrian standard OENORM S 5207 with the title R adiation protection training of intervention persons in the case of radiological emergency situations w ill be published. The standard is directed to persons who have to invent in case of a radiological emergency, security forces and as well training centres. The standard has to fulfil three objectives: 1. Regulation of the minimum requirements for the radiation protection training and education of intervention persons. 2. Harmonization of the radiation protection and training of different security forces, for instance Austrian army, Red Cross Austria, Fire Department, Police Department. 3. Mutual recognition of parts of the education between the different security forces. To fulfil these aims the standard is structured in different education modules. If , for instance, a person attended a special training module at the Austrian military, this part of the education is also valid for a career at the Fire Department. Further the modular structure of the education gives the possibility for persons of a special security force to attend one or more modules at another security force. This will lead to an improved cooperation between the different security forces in case of a radiological emergency situation. The education is structured in four levels. The topics of the standard are: 1. Requirements for training centres 2. Guidelines for the examinations of the candidates 3. Topics and goals of the basic education 4. Topics and goals of the advanced education level one 5. Topics and goals of the advanced education level two 6. Topics and examples of specialised education 7. Obligatory further education once every year. (Author)

  19. Early experience using an online reporting system for interventional radiology procedure-related complications integrated with a digital dictation system.

    Science.gov (United States)

    Gupta, Sanjay; Patel, Jay; McEnery, Kevin; Wallace, Michael J; Ahrar, Kamran; Suitor, Chuck; Hicks, Marshall E

    2011-08-01

    The absence of user-friendly systems for reporting complications is a major barrier to improving quality assurance (QA) programs in interventional radiology (IR) services. We describe the implementation of a QA application that is completely integrated with the radiology dictation system. We implemented an IR QA process as a module within the electronic medical record and radiologist dictation system applications used at our institution. After a radiologist completes a dictation, he or she must select from a drop-down list of complications before proceeding to the next case. Delayed QA events can be entered using the same applications. All complication entries are sent to a database, which is queried to run reports. During the study period, all the 20,034 interventional procedures were entered in the QA database, 1,144 complications were reported, 110 (9.6%) of which were classified as major. Although majority of the complications (996) were entered at the time of dictation, 148 complications (12.9%) were entered afterwards. All major complications were referred to the IR peer review committee, and 30 of these were discussed in the morbidity and mortality meetings. We studied post-lung-biopsy pneumothorax and chest tube rates and initiated a quality improvement process based on the results.The integration of the IR QA reporting system into the workflow process and the mandatory requirements for completion has the potential to minimize the work effort required to enter complication data, and improve participation in the QA process.

  20. A study of inventiveness among Society of Interventional Radiology members and the impact of their social networks.

    Science.gov (United States)

    Murphy, Kieran J; Elias, Gavin; Jaffer, Hussein; Mandani, Rashesh

    2013-07-01

    To investigate the nature of inventiveness among members of the Society of Interventional Radiology (SIR) and learn what influenced the inventors and assisted their creativity. The membership directory of the SIR was cross-referenced with filings at the United States Patent and Trademark Organization (USPTO) and the Patent Cooperation Treaty (PCT). The inventors were queried with an online survey to illuminate their institutions of training and practice as well as enabling or inhibiting factors to their inventiveness. Responses were analyzed through the construction of social network maps and thematic and graphical analysis. It was found that 457 members of the SIR held 2,492 patents or patent filings. After 1986, there was a marked and sustained increase in patent filings. The online survey was completed by 73 inventors holding 470 patents and patent filings. The social network maps show the key role of large academic interventional radiology departments and individual inventors in the formation of interconnectivity among inventors and the creation of the intellectual property (IP). Key inhibitors of the inventive process include lack of mentorship, of industry contacts, and of legal advice. Key enablers include mentorship, motivation, and industry contacts. Creativity and inventiveness in SIR members stem from institutions that are hubs of innovation and networks of key innovators; inventors are facilitated by personal motivation, mentorship, and strong industry contacts. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  1. Patients and personnel radiation protection in interventional radiology and in surgery;La radioprotection des patients et des travailleurs en radiologie interventionnelle et au bloc operatoire

    Energy Technology Data Exchange (ETDEWEB)

    Menechal, P. [Centre de Recherches en Psychopathologie et Psychologie Clinique - CRPPC, 69 - Lyon (France); Valero, M.; Godet, J.L. [Lyon-3 Univ. Jean Moulin, 69 (France)

    2009-10-15

    The development of the interventional radiology and acts realised under radiological guiding is a real benefit for patients. The doses delivered can however, generate important detriments (determinist effects). the patients and the personnel are exposed to important doses, heterogeneous and very different doses according the operator, the patient morphology and the treated pathology. This theme is considered by the the nuclear safety Authority as a priority in the medical medium. (N.C.)

  2. Solution in Cuba to ensuring the radiological protection in nuclear medicine

    International Nuclear Information System (INIS)

    Bentancourt, L.A.; Quevedo, J.R.; La Fuente, A. de

    1996-01-01

    In the middle of the 80's in Cuba takes place a widespread use of nuclear techniques in the national economy, particularly in nuclear medicine practice. In order to harmonize the constructive projects of the nuclear medical facilities, the National Regulatory Authority for Radiation Protection assessed the requirements to be adopted for the purpose of ensuring the optimum fulfillment of the radiation protection regulations in force in the country. As a result of this work a functional solution was developed for the distribution of the sites for the storage, dosage and handling of radioactive substances and the temporary deposit of the radioactive wastes produced. (authors). 4 refs., 1 tab

  3. Three dimensional printing: Basic principles and applications in medicine and radiology

    International Nuclear Information System (INIS)

    Kim, Guk Bae; Lee, Sang Wook; Kim, Hae Kang

    2016-01-01

    The advent of three-dimensional printing (3DP) technology has enabled the creation of a tangible and complex 3D object that goes beyond a simple 3D-shaded visualization on a flat monitor. Since the early 2000s, 3DP machines have been used only in hard tissue applications. Recently developed multi-materials for 3DP have been used extensively for a variety of medical applications, such as personalized surgical planning and guidance, customized implants, biomedical research, and preclinical education. In this review article, we discuss the 3D reconstruction process, touching on medical imaging, and various 3DP systems applicable to medicine. In addition, the 3DP medical applications using multi-materials are introduced, as well as our recent results

  4. New applications of planar image fusion in clinical nuclear medicine and radiology.

    Science.gov (United States)

    Zuckier, Lionel S; Koncicki, Holly M

    2006-01-01

    Fusion of multiple modalities has become an integral part of modern imaging methodology, especially in nuclear medicine where PET and SPECT scanning are frequently paired with computed tomography (CT). We have extended image fusion from the tomographic realm to planar imaging in 2 specific applications. In the first, we combine planar scintigraphic images with photographic images of the body part of interest, using a predetermined transformation of images between the frames of reference. This technique is especially helpful in "hot spot" imaging applications where minimal background activity makes it difficult to locate abnormalities in an anatomic context. The technique has been demonstrated to be accurate, and results in increased reader confidence. We have also begun fusing orthopedic radiographs with photographic images of the extremities, using fiducial markers within each image set to perform an affine transformation unique for the particular image set. Preliminary results indicate that this method is accurate, and clinical evaluation is underway.

  5. Three dimensional printing: Basic principles and applications in medicine and radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Guk Bae; Lee, Sang Wook; Kim, Hae Kang [Biomedical Engineering Research Center, Asan Institute of Life Science, Asan Medical Center, Seoul (Korea, Republic of); and others

    2016-04-15

    The advent of three-dimensional printing (3DP) technology has enabled the creation of a tangible and complex 3D object that goes beyond a simple 3D-shaded visualization on a flat monitor. Since the early 2000s, 3DP machines have been used only in hard tissue applications. Recently developed multi-materials for 3DP have been used extensively for a variety of medical applications, such as personalized surgical planning and guidance, customized implants, biomedical research, and preclinical education. In this review article, we discuss the 3D reconstruction process, touching on medical imaging, and various 3DP systems applicable to medicine. In addition, the 3DP medical applications using multi-materials are introduced, as well as our recent results.

  6. Making medicine a business in Japan: Shimadzu Co. and the diffusion of radiology (1900-1960).

    Science.gov (United States)

    Donzé, Pierre-Yves

    2010-01-01

    This contribution focuses on the role of the firm Shimadzu in the marketing of X-ray machines in Japan during the first part of the 20th century, viewed from a business history perspective. It attempts to further understanding of the process of technology diffusion in medicine. In a global market controlled by American and German multinational enterprises, Japan appears to have been a particular country, where a domestic independent firm, Shimadzu, succeeded in establishing itself as a competitive company. This success is the result of a strategy based on both the internalisation of technological capabilities (recruitment of university graduate engineers, subcontracting of research and development activities) and an original communication policy towards the medical world. Finally, the specific structure of the Japanese medical market, composed of numerous and largely privatised small healthcare centres, facilitated the rapid diffusion of X-ray machines, a new technology which conferred a comparative advantage on its holders.

  7. Mortality reporting in interventional radiology: Experience of a pilot audit with the Scottish Audit of Surgical Mortality

    International Nuclear Information System (INIS)

    White, R.D.; Ingram, S.; Moss, J.G.; Pace, N.; Chakraverty, S.

    2013-01-01

    Aim: To describe the initial pilot phase of the 2009 Scottish Audit of Surgical Mortality (SASM), which includes outcomes and difficulties that arose during any interventional radiology (IR) procedure performed on patients in this audit over an 18 month period. Materials and methods: Approximately 40 consultant interventional radiologists from all units in Scotland elected to participate in the audit. Each response was then peer reviewed after anonymisation of the patient and institution. If a relevant ACON (area for consideration or area of concern) was generated, this was checked by one of the other reviewers before communication with the original reporting radiologist and colleagues. There was then a right of reply by the reporting unit before formal documentation was sent out. Results: Initial results were analysed after 18 months period, during which time 95 forms relating to deaths of surgical inpatients were sent to interventional radiologists identified as having been involved in an IR procedure at some time during the patient’s admission. Seventy-one forms had been returned by July 2010, of which 46 had gone through the entire SASM process. From these, 10 ACONs were attributed. Anonymised case vignettes and reports from these were used as educational tools. Conclusion: Involvement with SASM is a useful process. Significant safety issues and learning points were identified in the pilot. The majority of ACONs identified by the audit were in patients who had undergone percutaneous biliary interventions

  8. Study of radiation exposure profiles in interventional radiology professionals; Estudo dos perfis de exposicao a radiacao em profissionais de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Alvarez, Matheus; Rosa, Maria E.D.; Miranda, Jose R.A.; Freitas, Carlos C.M. de; Moura, Regina; Pina, Diana R. de, E-mail: fernando.bacchim@gmail.com [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil)

    2014-07-01

    Interventional Radiology is the radiology area that provides the highest dose values to the medical staff. Recent surveys show that personal dosimeters may underestimate the radiation dose values in interventional physicians, especially in the extremities and crystalline. The objective of this work was to study the exposure levels to radiation from medical staff in different interventional radiology procedures. Therefore, thermoluminescent dosimeters type LiF: Mg, Ti (TLD-100) were used positioned in the main interventional physician and an assistant in the following locations: some inches below the crystalline, thyroid, chest, gonads, hand and foot. By comparing the values obtained with the annual reference dose levels in workers, maximum numbers of annual procedures were found. Altogether, there were 23 procedures evaluated: 10 diagnostics, 9 angioplasties and 4 stents. The maximum number of annual procedures were estimated by discounting the percentages of attenuation of radiological protection. For procedures of the type diagnosis, angioplasty and stent for the main interventionist, the maximum number of annual procedures were 641, 445 and 113 respectively, while for the interventionists assistants were 930, 1202 and 215 respectively. As each interventionist body region is subject to different levels of exposure, detailed studies of exposure in each region provide better conclusions about what actions are necessary to ensure radiological protection professionals.

  9. SU-D-209-03: Radiation Dose Reduction Using Real-Time Image Processing in Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Kanal, K; Moirano, J; Zamora, D; Stewart, B [University Washington, Seattle, WA (United States)

    2016-06-15

    Purpose: To characterize changes in radiation dose after introducing a new real-time image processing technology in interventional radiology systems. Methods: Interventional radiology (IR) procedures are increasingly complex, at times requiring substantial time and radiation dose. The risk of inducing tissue reactions as well as long-term stochastic effects such as radiation-induced cancer is not trivial. To reduce this risk, IR systems are increasingly equipped with dose reduction technologies.Recently, ClarityIQ (Philips Healthcare) technology was installed in our existing neuroradiology IR (NIR) and vascular IR (VIR) suites respectively. ClarityIQ includes real-time image processing that reduces noise/artifacts, enhances images, and sharpens edges while also reducing radiation dose rates. We reviewed 412 NIR (175 pre- and 237 post-ClarityIQ) procedures and 329 VIR (156 preand 173 post-ClarityIQ) procedures performed at our institution pre- and post-ClarityIQ implementation. NIR procedures were primarily classified as interventional or diagnostic. VIR procedures included drain port, drain placement, tube change, mesenteric, and implanted venous procedures. Air Kerma (AK in units of mGy) was documented for all the cases using a commercial radiation exposure management system. Results: When considering all NIR procedures, median AK decreased from 1194 mGy to 561 mGy. When considering all VIR procedures, median AK decreased from 49 to 14 mGy. Both NIR and VIR exhibited a decrease in AK exceeding 50% after ClarityIQ implementation, a statistically significant (p<0.05) difference. Of the 5 most common VIR procedures, all median AK values decreased, but significance (p<0.05) was only reached in venous access (N=53), angio mesenteric (N=41), and drain placement procedures (N=31). Conclusion: ClarityIQ can reduce dose significantly for both NIR and VIR procedures. Image quality was not assessed in conjunction with the dose reduction.

  10. SU-D-209-03: Radiation Dose Reduction Using Real-Time Image Processing in Interventional Radiology

    International Nuclear Information System (INIS)

    Kanal, K; Moirano, J; Zamora, D; Stewart, B

    2016-01-01

    Purpose: To characterize changes in radiation dose after introducing a new real-time image processing technology in interventional radiology systems. Methods: Interventional radiology (IR) procedures are increasingly complex, at times requiring substantial time and radiation dose. The risk of inducing tissue reactions as well as long-term stochastic effects such as radiation-induced cancer is not trivial. To reduce this risk, IR systems are increasingly equipped with dose reduction technologies.Recently, ClarityIQ (Philips Healthcare) technology was installed in our existing neuroradiology IR (NIR) and vascular IR (VIR) suites respectively. ClarityIQ includes real-time image processing that reduces noise/artifacts, enhances images, and sharpens edges while also reducing radiation dose rates. We reviewed 412 NIR (175 pre- and 237 post-ClarityIQ) procedures and 329 VIR (156 preand 173 post-ClarityIQ) procedures performed at our institution pre- and post-ClarityIQ implementation. NIR procedures were primarily classified as interventional or diagnostic. VIR procedures included drain port, drain placement, tube change, mesenteric, and implanted venous procedures. Air Kerma (AK in units of mGy) was documented for all the cases using a commercial radiation exposure management system. Results: When considering all NIR procedures, median AK decreased from 1194 mGy to 561 mGy. When considering all VIR procedures, median AK decreased from 49 to 14 mGy. Both NIR and VIR exhibited a decrease in AK exceeding 50% after ClarityIQ implementation, a statistically significant (p<0.05) difference. Of the 5 most common VIR procedures, all median AK values decreased, but significance (p<0.05) was only reached in venous access (N=53), angio mesenteric (N=41), and drain placement procedures (N=31). Conclusion: ClarityIQ can reduce dose significantly for both NIR and VIR procedures. Image quality was not assessed in conjunction with the dose reduction.

  11. Combined surgical and radiological intervention for complicated cholelithiasis in high-risk patients

    International Nuclear Information System (INIS)

    Gibney, R.G.; Fache, J.S.; Becker, C.D.; Nichols, D.M.; Cooperberg, P.L.; Stoller, J.L.; Burhenne, H.J.

    1987-01-01

    Surgical cholecystostomy under local infiltration anesthesia was combined with radiologic removal of gallstones in 36 high-risk patients with acute calculous gallbladder disease. At cholecystostomy, the fundus of the gallbladder was sutured to the anterior abdominal wall, permitting early percutaneous stone removal through the short surgical tract. All gallstones were removed in 31 of 36 patients, for an overall success rate of 86%. The success rate was 97% for gallbladder stones, 86% for cystic duct stones, and 63% for common bile duct stones which were removed by traversing the cystic duct. There were no deaths or serious complications

  12. Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: bacchim@ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem

    2014-08-15

    Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

  13. Contribution of interventional radiology to diagnosis and staging of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Wittich, G.R.; Jantsch, H.; Sonnenberg, E. van; Karnel, F.; Kumpan, W.; Greene, R.

    1986-01-01

    The value of percutaneous radiological fine needle biopsy of the thorax will be discussed in relation to sputum cytology, bronchoscopy, mediastinoscopy and open biopsy. Commun indications for fine needle biopsies are the solitary pulmonary nodule, unless it shows definite radiological criteria of a benign lesion, chest wall lesions including Pancoast tumors as well as pulmonary lesions, which were negative on bronchoscopy. Contraindications - in part relative - are coagulopathy, pulmonary arterial and venous hypertension, bullous emphysema, chronic obstructive pulmonary disease, diseases of the lung with an oxygen tension of less than 60 mm Hg and positive pressure mechanical ventilation. Fluoroscopy is the preferred method for localization. CT guidance is used for mediastinal and hilar lesions as well as for pulmonary lesions close to large vessels and for small lesions which are not clearly identified by fluoroscopy in two planes. The sensitivity of fine needle biopsy in the diagnosis of primary lung cancer was 87% in a total of 963 patients. The most common complication was pneumothorax which occurred in 27% of the biopsies guided by fluoroscopy and in 36% of those guided by CT. Catheter drainage of pneumothorax was performed in one third of these patients. Hemoptysis and local parenchymal hemorrhage were found in less than 5% and were without clinical consequence. In addition to technique, results and complications of percutaneous thoracic biopsies, methods of adrenal and liver biopsy in patients with carcinoma of the lung will be discussed. (Author)

  14. Minimally Invasive Radiologically Guided Intervention for the Treatment of Salivary Calculi

    International Nuclear Information System (INIS)

    Brown, Jackie E.; Drage, Nicholas A.; Escudier, Michael P.; Wilson, Ron F.; McGurk, Mark

    2002-01-01

    Purpose: To describe the technique and examine the value of salivary stone extraction using a minimally invasive, radiologically guided approach as an alternative to salivary gland surgery for the treatment of benign salivary gland obstruction. Methods: Eighty-six cases of sialolithiasis (83 patients) were treated by stone removal using a Dormia basket under local anesthesia and fluoroscopic guidance. Postoperative assessment was made clinically at review, by sialogram and by questionnaire. Results: Of 86 cases of sialolithiasis treated, in 55 (64%)it was possible to remove all stones. In 12 cases (14%) part of a stone or some of a number of calculi were removed and in 19 cases (22%) the procedure failed. The commonest reason for failure was fixation of the stone within the duct. Symptoms at review (range 1-49 months, mean 17 months) were relieved in 55 of 67 (82%) of cases where a stone or portion of stone was removed. Conclusions:Stone removal from the salivary duct system by radiologically guided,minimally invasive approach is a simple procedure with low morbidity and high patient acceptance when appropriate selection criteria are applied. These criteria are considered and recommendations made

  15. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.

    Science.gov (United States)

    Ryan, Rebecca; Santesso, Nancy; Lowe, Dianne; Hill, Sophie; Grimshaw, Jeremy; Prictor, Megan; Kaufman, Caroline; Cowie, Genevieve; Taylor, Michael

    2014-04-29

    Many systematic reviews exist on interventions to improve safe and effective medicines use by consumers, but research is distributed across diseases, populations and settings. The scope and focus of such reviews also vary widely, creating challenges for decision-makers seeking to inform decisions by using the evidence on consumers' medicines use.This is an update of a 2011 overview of systematic reviews, which synthesises the evidence, irrespective of disease, medicine type, population or setting, on the effectiveness of interventions to improve consumers' medicines use. To assess the effects of interventions which target healthcare consumers to promote safe and effective medicines use, by synthesising review-level evidence. We included systematic reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. We identified relevant reviews by handsearching databases from their start dates to March 2012. We screened and ranked reviews based on relevance to consumers' medicines use, using criteria developed for this overview. We used standardised forms to extract data, and assessed reviews for methodological quality using the AMSTAR tool. We used standardised language to summarise results within and across reviews; and gave bottom-line statements about intervention effectiveness. Two review authors screened and selected reviews, and extracted and analysed data. We used a taxonomy of interventions to categorise reviews and guide syntheses. We included 75 systematic reviews of varied methodological quality. Reviews assessed interventions with diverse aims including support for behaviour change, risk minimisation and skills acquisition. No reviews aimed to promote systems-level consumer participation in medicines-related activities. Medicines adherence was the most frequently-reported outcome, but others such as knowledge, clinical and service-use outcomes were also reported. Adverse events were less commonly

  16. Development and evaluation of Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in a Nuclear Medicine Service

    International Nuclear Information System (INIS)

    Krempser, Alexandre R.; Soares, Alexandre B.; Corbo, Rossana

    2011-01-01

    The quality management in Nuclear Medicine Services is a requirement of national and international standards. The Brazilian regulatory agency in health surveillance, the Agencia Nacional de Vigilancia Sanitaria (ANVISA), in its Resolucao de Diretoria Colegiada (Collegiate Directory Resolution) no. 38, requires the elaboration of documents describing the technical and clinical routine activities. This study aimed to elaborate, implement and evaluate Standard Operating Procedures (SOPs) for quality control tests and radiological protection activities in the Nuclear Medicine Service of a university hospital. Eighteen SOPs were developed, involving tasks related to dose calibrator, gamma camera, Geiger-Muller detectors and radiological protection activities. The performance of its application was evaluated for a period of six months. It was observed a reduction in 75% of reported operational errors and 42% of the number of reported incidents with contamination by radioactive material. The SOPs were adequate and successful in its application. New procedures involving clinical activities will also be developed and evaluated. (author)

  17. Medical imaging in personalised medicine: a white paper of the research committee of the European Society of Radiology (ESR).

    Science.gov (United States)

    2015-04-01

    The future of medicine lies in early diagnosis and individually tailored treatments, a concept that has been designated 'personalised medicine' (PM), which aims to deliver the right treatment to the right patient at the right time. Medical imaging has always been personalised and is fundamental to almost all aspects of PM. It is instrumental in solving clinical differential diagnoses. Imaging procedures are tailored to the clinical problem and patient characteristics. Screening for preclinical disease is done with imaging. Stratification based on imaging biomarkers can help identify individuals suited for preventive intervention. Treatment decisions are based on the in vivo visualisation of the location and extent of an abnormality, as well as the loco-regional physiological, biochemical and biological processes using structural and molecular imaging. Image-guided biopsy provides relevant tissue specimens for genetic/molecular characterisation. In addition, radiogenomics relate imaging biomarkers to these genetic and molecular features. Furthermore, imaging is essential to patient-tailored therapy planning, therapy monitoring and follow-up of disease, as well as targeting non-invasive or minimally invasive treatments, especially with the rise of theranostics. Radiologists need to be prepared for this new paradigm as it will mean changes in training, clinical practice and in research. Key Points • Medical imaging is a key component in personalised medicine • Personalised prevention will rely on image-based screening programmes • Anatomical, functional and molecular imaging biomarkers affect decisions on the type and intensity of treatment • Treatment response assessment with imaging will improve personalised treatment • Image-based invasive intervention integrates personalised diagnosis and personalised treatment.

  18. Reducing Blood-borne Exposure in Interventional Radiology: What the IR Should Know

    Energy Technology Data Exchange (ETDEWEB)

    Tso, David K. [University of British Columbia, Department of Radiology (Canada); Athreya, Sriharsha, E-mail: sathreya@stjoes.ca [St. Joseph' s Healthcare Hamilton, Department of Diagnostic Imaging (Canada)

    2013-08-01

    Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.

  19. Strengthening the technical research and clinical application for vertebral interventional radiology

    International Nuclear Information System (INIS)

    Wu Chungen; Cheng Yongde

    2008-01-01

    Interventional diagnostic and therapeutic techniques have developed rapidly in recent years with more and more practically and widely utilization as time goes by. The diagnostic procedures consist of percutaneous biopsy, CT discography, pressure measurement of intervertebral disc; and the therapeutic measures include percutaneous periradicular and joint therapy, decompression of sacral cyst, vertebroplasty, kyphoplasty, decompression of intervertebral disc, transarterial chemotherapy and embolization in spinal tumor, and newly developed percutaneous posterior lumbar intervertebral fusion. All above mentioned interventional techniques for spinal column diseases are developing day by day with a promising future and will play an important role in the field of interventional radiologist research. (authors)

  20. Cost-effectiveness analysis of implantable venous access device insertion using interventional radiologic versus conventional operating room methods in pediatric patients with cancer.

    Science.gov (United States)

    Hancock-Howard, Rebecca; Connolly, Bairbre L; McMahon, Meghan; Menon, Anita; Woo, Gloria; Wales, Paul W; Aziza, Albert; Laporte, Audrey; Nauenberg, Eric; Ungar, Wendy J

    2010-05-01

    Percutaneous image-guided techniques are associated with less tissue trauma and morbidity than open surgical techniques. Interventional radiology has received significant health care investment. The purpose was to determine the cost effectiveness of inserting implantable venous access devices (IVADs) by interventional radiologic means versus conventional operating room surgery in pediatric patients with cancer. In a retrospective cohort analysis, patients presenting with a new tumor diagnosis and receiving a first-time IVAD in January to June 2000 (operative group; n = 30) and January to June 2004 (interventional group; n = 30) were included. A societal costing perspective was adopted. Costs included labor, materials, equipment, inpatient wards, parent travel, and parental productivity losses for 30 days after insertion. Severe complications related to IVAD insertion were microcosted. Costs related to cancer therapy were not included. Incremental cost-effectiveness analysis and sensitivity analysis were performed. Interventional patients were older (7.3 years vs 4.1 years; P = .01). There were no significant differences between groups in sex, American Society of Anesthesiologists score, or length of hospital stay. Interventional radiologic procedures were shorter (84.9 minutes vs 112.8 minutes; P = 0.01). Interventional radiologic insertion was slightly less costly than operative insertion (Can$622,860 and Can$627,005 per 30-patient group, respectively) and more effective in reducing the complication rate (two vs eight complications per group, respectively; P = .039). The results were sensitive to the cost of operating the operating room. Interventional radiology was slightly less costly than operative IVAD insertion and resulted in fewer serious complications. It should be considered for IVAD insertions in pediatric patients with cancer.

  1. Preliminary characterization of dose in personnel of interventional radiology; Caracterizacao preliminar da dose em profissionais de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Godolfim, Laura Larre; Anes, Mauricio; Bacelar, Alexandre; Lykawka, Rochelle [Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS (Brazil)

    2016-07-01

    Exposure to X-rays of Interventional Radiology professionals (IR) impacts in the high dose rate received by these individuals, and there are reports of biological effects of this professional activity. Therefore, it is fomented greater control over the doses received by these workers. This research intends to characterize the doses received by the professionals during IR procedures. We evaluated the doses of radiologists, anesthesiologists and nursing staff of the Hospital de Clinicas de Porto Alegre, through measures with dosimeters of the OSL type, distributed in up to six regions of the body of these professionals. Until now were accompanied 33 cholangiography procedures and 29 embolization procedures. As a preliminary result, it was possible to identify a wide variation between doses of the professionals of the same function in each procedure. In overview, the dose of the professionals presented in descending order as a radiologist 1> radiologist 2 > anesthetist > nursing. (author)

  2. Summary of principles for intervention in food and drinking water in a radiological emergency developed by several international organizations

    International Nuclear Information System (INIS)

    Sugiyama, Hideo

    1994-01-01

    After the Chernobyl accident in April 1986 it became clear that the guidelines on the management of the consequence of a nuclear accident were needed for action over long time scales and for dealing with the widespread radioactive contamination that affected many countries at distances far from the accident site. One of the major difficulties in area away from the site of a nuclear accident concerns decisions on the safety of contaminated food and drinking water. International organizations, ICRP, IAEA, WHO and several other organizations, have considered it appropriate to develop guidelines to assist national authorities in making decisions on the control of food in the event of widespread contamination by radionuclides in a radiological emergency. These guidelines and the recommendations for intervention in food and drinking water by WHO, ICRP and CEC are summarized, and the considerations and problems to adopt the guidelines are proposed in this paper. (author)

  3. A comparison of the quality of the information available on the internet on interventional radiology, vascular surgery, and cardiology

    Directory of Open Access Journals (Sweden)

    A Alsafi

    2013-01-01

    Full Text Available Context and Aims: Internet use is rapidly expanding and increasingly plays a substantial role in patient education. We sought to evaluate and compare the quality of information available to patients online on three closely linked specialties: Interventional radiology (IR, cardiology, and vascular surgery. Materials and Methods: We searched the leading three search engines for the terms: "Interventional Radiology", "cardiology," and "vascular surgery," collating the top 50 hits from each search. After excluding duplicates and irrelevant sites, 43, 25, and 36 sites remained, respectively. Sites were analyzed using the LIDA instrument (an online tool for assessing health-related websites and Fleisch Reading Ease Scores (FRES were compared across the different search terms and correlated with the country of origin and certification by the Health on the Net (HON Foundation. Results: There was no significant difference ( P>0.05 in the total LIDA, accessibility, usability or reliability scores between the three specialties. HONCode certification was associated with higher LIDA (83.1±1.6 vs. 71.53±0.8 ( P<0.0001, reliability (75.7±3.6 vs. 49.0±1.6 ( P<0.0001 and FRES (37.4±4.0 vs. 29.7±1.4 ( P=0.0441. Conclusion: Websites are generally well designed and easy to use; the majority however, lacks currency and reliability. Despite similarity in quality of online information, there is a disparity in knowledge of IR; this may be due to low web-traffic figures of IR sites. Wikipedia′s user-generated content, ranks highly in major search engines, as such; this could serve as means of disseminating reliable health information to patients.

  4. MOrtality and infectious complications of therapeutic EndoVAscular interventional radiology: a systematic and meta-analysis protocol.

    Science.gov (United States)

    Mellouk Aid, Kaoutar; Tchala Vignon Zomahoun, Hervé; Soulaymani, Abdelmajid; Lebascle, Karin; Silvera, Stephane; Astagneau, Pascal; Misset, Benoit

    2017-04-24

    Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death. Moreover, additional non-life-threatening complications exist, but they are not well described and represent disparate information. A range of databases will be screened consulted to identify the relevant studies: PubMed, EMBASE, The Cochrane Library, NosoBase, and Google Scholar (to identify articles not yet indexed). Scientist librarian used Medical Subject Headings (MeSH) and free terms to construct the search strategy in PubMed. This search strategy will be adapted in other databases. Two coauthors will independently select the relevant studies, extract the relevant data, and assess the risk of bias in the included studies. Any disagreements between the two authors will be solved by a third author. This systematic review will provide a synthesis of EIR complications. The spotlighted results will be analyzed in order to provide a state-of-knowledge synopsis of the current evidence base in relation to the epidemiology of the infectious complications after EIR. In the event of conclusive results, our findings will serve as a reference background to assess guidelines on reality of the problem of the infections linked to endovascular interventional radiology and to formulate of assumptions and propose preventive measures, based on the results of our investigations. These propositions will aim to reduce the risk and/or the severity of these complications in the concerned population in favor a positive medical economics

  5. Radiologic considerations

    International Nuclear Information System (INIS)

    Judge, L.O.

    1987-01-01

    An increasing variety of imaging modalities as well as refinements of interventional techniques have led to a resurgence of radiologic interest and participation in urolithiasis management. Judicious selection of the diagnostic examination, close monitoring during the procedure, consultation with urologic colleagues, and a careful regard for radiation safety guidelines define the role of the radiologist in renal stone disease

  6. Proceedings of the 3. Brazilian forum on health science and technology; 15. Brazilian congress on biomedical engineering; 6. Brazilian congress of physicists in medicine; 5. Brazilian congress of informatics in health; Brazilian meeting on radiological protection. v. 1

    International Nuclear Information System (INIS)

    1996-01-01

    The importance of radiological protection and monitoring, development of quality control programs, radiation protection standards and procedures, are discussed. Such aspects are highlighted in nuclear medicine and radiodiagnosis to improve performance - considering both better image and safety working conditions

  7. When the Reading Room Meets the Team Room: Resident Perspectives From Radiology and Internal Medicine on the Effect of Personal Communication After Implementing a Resident-Led Radiology Rounds.

    Science.gov (United States)

    Klobuka, Andrew J; Lee, John; Buranosky, Raquel; Heller, Matthew

    2018-02-13

    Current radiology and internal medicine (IM) residents have trained to varying degrees depending on program in the post picture archiving and communication systems implementation era and thus have largely missed out on the benefits of in-person, 2-way communication between radiologists and consulting clinicians. The purpose of this study is to broadly explore resident perspectives from these groups on the desire for personal contact between radiologists and referring physicians and the effect of improved contact on clinical practice. A radiology rounds was implemented in which radiology residents travel to the IM teaching service teams to discuss their inpatients and review ordered imaging biweekly. Surveys were given to both cohorts following 9 months of implementation. A total of 23/49 diagnostic radiology (DR) and 72/197 IM residents responded. In all, 83% of DR and 96% of IM residents desired more personal contact between radiologists and clinicians. Of all, 92% of DR residents agree that contact with referring clinicians changes their approach to a study, 96% of IM residents agree that personal contact with a radiologist has changed patient management in a way that they otherwise would not have done having simply read a report, 85% of DR residents report that more clinician contact will improve resource use, and 96% report that it will improve care quality. Furthermore, 99% of IM residents report that increased access to a radiologist would make selecting the most appropriate imaging study easier in various clinical scenarios. A majority of IM residents prefer radiology reports that provide specific next-step recommendations and that include arrows/key-image series. We conclude that the newest generation of physicians is already attuned to the value of a radiologist who plays an active, in-person role in the clinical decision-making process. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Recent trend of diagnostic radiology

    International Nuclear Information System (INIS)

    Kim, S.Y.; Kim, H.K.

    1979-01-01

    Present status and recent trend of diagnostic radiology have been reviewed. The interrelationships and Characteristics of various fields of radiology such as computed tomography, X-ray radiology, and nuclear medicine were discussed. The mevit of computed tomography and the promising use of short lived, accelerator produced radionuclides, and radiotherapy in nuclear medicine were emphasized. (author)

  9. A survey of the role of the UK physicist in nuclear medicine: a report of a joint working group of the British Institute of Radiology, British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine.

    Science.gov (United States)

    Tindale, W B; Thorley, P J; Nunan, T O; Lewington, V; Shields, R A; Williams, N R

    2003-01-01

    Guidelines for the provision of physics support to nuclear medicine were published in 1999 by a joint working group of the British Institute of Radiology, the British Nuclear Medicine Society, and the Institute of Physics and Engineering in Medicine. Following publication of the guidelines, a survey was conducted by the working group to gather data on the actual level of physicist support in UK hospitals of different types and on the activities undertaken by physicists. The data were collected in the 12 months following the publication of guidelines and cover different hospital models and seven UK regions. The results provide evidence that many of the smaller units - small teaching hospitals and, particularly, small district general hospitals - have insufficient physics support. Although, on average, there is good agreement between the guidelines and the survey data for medium and large district general hospitals, there is wide variation in the level of physics provision between hospitals delivering apparently similar services. This emphasizes the need for national guidelines, against which institutions may be bench-marked and which may be used as a recommendation for the staffing levels necessary to ensure services are delivered safely and standards are not compromised. The complexity and variety of workload is an important factor in determining the level of physics support. As services develop, it is vital that this aspect is recognized to ensure that appropriate resources are available for the required physics input, even if any new service represents only a modest clinical throughput in terms of patient numbers.

  10. Occupational physicians' perceived value of evidence-based medicine intervention in enhancing their professional performance

    NARCIS (Netherlands)

    Hugenholtz, Nathalie I. R.; Schaafsma, Frederieke G.; Schreinemakers, Jos F.; van Dijk, Frank J. H.; Nieuwenhuijsen, Karen

    2008-01-01

    OBJECTIVES: This study evaluated how physicians in a nonclinical setting perceive the value of an intervention with multifaceted evidence-based medicine with regard to enhancing their professional performance. METHODS: A qualitative study was conducted using focus groups and face-to-face interviews

  11. How to improve eHealth interventions in Health Psychology and Behavioral Medicine

    NARCIS (Netherlands)

    van Gemert-Pijnen, Julia E.W.C.; Kulyk, Olga Anatoliyivna; Wentzel, M.J.; Sieverink, Floor; Beerlage-de Jong, Nienke; Kelders, Saskia Marion

    2014-01-01

    Introduction: eHealth is gaining more and more ground in health psychology and behavioural medicine to support wellbeing, a healthier lifestyle or adherence to medications. Despite the large number of eHealth projects to date, the actual use of eHealth interventions is lower than expected. Many

  12. Deliberation nr 2011-DL-0018 of the Nuclear Safety Authority on the 14 June 2011 regarding the improvement of radiation protection in interventional radiology

    International Nuclear Information System (INIS)

    2011-01-01

    After having presented and commented the context of interventional radiology (relatively high doses received by patients and workers, development of a return on experience, assessment of the ASN inspection programs), this report proposes actions in the field of radiation protection, and more particularly in the fields of training, of personnel availability, and of hospital management

  13. Monte Carlo simulations of scattered radiation fields in interventional radiology; Simulacion Monte Carlo de campos de radiacion dispersa en radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Duch, M. A.; Zaragoza, F. J.; Sempau, J.; Ginjaume, M.; Vano, E.; Sanchez, R.; Fernandez, J. M.

    2013-07-01

    The study shows that the MC simulation is a useful tool to facilitate the assessment of the spatial distribution of the dose due to the radiation scattered in interventional radiology procedures, as well as to determine the influence of various operational parameters in the same , avoiding experimental measures that require much time of use the Cath Labs. (Author)

  14. Periprocedural Prophylactic Antithrombotic Strategies in Interventional Radiology: Current Practice in the Netherlands and Comparison with the United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Wiersema, Arno M., E-mail: arno@wiersema.nu [Westfriesgasthuis, Hoorn, Department of Surgery (Netherlands); Vos, Jan-Albert, E-mail: j.a.vos@antonius.net [St Antonius Hospital, Nieuwegein, Department of Radiology, Division of Interventional Radiology (Netherlands); Bruijninckx, Cornelis M. A., E-mail: cmabruijninckx@planet.nl [Equipe Zorg Bedrijven, Rotterdam, Department of Surgery (Netherlands); Delden, Otto M. van, E-mail: o.m.vandelden@amc.uva.nl [Academic Medical Centre, University of Amsterdam, Department of Radiology, Division of Interventional Radiology (Netherlands); Reijnen, Michel M. P. J., E-mail: mmpj.reijnen@gmail.com [Rijnstate Hospital, Arnhem, Department of Surgery (Netherlands); Vahl, Anco, E-mail: a.c.vahl@olvg.nl [Onze Lieve Vrouwe Gasthuis, Amsterdam, Department of Surgery (Netherlands); Zeebregts, Clark J., E-mail: czeebregts@hotmail.com [University of Groningen, Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen (Netherlands); Moll, Frans L., E-mail: F.L.Moll@umcutrecht.nl [University of Utrecht, Department of Surgery, Division of Vascular Surgery, University Medical Centre Utrecht (Netherlands)

    2013-12-15

    Purpose: The use of prophylactic antithrombotic drugs to prevent arterial thrombosis during the periprocedural period during (percutaneous) peripheral arterial interventions (PAIs) is still a matter of dispute, and clear evidence-based guidelines are lacking. To create those guidelines, a study group was formed in the Netherlands in cooperation with the Dutch Society of Vascular Surgery and the Society of Interventional Radiology. The study group is called 'Consensus on Arterial PeriProcedural Anticoagulation (CAPPA).' Materials and Methods: The CAPPA study group devised and distributed a comprehensive questionnaire amongst Dutch interventional radiologists (IRs). Results: One hundred forty-two IRs responded (68 %) to the questionnaire. Almost no IR stopped acetyl salicylic acid before interventions, and 40 % stopped clopidogrel before PAI but not before carotid artery stenting (CAS). A flushing solution on the sideport of the sheath was used routinely by 30 % of IRs in PAI and by 50 % of IRs during CAS. A minority of IRs used a heparinised flushing solution (28 %). Unfractionated heparin was used by 95 % of IRs as bolus; 5000 IU was the most used dosage. Timing of administration varied widely. A majority of IRs (75 %) repeated heparin administration after 1 h. Conclusion: A substantial variety exists amongst IRs in the Netherlands regarding the use of prophylactic periprocedural antithrombotic drugs to prevent arterial thrombosis during PAI. When compared with varying results regarding the use of heparin in the United Kingdom, the variety in the Netherlands showed a different pattern. The proven variety in these countries, and also between these countries, emphasises the need for authoritative studies to develop evidence-based practical guidelines.

  15. Radioprotection of patients and workers in interventional and operating block radiology

    International Nuclear Information System (INIS)

    Menechal, P.; Valero, M.; Megnigbeto, C.; Marchal, C.; Godet, J.L.

    2011-01-01

    Over the last ten years or so, extensive development in radiological and implantable equipment has generated significant growth in radio-guided procedures. The real benefit of these practices to patients explains their development. These procedures can be undertaken using not only dedicated, specific fixed installations and computed tomography scanners, but also mobile installations in facilities not designed for radiography, such as operating blocks. The complexity of these procedures and the times spent implementing the required radiation can lead to major detrimental effects on personnel and patients, if they are not fully controlled. Many specialist medical disciplines now perform invasive procedures guided by images. Optimisation of patient doses mainly depends on the training level of medical teams, the intrinsic performance characteristics of the equipment used, adjustment of the technical parameters and the presence or absence of qualified personnel. Optimisation of professional personnel exposure is complex and depends on the performance conditions of procedures, which can expose workers extensively and non-uniformly. Designation of personnel competent in radioprotection, assessment of risks and definition of controlled areas, analysis of workstations and dosimetric monitoring of operators (especially of body extremities) are difficult to implement. Use of collective and personal protective equipment must be improved. The general manager of the French nuclear safety authority (ASN) has referred the matter to the permanent group of radioprotection experts (GPMED) to ensure that recommendations are drawn up in the short term. (authors)

  16. Development of master slave system for interventional radiology with force-rate control

    International Nuclear Information System (INIS)

    Ide, Masaru; Zobel, P.B.; Claudio, P.D.; Mohri, Makoto; Komeda, Takashi

    2010-01-01

    The objective of this study is to develop a master-slave system for a catheter-guided operation, which is performed by using radiology, through the vascular system. When the master-slave system is used, the surgeon is not exposed to x-rays during the operation. The master tool is managed by an operator away from the slave tool, which is near the patient. The system must provide a realistic picture to the surgeon, particularly in term of force information because this operation is performed by observing three-dimensional fields on a two-dimensional monitor. In this paper, we describe the development of a master slave system that involves the use of force-rate control for guiding the catheter without using force sensors. The master tool has a force-display function. This system can be controlled by force and velocity controlling; hence, this system realized an innovative mechanism and algorism. Finally, the preliminary experiment indicated that the new control method was effective. Further, the force display was stable and achieved fast response. (author)

  17. Outcomes of Music Therapy Interventions on Symptom Management in Palliative Medicine Patients.

    Science.gov (United States)

    Gallagher, Lisa M; Lagman, Ruth; Rybicki, Lisa

    2018-02-01

    Evidence has demonstrated the positive effects of music therapy on symptom management for palliative medicine patients. Previous studies have addressed patient needs, with limited discussion involving the relationship between interventions utilized to improve symptoms. The purpose of this study was to understand the impact of music therapy sessions; identify common music therapy goals and interventions and assess their effect; and investigate the effects of gender, age, and type of cancer on symptoms in patients who experienced music therapy. This was a retrospective study of data collected during music therapy sessions. Patients scored their symptoms (pain, anxiety, depression, shortness of breath, and mood) before and after sessions. Data collected from over 1500 patients included symptom evaluation, goals, interventions, music used, patient/family reactions, and narratives. Among 293 patients who met all study inclusion criteria, significant improvement in pain, anxiety, depression, shortness of breath, mood, facial expression, and vocalization scores was noted. In addition, 96% of patients had positive responses to participating in music therapy. Vocal and emotional were the 2 most effective interventions in improving symptoms. All 5 patient-reported symptoms improved when the therapist focused on these symptoms as goals. Age, gender, and diagnosis had no impact on symptom improvement. This study demonstrated the importance of music therapy for addressing symptoms and behaviors of palliative medicine patients. Statistically and clinically significant effects were noted. The most effective interventions were identified. More research needs to be conducted to better understand the benefits of music therapy for palliative medicine patients.

  18. Radiological diagnostics in hyperparathyroidism

    International Nuclear Information System (INIS)

    Moedder, U.; Kuhn, F.P.; Gruetzner, G.

    1991-01-01

    The most important radiologically detectable effects of the primary and secondary hyperparathyroidism of the skeletal system and the periarticular soft tissue structures are presented. In the following sensitivity and specificity of radiological imaging - sonography, scintigraphy, computed tomography, magnetic resonance imaging, arteriography and selective venous sampling - in the preoperative diagnostic of the parathyroid adenomas are discussed. Therefore, radiological imaging can be omitted before primary surgery. It was only in secondary surgery that radiological process proved useful and a guide during surgical intervention. (orig.) [de

  19. EU-CIS joint study project 2. Intervention criteria in CIS, risk assessments and non-radiological factors in decision-making

    Energy Technology Data Exchange (ETDEWEB)

    Hedemann Jensen, P. [Risoe National Lab., Roskilde (Denmark); Demin, V.F. [Russian Reserch Centre `Kurchatov Inst.`, Moscow (Russian Federation); Konstantinov, Y.O. [Research Inst. of Radiation Hygiene, St. Petersburg (Russian Federation); Likhtarev, I.A. [Ukrainian Scientific Centre for Radiation Medicine, Kiev (Ukraine); Rolevich, I.V. [Chernobyl State Commiettee, Minsk (Belarus); Schneider, T. [Centre d`etudes sur l`Evaluation de la Protection dans le domaine Nucleaire, CEPN, Paris (France)

    1996-05-01

    An extensive radiation risk estimation methodology has recently been developed in Russia and used for estimates of risk in exposed populations in the republics of Russia, Belarus and Ukraine. Results based on demographic data for the three republics are presented and compared with risk estimates from the EU risk model ASQRAD. The intervention criteria in the CIS republics have been evolving since the Chernobyl accident. The development of criteria in each of the three republics has been analysed and the CIS-Criteria have been compared to international guidance on intervention. After a nuclear or radiological emergency both radiological and non-radiological protection factors will influence the level of protective actions being introduced. The role of non-radiological protection factors in the overall optimization of health protection is addressed. It is argued that optimization of the overall health protection is not a question of developing radiation radiation protection philosophy to fully include socio-psychological factors. It is rather a question of including these factors - in parallel with the radiological protection factors - in cooperation between radiation protection experts and psychological specialists under the responsibility of the decision maker. (au) 19 tabs., 10 ills., 45 refs.

  20. EU-CIS joint study project 2. Intervention criteria in CIS, risk assessments and non-radiological factors in decision-making

    International Nuclear Information System (INIS)

    Hedemann Jensen, P.; Demin, V.F.; Konstantinov, Y.O.; Likhtarev, I.A.; Rolevich, I.V.; Schneider, T.

    1996-05-01

    An extensive radiation risk estimation methodology has recently been developed in Russia and used for estimates of risk in exposed populations in the republics of Russia, Belarus and Ukraine. Results based on demographic data for the three republics are presented and compared with risk estimates from the EU risk model ASQRAD. The intervention criteria in the CIS republics have been evolving since the Chernobyl accident. The development of criteria in each of the three republics has been analysed and the CIS-Criteria have been compared to international guidance on intervention. After a nuclear or radiological emergency both radiological and non-radiological protection factors will influence the level of protective actions being introduced. The role of non-radiological protection factors in the overall optimization of health protection is addressed. It is argued that optimization of the overall health protection is not a question of developing radiation radiation protection philosophy to fully include socio-psychological factors. It is rather a question of including these factors - in parallel with the radiological protection factors - in cooperation between radiation protection experts and psychological specialists under the responsibility of the decision maker. (au) 19 tabs., 10 ills., 45 refs

  1. The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

    LENUS (Irish Health Repository)

    O'Sullivan, Gerard J

    2011-06-01

    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer "single-session" techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  2. Entrance skin dose measured with MOSFETs in children undergoing interventional radiology procedures

    International Nuclear Information System (INIS)

    Glennie, Diana; Connolly, Bairbre L.; Gordon, Christopher

    2008-01-01

    Interventional procedures frequently employ fluoroscopy or digital subtraction angiography (DSA). Few studies have documented radiation doses received by children during these procedures. To measure skin entrance dose received during common pediatric interventional procedures. MOSFET dosimeters were placed to record skin doses in 143 children undergoing any of five procedures: 30 PICC insertions, 34 CVL/port insertions, 30 G/GJ tube insertions, 25 sclerotherapy/vascular anomaly procedures, 24 cerebral angiography procedures. The highest recorded dose (HRD) from the five MOSFET probes was assumed to be the peak skin dose per child. HRD values were averaged for children within each group and correlated with patient weight, fluoroscopy time and number of DSA frames. Average HRD was 1.8 mGy for PICC insertions, 1.4 mGy for CVL/port insertions, 3.9 mGy for G/GJ tube insertions, 39.1 mGy for sclerotherapy/vascular anomaly procedures, and 149.9 and 101.6 mGy for frontal and lateral portions of cerebral angiography procedures. These entrance doses corresponded to effective dose estimates in the range 0.4-3 mSv. There were only modest correlations between peak skin dose and fluoroscopy time, patient weight and DSA frames (r 2 <0.4, P<0.01). Pediatric interventional procedures are associated with a wide range of doses; those at the higher end require careful monitoring. (orig.)

  3. Entrance skin dose measured with MOSFETs in children undergoing interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Glennie, Diana [McMaster University, Medical and Health Physics Department, Hamilton (Canada); Connolly, Bairbre L. [The Hospital for Sick Children, Image-Guided Therapy, Department of Diagnostic Imaging, Toronto (Canada); Gordon, Christopher [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada)

    2008-11-15

    Interventional procedures frequently employ fluoroscopy or digital subtraction angiography (DSA). Few studies have documented radiation doses received by children during these procedures. To measure skin entrance dose received during common pediatric interventional procedures. MOSFET dosimeters were placed to record skin doses in 143 children undergoing any of five procedures: 30 PICC insertions, 34 CVL/port insertions, 30 G/GJ tube insertions, 25 sclerotherapy/vascular anomaly procedures, 24 cerebral angiography procedures. The highest recorded dose (HRD) from the five MOSFET probes was assumed to be the peak skin dose per child. HRD values were averaged for children within each group and correlated with patient weight, fluoroscopy time and number of DSA frames. Average HRD was 1.8 mGy for PICC insertions, 1.4 mGy for CVL/port insertions, 3.9 mGy for G/GJ tube insertions, 39.1 mGy for sclerotherapy/vascular anomaly procedures, and 149.9 and 101.6 mGy for frontal and lateral portions of cerebral angiography procedures. These entrance doses corresponded to effective dose estimates in the range 0.4-3 mSv. There were only modest correlations between peak skin dose and fluoroscopy time, patient weight and DSA frames (r{sup 2}<0.4, P<0.01). Pediatric interventional procedures are associated with a wide range of doses; those at the higher end require careful monitoring. (orig.)

  4. Mobile computing for radiology.

    Science.gov (United States)

    Auffermann, William F; Chetlen, Alison L; Sharma, Arjun; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Kung, Justin W; Loehfelm, Thomas W; Sherry, Steven J

    2013-12-01

    The rapid advances in mobile computing technology have the potential to change the way radiology and medicine as a whole are practiced. Several mobile computing advances have not yet found application to the practice of radiology, while others have already been applied to radiology but are not in widespread clinical use. This review addresses several areas where radiology and medicine in general may benefit from adoption of the latest mobile computing technologies and speculates on potential future applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  5. Interventional recanalization combined with chinese traditional medicine in the treatment of fallopian tube obstruction

    International Nuclear Information System (INIS)

    Sun Lizhe; Liu Hui; He Zhao; Wei Feng; Ma Xuanpeng

    2004-01-01

    Objective: To observe the curative effect of interventional recanalization combined with chinese traditional medicine in treatment of fallopian tube obstruction. Methods: There were 200 cases in treatment group and 120 cases in control group. In the treatment group patients were given chinese herbal medicine after the intervention. In sixth month a follow up imaging was performed assessing the patency. The follow up also included the pregnancy rate 1 year later. Results: The patency rate was 83% in treatment group, and 81.5% in control group (P>0.05). Re-conjunction rate was 7.6% in the study group and 22% in control group (P<0.01). The pregnancy rate was 67% in study group and 42% in control group (P<0.01). Conclusion: With interventional recanalization combined with chinese traditional medicine, good curative effect obtained in treatment of fallopian tube obstructive infertility. Combined with Chinese traditional medicine, the post-procedure re-conjunction rate is decreased, especially in the case of short fallopian tube obstruction

  6. RADIOLOGY IN URGENT MEDICINE

    Directory of Open Access Journals (Sweden)

    Article Editorial

    2017-01-01

    Full Text Available Интервью с директором Научно-образовательного клинического центра Гибридных технологий лучевой медицины, заведующим кафедрой лучевой диагностики и лучевой терапии Первого МГМУ им. И.М. Сеченова, руководителем отдела томографии Института клинической кардиологии им. А.Л. Мясникова, главным консультантом Главного медицинского управления УД Президента РФ, академиком РАН Сергеем Константиновичем Терновым.

  7. Gadopentetate di-meglumine as contrast agent for arteriography and interventional radiologic procedures: preliminary application

    International Nuclear Information System (INIS)

    Wang Zhongpu; Wang Maoqiang; Sun Yongguang; Liu Xiaojun

    2002-01-01

    Objective: To investigate the feasibility of gadopentetate di-meglumine as contrast agent for arteriography and interventional procedures. Methods: Nine patients received gadopentetate di-meglumine as contrast agent during interventional procedures. Gadopentetate di-meglumine wa used in 2 patients with contraindications to iodinated contrast media. In addition to the standard injection sequences with iodinated contrast media, arteriograms were obtained after administration of gadopentetate di-meglumine in seven patients. Diagnostic arteriography were performed in thoracic aorta, common carotid artery, bronchial artery, intercostal artery, hepatic artery, iliac artery and uterine artery. The doses of gadopentetate di-meglumine used in this series were ≤0.3 mmol/kg. Vital signs and arterial oxygen saturation were monitored during the procedures. The blood and urine routine examinations, the hepatic and renal functions tests were done after the procedure. Results: There were no significant differences between the gadopentetate di-meglumine and the iodinated contrast media examinations for illustrating the main trunk of these arteries. Angiograms obtained with the iodinated contrast media appeared to be better than that of with gadopentetate di-meglumine for visualizing the distal branches of these arteries and the tumor stain. The interventional procedure was completed successfully in the two patients using gadopentetate di-meglumine alone. No patient suffered from complication related to the use of gadopentetate di-meglumine, and also no worsened renal function was shown after the procedure. Conclusions: Diagnostic arteriograms can be achieved safely and successfully by using gadopentetate di-meglumine, especially in patients with allergy to iodinate contrast media and chronic renal insufficiency

  8. Intervention in radiological emergency situations - the missions of the French fire brigades

    International Nuclear Information System (INIS)

    Giordan, D.

    2006-01-01

    The radioactive risks listed in France are: the use of sources in industry, education, research and medical environment, transport, by railways and road, of radioactive sources, and, of course, nuclear installations September 11. brought to attention the possible consequences of a hostile act using radioactive sources. The radiological units, created in 1980, are teams of 7 firemen able to cope with and overcome an incident or an accident of a radioactive nature. According to the level of responsibility, there are 4 levels of competency. Experience is essential to these small teams. The radioactivity engine has numerous materials, in particular radioactivity detectors, adapted for each specific task within the assignments of the C.M.I.R.: marking out of the irradiant and contaminated zones, search for sealed sources, search for contamination in the soiled zone, contamination inspection of persons. There are two radioactive engine in the County of the Yvelines: the first one is a C.M.I.R., the second one is radioactive support engine with: a photon spectrometry lab, a dosimetry headquarters, a decontamination unit. Some fire brigades have been equipped with decontamination units insuring the treatment of twenty contaminated people per hour. This year, we tested the contamination unit with radioactive contamination three times. The technetium 99 m has a half life of six hours. Contaminated victims were dummies. We gained much logical knowledge from these experiments and as a result have revised our operational doctrine and techniques: by example, to gain time in decontamination operation, it is necessary to undress contaminated people precociously, even the shower will be deferred, it is impossible to evaluate good decontamination, in the third part of the unit of account of count rate (doctrine says it is the right place), without special stretcher, who do not fixed contamination, without remove the soiled water tanks, decontamination will take a long time, then it

  9. Development and validation of a virtual reality simulator: human factors input to interventional radiology training.

    Science.gov (United States)

    Johnson, Sheena Joanne; Guediri, Sara M; Kilkenny, Caroline; Clough, Peter J

    2011-12-01

    This study developed and validated a virtual reality (VR) simulator for use by interventional radiologists. Research in the area of skill acquisition reports practice as essential to become a task expert. Studies on simulation show skills learned in VR can be successfully transferred to a real-world task. Recently, with improvements in technology, VR simulators have been developed to allow complex medical procedures to be practiced without risking the patient. Three studies are reported. In Study I, 35 consultant interventional radiologists took part in a cognitive task analysis to empirically establish the key competencies of the Seldinger procedure. In Study 2, 62 participants performed one simulated procedure, and their performance was compared by expertise. In Study 3, the transferability of simulator training to a real-world procedure was assessed with 14 trainees. Study I produced 23 key competencies that were implemented as performance measures in the simulator. Study 2 showed the simulator had both face and construct validity, although some issues were identified. Study 3 showed the group that had undergone simulator training received significantly higher mean performance ratings on a subsequent patient procedure. The findings of this study support the centrality of validation in the successful design of simulators and show the utility of simulators as a training device. The studies show the key elements of a validation program for a simulator. In addition to task analysis and face and construct validities, the authors highlight the importance of transfer of training in validation studies.

  10. Radiation Protection in Interventional Radiology. Training objectives for the medical specialists

    International Nuclear Information System (INIS)

    Ruiz-Cruces, R.; Vano, E.; Hernandez Armas, J.; Carrera, F.

    2003-01-01

    The Directive 97/43 Euratom on medical exposures and the report RP 116 published by the European Commission on Education and Training in radiation protection for medical exposures, established that interventional radiologists should have a more skilled training for handling X-Ray equipment and a better knowledge about the ways of protecting patients and staff against ionising radiation. To analyse the objectives for training in radiation protection recommended in the European Guideline and to show the most important points and modifications for a better practical application of this guide. An inquiry has been performed into the specific objectives recommended by the European Guideline RP 116 about training on Radiation Protection. Twenty interventional radiologists were requested to fill in the test, pointing out the importance of each objective (0-no necessary, 1-medium importance, 2-very important), and they were encouraged to suggest other more interesting for them not included in the European Guideline. The average scores for each of the objectives included in the European Guideline are shown, and an additional relation of suggested topics has been added to the current list. The scoring system show the priority and importance of the objectives that could be taken into account during the next training courses to be held in Spain and it could be used as a base of discussion in some European meeting in order to improve the European Guideline in the future. (Author) 13 refs

  11. Socioeconomic and political issues in radiology

    International Nuclear Information System (INIS)

    Stiles, R.G.; Belt, H.C.

    1990-01-01

    This paper compares editorials on socioeconomic and political issues published in the radiologic literature during 1920-1940 with those published during 1970-1990. Radiologists literature indexes were searched for editorials on socioeconomic and political issues published during two 20-year periods: 1920-1940 and 1970- 1990. One hundred editorials from each period were chosen from two major journals. The editorials were organized into 20 categories including turf, subspecialization, radiologist as physician, public relations, governmental intervention (socialized medicine), future of radiology, overuse of studies

  12. The application of nursing process method in training nurses working in the department of interventional radiology

    International Nuclear Information System (INIS)

    Ni Daihui; Wang Hongjuan; Yang Yajuan; Ye Rui; Qu Juan; Li Xinying; Xu Ying

    2010-01-01

    Objective: To describe the training procedure,typical training method and the clinical effect of nursing process method which was used to cultivate nurses working in the interventional ward. Methods: According to the evaluation index, the authors made a detail assessment of each nurse and found out individually the problems which needed to be perfected, then, the practicable measures were made for each individual nurse, after the training course the clinical results were evaluated. Results: After the nurses on different technical levels were cultivated with nursing process method, the comprehensive quality of each nurse was improved in different degree, and the general nursing quality of entire Department was also markedly improved. Conclusion: By using the nursing process method the cultivating period can be effectively shortened, the possible waste of time, manpower, material and energy cause by the blind training plan can be avoided. (authors)

  13. Order of 24 October 2011 related to diagnosis reference levels in radiology and nuclear medicine; Arrete du 24 octobre 2011 relatif aux niveaux de reference diagnostiques en radiologie et en medecine nucleaire

    Energy Technology Data Exchange (ETDEWEB)

    Grall, J.Y. [Ministere du travail, de l' emploi et de la sante, Direction generale de la sante, 14, avenue Duquesne, 75350 PARIS 07 SP (France)

    2012-01-14

    This order defines diagnosis reference levels for examinations exposing to the most common or irradiating ionizing radiations in the case of radiology and nuclear medicine. It also specifies the role of the person authorized to use nuclear medicine equipment, the role of the IRSN in collecting and analysing data. Doses are specified in appendix for different types of examinations

  14. Reducing Implicit Gender Leadership Bias in Academic Medicine With an Educational Intervention.

    Science.gov (United States)

    Girod, Sabine; Fassiotto, Magali; Grewal, Daisy; Ku, Manwai Candy; Sriram, Natarajan; Nosek, Brian A; Valantine, Hannah

    2016-08-01

    One challenge academic health centers face is to advance female faculty to leadership positions and retain them there in numbers equal to men, especially given the equal representation of women and men among graduates of medicine and biological sciences over the last 10 years. The purpose of this study is to investigate the explicit and implicit biases favoring men as leaders, among both men and women faculty, and to assess whether these attitudes change following an educational intervention. The authors used a standardized, 20-minute educational intervention to educate faculty about implicit biases and strategies for overcoming them. Next, they assessed the effect of this intervention. From March 2012 through April 2013, 281 faculty members participated in the intervention across 13 of 18 clinical departments. The study assessed faculty members' perceptions of bias as well as their explicit and implicit attitudes toward gender and leadership. Results indicated that the intervention significantly changed all faculty members' perceptions of bias (P leadership of all participants regardless of age or gender (P = .008). These results suggest that providing education on bias and strategies for reducing it can serve as an important step toward reducing gender bias in academic medicine and, ultimately, promoting institutional change, specifically the promoting of women to higher ranks.

  15. Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve.

    Science.gov (United States)

    Rotzinger, Roman; Gebauer, Bernhard; Schnapauff, Dirk; Streitparth, Florian; Wieners, Gero; Grieser, Christian; Freyhardt, Patrick; Hamm, Bernd; Maurer, Martin H

    2017-12-01

    Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions' durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.

  16. Lessons learned from events declared to the ASN related to interventional radiology and having occurred during radiation-based acts

    International Nuclear Information System (INIS)

    Lachaume, Jean-Luc

    2014-01-01

    Based on an analysis of events declared to the ASN and inspection observations performed in the field of interventional radiology, this report outlines that the majority of these events could have been avoided and that they result from a lack of culture in radiation protection, notably an unawareness of doses delivered to patients or received by practitioners, and of risks related to exposure to ionizing radiations. The report notably outlines that events are related to a lack of staff and means in the field of patient and personnel radiation protection, an underdeveloped risk management and radiation protection implementation, lacks in the management of delivered or received doses and absence of approaches of professional practice assessment, operator insufficient education, and weaknesses in the management of subcontracted operations. Recommendations are made related to needs in medical radio-physics, identification of acts and patients at risk and definition of patient follow-up modalities, the implementation of an approach of professional practice assessment, the storage of dosimetric data, the improvement of operator technical education, the control of subcontracted operations, and the anticipation of technical and organisational changes

  17. Medical liability and patient law in Germany. Main features with particular focus on treatments in the field of interventional radiology

    International Nuclear Information System (INIS)

    Sommer, S.A.; Geissler, R.; Stampfl, U.; Radeleff, B.A.; Kauczor, H.U.; Sommer, Christof M.; Richter, G.M.; Pereira, P.L.

    2016-01-01

    On February 26th, 2013 the patient law became effective in Germany. Goal of the lawmakers was a most authoritative case law for liability of malpractice and to improve enforcement of the rights of the patients. The following article contains several examples detailing legal situation. By no means should these discourage those persons who treat patients. Rather should they be sensitized to to various aspects of this increasingly important field of law. To identify relevant sources according to judicial standard research was conducted including first- and second selection. Goal was the identification of jurisdiction, literature and other various analyses that all deal with liability of malpractice and patient law within the field of Interventional Radiology - with particular focus on transarterial chemoembolization of the liver and related procedures. In summary, 89 different sources were included and analyzed. The individual who treats a patient is liable for an error in treatment if it causes injury to life, the body or the patient's health. Independent of the error in treatment the individual providing medical care is liable for mistakes made in the context of obtaining informed consent. Prerequisite is the presence of an error made when obtaining informed consent and its causality for the patient's consent for the treatment. Without an effective consent the treatment is considered illegal whether it was free of treatment error or not. The new patient law does not cause material change of the German liability of malpractice law.

  18. Optimizing Travel Time to Outpatient Interventional Radiology Procedures in a Multi-Site Hospital System Using a Google Maps Application.

    Science.gov (United States)

    Mandel, Jacob E; Morel-Ovalle, Louis; Boas, Franz E; Ziv, Etay; Yarmohammadi, Hooman; Deipolyi, Amy; Mohabir, Heeralall R; Erinjeri, Joseph P

    2018-02-20

    The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient's home to each a nearby IR facility in our hospital system. Hypothetical patient home addresses based on the 33 cities comprising our institution's catchment area were used to determine the optimal IR site for hypothetical patients traveling from each city based on real-time traffic conditions. For 10/33 (30%) cities, there was discordance between the optimal IR site based on ETT and the optimal IR site based on ETD at non-rush hour time or rush hour time. By choosing to travel to an IR site based on ETT rather than ETD, patients from discordant cities were predicted to save an average of 7.29 min during non-rush hour (p = 0.03), and 28.80 min during rush hour (p Google Maps application to schedule outpatients for IR procedures can effectively reduce patient travel time when more than one location providing IR procedures is available within the same hospital system.

  19. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... to Children's (Pediatric) Nuclear Medicine Sponsored by Please note RadiologyInfo.org is not a medical facility. Please ... is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of ...

  20. Statistical design of personalized medicine interventions: The Clarification of Optimal Anticoagulation through Genetics (COAG trial

    Directory of Open Access Journals (Sweden)

    Gage Brian F

    2010-11-01

    Full Text Available Abstract Background There is currently much interest in pharmacogenetics: determining variation in genes that regulate drug effects, with a particular emphasis on improving drug safety and efficacy. The ability to determine such variation motivates the application of personalized drug therapies that utilize a patient's genetic makeup to determine a safe and effective drug at the correct dose. To ascertain whether a genotype-guided drug therapy improves patient care, a personalized medicine intervention may be evaluated within the framework of a randomized controlled trial. The statistical design of this type of personalized medicine intervention requires special considerations: the distribution of relevant allelic variants in the study population; and whether the pharmacogenetic intervention is equally effective across subpopulations defined by allelic variants. Methods The statistical design of the Clarification of Optimal Anticoagulation through Genetics (COAG trial serves as an illustrative example of a personalized medicine intervention that uses each subject's genotype information. The COAG trial is a multicenter, double blind, randomized clinical trial that will compare two approaches to initiation of warfarin therapy: genotype-guided dosing, the initiation of warfarin therapy based on algorithms using clinical information and genotypes for polymorphisms in CYP2C9 and VKORC1; and clinical-guided dosing, the initiation of warfarin therapy based on algorithms using only clinical information. Results We determine an absolute minimum detectable difference of 5.49% based on an assumed 60% population prevalence of zero or multiple genetic variants in either CYP2C9 or VKORC1 and an assumed 15% relative effectiveness of genotype-guided warfarin initiation for those with zero or multiple genetic variants. Thus we calculate a sample size of 1238 to achieve a power level of 80% for the primary outcome. We show that reasonable departures from these

  1. Statistical design of personalized medicine interventions: the Clarification of Optimal Anticoagulation through Genetics (COAG) trial.

    Science.gov (United States)

    French, Benjamin; Joo, Jungnam; Geller, Nancy L; Kimmel, Stephen E; Rosenberg, Yves; Anderson, Jeffrey L; Gage, Brian F; Johnson, Julie A; Ellenberg, Jonas H

    2010-11-17

    There is currently much interest in pharmacogenetics: determining variation in genes that regulate drug effects, with a particular emphasis on improving drug safety and efficacy. The ability to determine such variation motivates the application of personalized drug therapies that utilize a patient's genetic makeup to determine a safe and effective drug at the correct dose. To ascertain whether a genotype-guided drug therapy improves patient care, a personalized medicine intervention may be evaluated within the framework of a randomized controlled trial. The statistical design of this type of personalized medicine intervention requires special considerations: the distribution of relevant allelic variants in the study population; and whether the pharmacogenetic intervention is equally effective across subpopulations defined by allelic variants. The statistical design of the Clarification of Optimal Anticoagulation through Genetics (COAG) trial serves as an illustrative example of a personalized medicine intervention that uses each subject's genotype information. The COAG trial is a multicenter, double blind, randomized clinical trial that will compare two approaches to initiation of warfarin therapy: genotype-guided dosing, the initiation of warfarin therapy based on algorithms using clinical information and genotypes for polymorphisms in CYP2C9 and VKORC1; and clinical-guided dosing, the initiation of warfarin therapy based on algorithms using only clinical information. We determine an absolute minimum detectable difference of 5.49% based on an assumed 60% population prevalence of zero or multiple genetic variants in either CYP2C9 or VKORC1 and an assumed 15% relative effectiveness of genotype-guided warfarin initiation for those with zero or multiple genetic variants. Thus we calculate a sample size of 1238 to achieve a power level of 80% for the primary outcome. We show that reasonable departures from these assumptions may decrease statistical power to 65%. In a

  2. Genitourinary radiology

    Energy Technology Data Exchange (ETDEWEB)

    McClennan, B.L.

    1982-01-01

    A literature review of genitourinary radiology highlights new findings in the field that have occurred in the past year. The physiology of contrast media, and the occasional life-threatening contrast medial reaction are discussed. Common urologic problems such as stones, infection, and obstruction are examined in order to interpret static radiographs in a more meaningful way. The field of interventional uroradiology continues to expand, with new procedures being tried and new indications for old procedures being developed. (KRM)

  3. Radiology and Global Health: The Case for a New Subspecialty

    Directory of Open Access Journals (Sweden)

    Matthew P. Lungren

    2016-08-01

    Full Text Available In high- and medium-income countries, the use of radiology has grown substantially in the last several decades. But in the developing world, access to medical imaging remains a critical problem. Unlike more structured efforts in the field of global health, interventions in global radiology have been largely unplanned, fragmented and sometimes irrelevant to the needs of the recipient society, and have not resulted in any significant progress. Access to medical imaging around the world remains dismal. There is a therefore a clear and urgent need for the radiology community to develop a vision for global radiology, beginning with defining the scope of the subject and establishing measurable goals. Agreement must be reached to declare global radiology as a bona fide subspecialty of radiology. This should soon be followed by the establishment of divisions of Global Radiology in academic radiology departments. Resident and medical students should be taught how physicians in low -income countries practice medicine without access to adequate radiology. As part of training and electives, residents and medical students should accompany global health teams to countries where the need for radiology services is great. Global scholar exchange and sabbatical opportunities should be offered to staff radiologists. Successful implementation of a unified vision of global radiology has the potential to improve access to medical imaging on a large scale. Radiology journals dedicated to the promotion of global radiology can play an important role in providing forums of discussion, analyses and sharing of field experiences. In this discussion we have attempted to make a case for assigning global radiology a subspecialty status.

  4. Comparing strategies for operator eye protection in the interventional radiology suite.

    Science.gov (United States)

    Thornton, Raymond H; Dauer, Lawrence T; Altamirano, Joaquin P; Alvarado, Keith J; St Germain, Jean; Solomon, Stephen B

    2010-11-01

    To evaluate the impact of common radiation-shielding strategies, used alone and in combination, on scattered dose to the fluoroscopy operator's eye. With an operator phantom positioned at the groin, upper abdomen, and neck, posteroanterior low-dose fluoroscopy was performed at the phantom patient's upper abdomen. Operator lens radiation dose rate was recorded with a solid-state dosimeter with and without a leaded table skirt, nonleaded and leaded (0.75 mm lead equivalent) eyeglasses, disposable tungsten-antimony drapes (0.25 mm lead equivalent), and suspended and rolling (0.5 mm lead equivalent) transparent leaded shields. Lens dose measurements were also obtained in right and left 15° anterior obliquities with the operator at the upper abdomen and during digital subtraction angiography (two images per second) with the operator at the patient's groin. Each strategy's shielding efficacy was expressed as a reduction factor of the lens dose rate compared with the unshielded condition. Use of leaded glasses alone reduced the lens dose rate by a factor of five to 10; scatter-shielding drapes alone reduced the dose rate by a factor of five to 25. Use of both implements together was always more protective than either used alone, reducing dose rate by a factor of 25 or more. Lens dose was routinely undetectable when a suspended shield was the only barrier during low-dose fluoroscopy. Use of scatter-shielding drapes or leaded glasses decreases operator lens dose by a factor of five to 25, but the use of both barriers together (or use of leaded shields) provides maximal protection to the interventional radiologist's eye. Copyright © 2010 SIR. Published by Elsevier Inc. All rights reserved.

  5. WE-DE-207A-04: Advances in Radiological Neuro-Endovascular Interventional Imaging

    International Nuclear Information System (INIS)

    Rudin, S.

    2016-01-01

    1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being

  6. WE-DE-207A-04: Advances in Radiological Neuro-Endovascular Interventional Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rudin, S. [University at Buffalo (SUNY) School of Medicine (United States)

    2016-06-15

    1. Parallels in the evolution of x-ray angiographic systems and devices used for minimally invasive endovascular therapy Charles Strother - DSA, invented by Dr. Charles Mistretta at UW-Madison, was the technology which enabled the development of minimally invasive endovascular procedures. As DSA became widely available and the potential benefits for accessing the cerebral vasculature from an endovascular approach began to be apparent, industry began efforts to develop tools for use in these procedures. Along with development of catheters, embolic materials, pushable coils and the GDC coils there was simultaneous development and improvement of 2D DSA image quality and the introduction of 3D DSA. Together, these advances resulted in an enormous expansion in the scope and numbers of minimally invasive endovascular procedures. The introduction of flat detectors for c-arm angiographic systems in 2002 provided the possibility of the angiographic suite becoming not just a location for vascular imaging where physiological assessments might also be performed. Over the last decade algorithmic and hardware advances have been sufficient to now realize this potential in clinical practice. The selection of patients for endovascular treatments is enhanced by this dual capability. Along with these advances has been a steady reduction in the radiation exposure required so that today, vascular and soft tissue images may be obtained with equal or in many cases less radiation exposure than is the case for comparable images obtained with multi-detector CT. Learning Objectives: To understand the full capabilities of today’s angiographic suite To understand how c-arm cone beam CT soft tissue imaging can be used for assessments of devices, blood flow and perfusion. Advances in real-time x-ray neuro-endovascular image guidance Stephen Rudin - Reacting to the demands on real-time image guidance for ever finer neurovascular interventions, great improvements in imaging chains are being

  7. A behavioral medicine intervention for older women living alone with chronic pain – a feasibility study

    Directory of Open Access Journals (Sweden)

    Cederbom S

    2014-08-01

    Full Text Available Sara Cederbom,1,2 Elisabeth Rydwik,2,3 Anne Söderlund,2 Eva Denison,2 Kerstin Frändin,1 Petra von Heideken Wågert2 1Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, 2School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, 3Research and Development Unit, Jakobsbergs Hospital, Stockholm County Council, Järfälla, Sweden Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women.Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance.Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study.Conclusion: Results from this study are encouraging, but

  8. Medical intervention in case of a nuclear or radiological event - national guide, release V3.6

    International Nuclear Information System (INIS)

    Ammerich, M.; Giraud, J.M.; Helfer, N.; Menetrier, F.; Schoulz, D.; Blanc, J.; Vilain, D.; Boll, H.; Bourguignon, M.; Chappe, P.; Mehl-Auget, I.; Carli, P.; Telion, C.; Carosella, E.; Castagnet, X.; Romet, G.; Ducousso, R.; Challeton de Vathaire, C.; Gourmelon, P.; Herbelet, G.; Martin, J.C.; Chicorp, J.; Cosset, J.M.; Court, L.; Lallemand, J.; Facon, A.; Goldstein, P.; Fleutot, J.B.; Geneau, C.; Kolodie, H.; Vrousos, C.; Lachenaud, L.; Maison, D.; Masse, R.; Massiot, P.; Menthonnex, P.; Origny, S.; Peton Klein, D.; Pasnon, J.; Quesne, B.; Rougy, C.; Sapori, JM.; Talbot, JN.; Van Rechem, M.

    2008-01-01

    This guide proposes a set of thematic sheets which address the following topics: generalities (intervention strategy, categories of casualties, definitions, emergency medical care organisation), taking into care in case of irradiation (generalities, clinical observation, additions examinations, localized acute external irradiation), cross-examination and description of circumstances, behaviour in case of contamination (general principles, rescuers protection, first gestures, etc.), behaviour in case of radio-combined lesions, reception in proximity medical structures and in a hospital. Some technical sheets are also proposed. They address how to handle a radio-contaminated casualty, how to undress a lying or a valid casualty, protection means (clothes, masks, gloves), dosimetry means, detection means, specific antidotes and other medicines

  9. SU-F-I-72: Evaluation of the Ancillary Lead Shielding for Optimizing Radiation Protection in the Interventional Radiology Department

    Energy Technology Data Exchange (ETDEWEB)

    Tonkopi, E; Lightfoot, C [Dalhousie University, Queen Elizabeth II Health Sciences Ctr, Halifax, NS (Canada); LeBlanc, E [Queen Elizabeth II Health Sciences Ctr, Halifax, NS (Canada)

    2016-06-15

    Purpose: The rising complexity of interventional fluoroscopic procedures has resulted in an increase of occupational radiation exposures in the interventional radiology (IR) department. This study assessed the impact of ancillary shielding on optimizing radiation protection for the IR staff. Methods: Scattered radiation measurements were performed in two IR suites equipped with Axiom Artis systems (Siemens Healthcare, Erlangen, Germany) installed in 2006 and 2010. Both rooms had suspended ceiling-mounted lead-acrylic shields of 75×60 cm (Mavig, Munich, Germany) with lead equivalency of 0.5 mm, and under-table drapes of 70×116 cm and 65×70 cm in the newer and the older room respectively. The larger skirt can be wrapped around the table’s corner and in addition the newer suite had two upper shields of 25×55 cm and 25×35 cm. The patient was simulated by 30 cm of acrylic, air kerma rate (AKR) was measured with the 180cc ionization chamber (AccuPro Radcal Corporation, Monrovia, CA, USA) at different positions. The ancillary shields, x-ray tube, image detector, and table height were adjusted by the IR radiologist to simulate various clinical setups. The same exposure parameters were used for all acquisitions. AKR measurements were made at different positions relative to the operator. Results: The AKR measurements demonstrated 91–99% x-ray attenuation by the drapes in both suites. The smaller size of the under-table skirt and absence of the side-drapes in the older room resulted in a 20–50 fold increase of scattered radiation to the operator. The mobile suspended lead-acrylic shield reduced AKR by 90–94% measured at 150–170 cm height. The recommendations were made to replace the smaller under-table skirt and to use the ceiling-mounted shields for all IR procedures. Conclusion: The ancillary shielding may significantly affect radiation exposure to the IR staff. The use of suspended ceiling-mounted shields is especially important for reduction of

  10. Establishment of an inferior vena cava filter database and interventional radiology led follow-up - retrieval rates and patients lost to follow-up.

    Science.gov (United States)

    Klinken, Sven; Humphries, Charlotte; Ferguson, John

    2017-10-01

    To evaluate the rates of inferior vena cava (IVC) filter retrieval and the number of patient's lost to follow-up, before and after the establishment of an IVC filter database and interventional radiology (inserting physician) led follow-up. On the 1st of June 2012, an electronic interventional radiology database was established at our Institution. In addition, the interventional radiology team took responsibility for follow-up of IVC filters. Data were prospectively collected from the database for all patients who had an IVC filter inserted between the 1st June 2012 and the 31st May 2014. Data on patients who had an IVC filter inserted between the 1st of June 2009 to the 31st of May 2012 were retrospectively reviewed. Patient demographics, insertion indications, filter types, retrieval status, documented retrieval decisions, time in situ, trackable events and complications were obtained in the pre-database (n = 136) and post-database (n = 118) cohorts. Attempted IVC filter retrieval rates were improved from 52.9% to 72.9% (P = 0.001) following the establishment of the database. The number of patients with no documented decision (lost to follow-up) regarding their IVC filter reduced from 31 of 136 (23%) to 0 of 118 patients (P = database group (113 as compared to 137 days, P = 0.129). Following the establishment of an IVC filter database and interventional radiology led follow-up, we demonstrate a significant improvement in the attempted retrieval rates of IVC filters and the number of patient's lost to follow-up. © 2017 The Royal Australian and New Zealand College of Radiologists.

  11. Evaluating different dimensions of programme effectiveness for private medicine retailer malaria control interventions in Kenya.

    Directory of Open Access Journals (Sweden)

    Timothy O Abuya

    2010-01-01

    Full Text Available Private medicine retailers (PMRs are key partners in the home management of fevers in many settings. Current evidence on effectiveness for PMR interventions at scale is limited. This study presents evaluation findings of two different programs implemented at moderate scale targeting PMRs for malaria control in the Kisii and Kwale districts of Kenya. Key components of this evaluation were measurement of program performance, including coverage, PMR knowledge, practices, and utilization based on spatial analysis.The study utilized mixed quantitative methods including retail audits and surrogate client surveys based on post-intervention cross-sectional surveys in intervention and control areas and mapping of intervention outlets. There was a large and significant impact on PMR knowledge and practices of the program in Kisii, with 60.5% of trained PMRs selling amodiaquine medicines in adequate doses compared to 2.8% of untrained ones (OR; 53.5: 95% CI 6.7, 428.3, a program coverage of 69.7% targeted outlets, and a potential utilization of about 30,000 children under five. The evaluation in Kwale also indicates a significant impact with 18.8% and 2.3% intervention and control PMRs selling amodiaquine with correct advice, respectively (OR; 9.4: 95% CI 1.1, 83.7, a program coverage of 25.3% targeted outlets, and a potential utilization of about 48,000 children under five. A provisional benchmark of 7.5 km was a reasonable threshold distance for households to access PMR services.This evaluation show that PMR interventions operationalized in the district level settings are likely to impact PMR knowledge and practices and lead to increased coverage of appropriate treatment to target populations. There is value of evaluating different dimensions of public health programs, including quality, spatial access, and implementation practice. This approach strengthens the potential contribution of pragmatic study designs to evaluating public health programs in the

  12. Pilot study of the dose in crystalline lens in the interventional radiology practice; Estudio piloto de la dosis en cristalino en la practica de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Castro, A.; Martinez, A.; Fernandez, A.; Molina, D. [Centro de Proteccion e Higiene de las Radiaciones, Carretera de la Cantera, Victoria II, Km. 21.5 Guanabacoa, La Habana (Cuba); Sanchez, L.; Diaz, A., E-mail: ailza@cphr.edu.cu [Hospital Clinico Quirurgico Hermanos Ameijeiras, San Lazaro 701, Centro Habana, La Habana (Cuba)

    2014-08-15

    The interventional radiology involves considerable exposure levels for the occupationally exposed personnel (OEP). The doses can encompass a wide range of values in dependence of the function that develops the personnel and the complexity of each procedure. In organs like the crystalline lens and skin values can be reached that imply the appearance of deterministic effects if is not fulfilled the appropriate measures of radiological protection. This has been demonstrated through multiple studies, among those that the retrospective study of damages in the crystalline lens and dose has been one of those most commented, known as RELID. The objective of that study was to examine the opacity prevalence in the crystalline lens in workers linked to the interventional cardiology and to correlate it with the occupational exposition. The obtained results contributed to that the ICRP recommend a new limit value of equivalent dose for crystalline lens of 20 mSv in one year. With the objective of analyzing the operational implications, in the radiological surveillance programs that they could originate with the new recommendations was developed a pilot study to evaluate the dose in crystalline lens in the OEP linked to the interventional radiology in a Cuban hospital. For this, an anthropomorphic mannequin RANDO-ALDERSON was used on which thermoluminescent dosimeters were placed below and above of the leaded apron and in different positions at level of the crystalline lens: above, below and to the sides of the leaded lenses that the personnel uses routinely. The mannequin was located on the same positions that occupy the main specialist that execute the procedure, as well as of the nurse to assist him. The measurements were made simulating the more representative procedures about complexity, duration time and exposure rate. The used dosimeters were RADOS model for whole body composed of two thermoluminescent detectors Gr-200 (LiF: Mg, Cu, P) to evaluate personal equivalent dose

  13. Medical Liability and Patient Law in Germany: Main Features with Particular Focus on Treatments in the Field of Interventional Radiology.

    Science.gov (United States)

    Sommer, S A; Geissler, R; Stampfl, U; Wolf, M B; Radeleff, B A; Richter, G M; Kauczor, H-U; Pereira, P L; Sommer, C M

    2016-04-01

    On February 26th, 2013 the patient law became effective in Germany. Goal of the lawmakers was a most authoritative case law for liability of malpractice and to improve enforcement of the rights of the patients. The following article contains several examples detailing legal situation. By no means should these discourage those persons who treat patients. Rather should they be sensitized to to various aspects of this increasingly important field of law. To identify relevant sources according to judicial standard research was conducted including first- and second selection. Goal was the identification of jurisdiction, literature and other various analyses that all deal with liability of malpractice and patient law within the field of Interventional Radiology--with particular focus on transarterial chemoembolization of the liver and related procedures. In summary, 89 different sources were included and analyzed. The individual who treats a patient is liable for an error in treatment if it causes injury to life, the body or the patient's health. Independent of the error in treatment the individual providing medical care is liable for mistakes made in the context of obtaining informed consent. Prerequisite is the presence of an error made when obtaining informed consent and its causality for the patient's consent for the treatment. Without an effective consent the treatment is considered illegal whether it was free of treatment error or not. The new patient law does not cause material change of the German liablity of malpractice law. •On February 26th, 2013 the new patient law came into effect. Materially, there was no fundamental remodeling of the German liability for medical malpractice. •Regarding a physician's liability for medical malpractice two different elements of an offence come into consideration: for one the liability for malpractice and, in turn, liability for errors made during medical consultation in the process of obtaining informed consent.

  14. Radiation dose to patients from the coronary angiography and percutaneous transluminal coronary angioplasty in interventional radiology procedures

    International Nuclear Information System (INIS)

    Zheng, Jun-Zheng; Bai, Mei; Liu, Bin

    2008-01-01

    Full text: Objective: To survey and assess radiation dose to patients from coronary angiography (CA) and percutaneous transluminal coronary angioplasty (PTCA) in Beijing Xuanwu Hospital of Capital University of Medical Sciences. Methods: The dose-area product (DAP) values to the patient and cumulative dose (CD) were recorded from 84 coronary angiographies and 51 percutaneous transluminal coronary angioplasty. A Monte-Carlo based program PCXMC was used to calculate the effective dose from DAP values for each patient. Organ doses were also measured by thermoluminescent dosimeters (TLD) using a human-shaped phantom to compare the calculated organ dose from DAP. Results: The difference between the organ doses measured by TLDs and those from PCXMC software (P>0.05) were tolerable. The DAP value ranged from 7611∼60538 mGy·cm 2 for CA and 16423∼161973 mGy·cm 2 for PTCA. The effective dose for all procedures was determined to be in the range of 1.1∼6.9 mSv for CA and 2.3∼20.1 mSv for PTCA. CD ranged from 120.0 to 1016.0 mGy for CA and 287 to 2883 mGy for PTCA. Conversion factors between effective dose and DAP were 0.114∼0.139 mSv·Gy - 1·cm -2 for CA and 0.124∼0.142 mSv·Gy -1 ·cm -2 for PTCA; Conversion factors between organ dose and CD were derived for CA and PTCA, respectively. Conclusions: DAP and CD can be used as the dose indicator to calculate the organ dose and effective dose of patient based on Monte Carlo simulation. Using this method can provide important information of patient absorbed dose and enhance the radiation protection of patient in interventional radiology procedures. (author)

  15. La carpeta de aprendizaje: una innovación docente en la asignatura de Radiología y Medicina Física Especial The portfolio: an innovate educational project on the subject of Radiology and Special Physical Medicine

    Directory of Open Access Journals (Sweden)

    J.D. Berná

    2008-12-01

    Full Text Available Objetivo. Presentar una innovación docente desarrollada en la asignatura de Radiología y Medicina Física Especial durante el curso académico 2006-2007. Sujetos y métodos. Los alumnos realizaron una rotación durante dos semanas en los servicios de Radiodiagnóstico y Medicina Nuclear, en grupos pequeños. La metodología docente utilizada fue la carpeta de aprendizaje o portafolio. Se describen los aspectos fundamentales para la elaboración de la carpeta y de los casos clínicos, así como del sistema de evaluación. Dentro del ciclo de mejora continuada se llevó a cabo una encuesta de satisfacción. Resultados. Los resultados académicos obtenidos fueron excelentes. La mayoría de los alumnos consideraron que la asignatura fue interesante. También señalaron una valoración positiva de la rotación, de los seminarios y del sistema de evaluación. Asimismo, la opinión de los alumnos acerca de la experiencia docente realizada fue muy favorable. Conclusión. La satisfacción global de los alumnos ha sido muy alta con la metodología docente implantada en la asignatura.Aim. To introduce a learning innovation on the subject of Radiology and Special Physical Medicine along the academic year 2006/2007. Subjects and methods. Working in small groups, students carried out a two-week rotation in the departments of Radiology and Nuclear Medicine. The portfolio was the educational methodology used. The main aspects to elaborate the portfolio, the case reports, as well as the evaluation system are described. A satisfaction survey within the continuous improvement course was performed. Results. The academic results achieved were excellent. The subject was considered interesting by most of the students. A positive evaluation about the rotation made by the students, the seminaries and the evaluation system was made. Students’ opinion about the educational experience performed was also, very favourable. Conclusion. The educational methodology

  16. Upgrade the intervention levels derived for water and foods, to be include in the PERE 607 procedure the external radiological emergency plan in the Laguna Verde nuclear power plant

    International Nuclear Information System (INIS)

    Llado Castillo, R.; Aguilar Pacheco, R.

    1998-01-01

    The work shows the results obtained in the upgrade the intervention levels derived for water and foods, to be include in the PERE 607 procedure the external radiological emergency plan in the Laguna Verde nuclear power plant

  17. Radiological protection in the interventional techniques: experience in the Pain Clinic of the CIMEQ; Proteccion radiologica en las tecnicas intervencionistas: experiencia en la Clinica del Dolor del CIMEQ

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero C, M. C.; Benitez N, P. P.; Gonzalez G, Y. [Centro de Investigaciones Medico Quirurgicas, Av. 216 Esq. 11B, Playa Siboney, 6096 La Habana (Cuba); Martinez G, A.; Gonzalez R, N. [Centro de Proteccion e Higiene de las Radiaciones, Carretera de la Cantera, Victoria II, Km. 21.5 Guanabacoa, La Habana (Cuba); Sanchez Z, L. R., E-mail: mayka@infomed.sld.cu [Hospital C. Q. Hermanos Ameijeiras, San Lazaro 701, Centro Habana, La Habana (Cuba)

    2014-08-15

    The Pain Clinic of the CIMEQ offers treatment to patients with different pathologies, using interventional techniques as the radiology like visual guide to reach the target structure and to apply the election technique. The personnel that carry out these procedures are inserted in the program of radiological surveillance of the institution, reason for which a radiological event could be detected where the main physician responsible of the service was implied. In this work the results of an investigation are presented realized with the objective of to know the causes of the event and to determine the necessary measures to avoid that this repeats again. The investigation was oriented to three fundamental aspects: medical exam of the affected worker; evaluation of the operational procedures from the radiological protection view point; and dosimetric measurements simulating the real conditions of work for which were used ionization chamber, radiometer and PMMA mannequin. As a result of the medical exam was detected that the main physician of the service did not use during the execution of all the procedures the extremities dosimetry and that he presented a radio induced erythema in the right hand, reason for which he was separated of the activity with ionizing radiations, until the conclusion of the investigation. With relationship to the evaluation of the operational procedures from the radiological protection view point, was verified that the medical physician not carried out any collimation of the beam and he was located in the positions where the dose rate reached the maximum values, frequently introducing the hands in the direct beam; that which implied an overexposure of the superior extremities and a not optimized exposure for whole body. This result was proven with the realized experimental measurements, which gave dose estimated values in extremities of the order of the deterministic effects. The investigation facilitated to introduce modifications in the

  18. Technical note: A preliminary comparative study between classical and interventional radiological approaches for multi-phase post-mortem CT angiography.

    Science.gov (United States)

    Mokrane, Fatima-Zohra; Savall, Frederic; Dercle, Laurent; Crubezy, Eric; Telmon, Norbert; Rousseau, Hervé; Dedouit, Fabrice

    2017-02-01

    Multi-phase post-mortem computed tomography angiography (MPMCTA) is a new diagnostic tool, used in forensic pathology. On the one hand, this technique allows a better and direct visualization of vascular and solid organ lesions. On the other hand, the invasiveness of the procedure-which requires surgical denudation (inguinal and/or cervical) and the insertion of surgical cannulas-leads to many relatives refusing scientific autopsies. Our hypothesis states that a minimally-invasive procedure combining interventional radiological techniques with MPMCTA (replacement of surgical cannulas by radiological catheters) will improve the approval rate of scientific autopsies by families. The aim of this study was to evaluate the feasibility of the minimally-invasive MPMCTA approach and to compare its performance to the current reference-standard (the conventional approach). We included consecutively 16 corpses divided in two groups according to the contrast enhancement approach: radiological catheters (n=8), and surgical cannulas (n=8). Corpses were chosen and assigned randomly from our local data. The quality of the imaging procedure was compared according to four items: global vascular opacification, cerebral venous opacification, and lower limbs opacification (arterial and venous). A minimally-invasive approach for scientific autopsies is feasible through a radiological catheter. Vascular opacification was optimal in 8 out of 8 cases and was no less effective than the control reference group using surgical cannula incision associated with their non-occlusive aspects. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Society of Interventional Radiology

    Science.gov (United States)

    ... clinical workspace design, tips for negotiating contracts and salaries and much, much more. Latest issue SIRcloud: Now ... Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma ...

  20. Paediatric interventional radiology

    African Journals Online (AJOL)

    2016-06-29

    Jun 29, 2016 ... performed by paediatric IR physicians, although the numbers of these procedures performed can vary significantly between institutions, particularly if traditionally performed by ..... sedation, a nurse practitioner and/or physician assistant and an anaesthesiologist comfortable with the particular demands of ...

  1. Percutaneous arteriovenous shunting in patients with severe COPD. A new interventional radiological treatment; Perkutane arteriovenoese Shuntanlage bei Patienten mit schwerer COPD. Eine neue interventionelle radiologische Technik

    Energy Technology Data Exchange (ETDEWEB)

    Schlosser, Thomas; Forsting, M. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Burbelko, M. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Ulrich, M. [Parkkrankenhaus Leipzig (Germany). Klinik fuer Innere Medizin/Angiologie/Kardiologie; Ludwig, F.; Reutiman, T. [ROX Medical, San Clemente, CA (United States); Antoch, G. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Adamus, R. [Klinikum Nuernberg Nord (Germany). Inst. fuer Radiologie

    2013-03-15

    Purpose: The aim of this study was to evaluate the technical feasibility and safety of a new interventional radiological technique to create a shunt percutanously between the external iliac vein and artery in patients with severe COPD. Materials and Methods: 40 patients were included in this multicenter trial. In 38 patients the artery was punctured from the vein using a novel crossing needle. A special delivery system was used to implant a novel nitinol device (ACS, ROX Medical) between the artery and the vein to maintain a 4 mm calibrated and structured fistula between the two vessels. Results: Shunt implantation was successful in 38 patients. The perfused arteriovenous shunts could be well documented in DSA and the diameter was measured between 3 and 4 mm in all cases. Peri-interventional non-flow-limiting dissection of the iliac artery occurred in one patient. Post-interventional venous bleeding in two patients was treated successfully by local compression. In one patient a peripheral artery thrombembolism was successfully treated by thrombolysis. Conclusion: The new interventional radiological technique to create an arteriovenous shunt in the iliac vessels presented in this study has proven to be feasible and safe. (orig.)

  2. First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine.

    Science.gov (United States)

    Landau, Marina; Anand, Chytra V; Besins, Thierry; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Gout, Uliana; Kerscher, Martina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Braz, Andre

    2017-09-01

    Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed. To provide treatment recommendations for primary prevention and early intervention in individuals with no or minimal signs of aging. Fourteen specialists in aesthetic medicine convened over a full-day meeting under the guidance of a certified moderator. Tailored treatment recommendations have been provided for prevention and early intervention of fine wrinkles, static lines and folds, irregular pigmentation, laxity, and subcutaneous volume loss by protecting the epidermis, stimulating neocollagenesis, reducing hyperkinetic musculature, and reinforcing supporting structures. Preventive measures and early therapeutic interventions that may alter the course of facial aging were defined. Further studies are needed to support these recommendations with the best possible evidence. J Drugs Dermatol. 2017;16(9):846-854..

  3. Communication Concepts for Prevention and Early Intervention in Aesthetic Medicine: Consensus and Literature Review.

    Science.gov (United States)

    Gout, Uliana; Anand, Chytra V; Braz, Andre; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Kerscher, Martina; Landau, Marina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Besins, Thierry

    2017-09-01

    Communication concepts relating to prevention and early intervention (P&E) within aesthetic medicine are poorly understood and highly underexplored. However, effective communication is a key criterion for successful outcomes. To introduce the framework for P&E communication strategies within a younger population and explore the barriers that may be encountered. A literature review on P&E communication strategies in aesthetic medicine and related topics of interest was conducted and used to construct a working framework that may be applied in clinical practice. Examination of existing literature revealed a need for a more structured communication framework for P&E encompassing up-to-date evidence-based learning and educational marketing that is tailored to individual needs and target populations. Message framing-the way in which a message is presented-is an important consideration in the dissemination of information to promote changes in health behaviour. A structured consultation is key to optimising patient engagement and ensures a tailored approach to understanding and catering to the specific needs of each patient. This is the first paper to discuss the communication concepts behind P&E within aesthetic medicine and paves the way for further research and focus in this significant field. J Drugs Dermatol. 2017;16(9):859-864..

  4. Radiology and the law

    International Nuclear Information System (INIS)

    Bundy, A.L.

    1988-01-01

    This book contains 12 chapters. Some of the chapter titles are: The Law of Medical Malpractice: An Overview; The Radiologist as Defendant; The Radiologist as an Expert Witness; The Missed Diagnosis; Legalities of the Radiograph; and Angiography and Interventional Radiology

  5. Highly cited works in radiology: the top 100 cited articles in radiologic journals.

    Science.gov (United States)

    Pagni, Matthew; Khan, Nickalus R; Cohen, Harris L; Choudhri, Asim F

    2014-08-01

    The number of citations a publication receives can be used to show its impact on a field of study. It may indicate the educational interest in a given population or underline a perceived or real educational gap. This article identifies and characterizes the 100 top cited publications in radiologic journals as of May 2013. All clinical radiologic journals listed by Thomson Reuters Journal Citation Reports in 2011 were identified. A total of 46 journals were identified, and all articles published within these journals were analyzed for citation counts. The top 100 highly cited articles were recorded. The most frequently cited radiologic articles appeared in 9 of the 46 journals. These included 59 articles in Radiology, 17 in Journal of Nuclear Medicine, 9 in the American Journal of Roentgenology, 5 in the British Journal of Radiology, 4 in Investigative Radiology, 2 in American Journal of Neuroradiology, 2 in European Radiology, 2 in Radiologic Clinics of North America, 1 in the Seminars in Nuclear Medicine, and 1 in Pediatric Radiology. The citation values ranged from 422 to 7506 with a mean of 751. Publication dates ranged from 1967 to 2006 with the 5-year period between 1986 and 1990 accounting for the largest percentage of articles. The most frequently studied radiologic modality was magnetic resonance imaging (MRI; 28 articles), followed by vascular/interventional (19 articles) and nuclear medicine (13 articles). The central nervous system was the most frequently studied organ system (22 articles), followed by mixed organ systems (14 articles) and liver (12 articles). The top cited articles in radiologic journals span a wide range of imaging modalities, subspecialties, and organ systems. Topics that occurred frequently in the top 100 cited articles included contrast and radiopharmaceutical characterization, MRI of motion, percutaneous radiofrequency ablation in the liver and percutaneous vertebroplasty. We present a methodology that uses citation analysis to

  6. The development of Operational Intervention Levels (OILs) for Soils - A decision support tool in nuclear and radiological emergency response

    Science.gov (United States)

    Lee Zhi Yi, Amelia; Dercon, Gerd; Blackburn, Carl; Kheng, Heng Lee

    2017-04-01

    In the event of a large-scale nuclear accident, the swift implementation of response actions is imperative. For food and agriculture, it is important to restrict contaminated food from being produced or gathered, and to put in place systems to prevent contaminated produce from entering the food chain. Emergency tools and response protocols exist to assist food control and health authorities but they tend to focus on radioactivity concentrations in food products as a means of restricting the distribution and sale of contaminated produce. Few, if any, emergency tools or protocols focus on the food production environment, for example radioactivity concentrations in soils. Here we present the Operational Intervention Levels for Soils (OIL for Soils) concept, an optimization tool developed at the IAEA to facilitate agricultural decision making and to improve nuclear emergency preparedness and response capabilities. Effective intervention relies on the prompt availability of radioactivity concentration data and the ability to implement countermeasures. Sampling in food and agriculture can be demanding because it may involve large areas and many sample types. In addition, there are finite resources available in terms of manpower and laboratory support. Consequently, there is a risk that timely decision making will be hindered and food safety compromised due to time taken to sample and analyse produce. However, the OILs for Soils concept developed based on experience in Japan can help in this situation and greatly assist authorities responsible for agricultural production. OILs for Soils - pre-determined reference levels of air dose rates linked to radionuclide concentrations in soils - can be used to trigger response actions particularly important for agricultural and food protection. Key considerations in the development of the OILs for Soils are: (1) establishing a pragmatic sampling approach to prioritize and optimize available resources and data requirements for

  7. Optimization of corrective and preventive maintenance on computers in Radiology, Nuclear Medicine and Radiotherapy; Optimizacion del mantenimiento correctivo y preventivo en los equipos de Radiodiagnostico, Medicina Nuclear Y Radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Carrascosa Fernandez, C. B.; Gil Agudo, A.; Rodriguez Exodo, J. M.; Torres Donaire, J.; Zapata jimenez, J. C.; Arjona Gutierrez, J.

    2011-07-01

    One of the functions of a Service of Radio physics and Radiation Protection is the quality control of equipment emitting ionizing radiation and detectors for clinical use and verification to incidents and actions of the commercial house that could affect the dose or the quality image. The following is the procedure used in our hospital to track incidents that cause teams in Radiology (DR), Nuclear Medicine (MN) and Radiation Oncology (ONRT) in collaboration with the Electro medicine Service (EM .).

  8. Radiological protection in the Cuban radiotherapy services and Nuclear Medicine by the light of the national requirements of the national normative

    International Nuclear Information System (INIS)

    Dumenigo Gonzalez, Cruz; De la Fuente Puch, Andres; Quevedo Garcia, Jose R.; Diaz Guerra, Pedro Ibrahin; Lopez Forteza; Yamil

    2003-01-01

    With the approval, recently, of the Regulation Basic Norms of Radiological Security and the Guide for the Implementation of the Regulations of Security in the Practice of the Radiotherapy and it Guides for the Implementation of the Regulations of Security in the Practice of the Nuclear Medicine is completed the essential normative base that governs the realization of these practices in the Republic of Cuba. The principles of this normative one are in agreement with those recommendations of the International Organism of Atomic Energy, the World Organization of the Health and particularly with the good ones practical international in the practice of the Radiotherapy. In order to a politics of gradual implementation that he/she takes in consideration the to settle down preparation that really exists in the country to complete the requirements that settle down in this normative one, the Cuban Regulatory Authority (CNSN) carried out a study of applicability whose results are presented work presently. Through the evaluations of the documentation of the radiotherapy facilities and medicine nuclear of the country, as well as of the inspections and the mensurations carried out to the same ones they are evaluated those not existent conformities with regard to the requirements of the normative one, are categorized the same ones in function of their importance and a group of possible solutions is recommended to the problematic existent. Finally the authors conclude that, in spite of the non conformities identified, they don't exist impediments that from the point of view of the radiological protection commit the execution of the practice

  9. MO-DE-201-03: This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine

    International Nuclear Information System (INIS)

    Fundamental knowledge of radiologic anatomy and physiology is critical for medical physicists. Many physicists are exposed to this topic only in graduate school, and knowledge is seldom formally evaluated or assessed after Part I of the ABR exam. Successful interactions with clinicians, including surgeons, radiologists, and oncologists requires that the medical physicist possess this knowledge. This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine. We will review structural anatomy, manipulation of tissue contrast, the marriage between anatomy and physiology, and explore how medical imaging exploits normal and pathological processes in the body to generate contrast. Learning Objectives: Review radiologic anatomy. Examine techniques to manipulate tissue contrast in radiology. Integrate anatomy and physiology in molecular imaging

  10. MO-DE-201-03: This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Fahey, F.

    2015-06-15

    Fundamental knowledge of radiologic anatomy and physiology is critical for medical physicists. Many physicists are exposed to this topic only in graduate school, and knowledge is seldom formally evaluated or assessed after Part I of the ABR exam. Successful interactions with clinicians, including surgeons, radiologists, and oncologists requires that the medical physicist possess this knowledge. This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine. We will review structural anatomy, manipulation of tissue contrast, the marriage between anatomy and physiology, and explore how medical imaging exploits normal and pathological processes in the body to generate contrast. Learning Objectives: Review radiologic anatomy. Examine techniques to manipulate tissue contrast in radiology. Integrate anatomy and physiology in molecular imaging.

  11. Socioeconomic trends in radiology

    International Nuclear Information System (INIS)

    Barneveld Binkhuysen, F.H.

    1998-01-01

    For radiology the socioeconomic environment is a topic of increasing importance. In addition to the well-known important scientific developments in radiology such as interventional MRI, several other major trends can be recognized: (1) changes in the delivery of health care, in which all kinds of managed care are developing and will influence the practice of radiology, and (2) the process of computerization and digitization. The socioeconomic environment of radiology will be transformed by the developments in managed care, teleradiology and the integration of information systems. If radiologists want to manage future radiology departments they must have an understanding of the changes in the fields of economics and politics that are taking place and that will increasingly influence radiology. Some important and recognizable aspects of these changes will be described here. (orig.)

  12. Analysis of dose to crystalline in Interventional radiology: a purpose of one case; Analisis de dosis a cristalino en Radiologia intervencionista: a proposito de un caso

    Energy Technology Data Exchange (ETDEWEB)

    Carrera M, F.; Moreno R, F.; Velazquez M, F.; Manzano M, F.J.; Moreno S, T. [Hospital `Juan Ramon Jimenez` Ronda Norte s/n 21005. Huelva, Espana (Spain)

    1998-12-31

    The present work shows the dose values to crystalline for the personnel which works in interventional radiology procedures. It was took data of 436 studies with a total of 2,133.4 minutes in fluoroscopy and 19,563 images. It was showed dose values to crystalline in three situations: without blinding, with blinding of 0.25 and 0.50 mm Pb and by type of study: fluoroscopy, graphie and total. The dose means and ranges to patient for each of these studies also are detailed. (Author)

  13. Role and responsibilities of medical physicists in radiological protection of patients

    International Nuclear Information System (INIS)

    Niroomand-Rad, A.

    2001-01-01

    The paper provides a brief history of the International Organization for Medical Physics (IOMP), followed by some general comments on the radiological protection of patients. The importance of establishing scientific guidelines and professional standards is emphasized, as is the need to ensure the protection of patients undergoing radiation therapy. The responsibility of qualified medical physicists in the protection of patients in nuclear medicine and in diagnostic and interventional radiology is also discussed. (author)

  14. Consumer-oriented interventions for evidence-based prescribing and medicines use: an overview of systematic reviews.

    Science.gov (United States)

    Ryan, Rebecca; Santesso, Nancy; Hill, Sophie; Lowe, Dianne; Kaufman, Caroline; Grimshaw, Jeremy

    2011-05-11

    Numerous systematic reviews exist on interventions to improve consumers' medicines use, but this research is distributed across diseases, populations and settings. The scope and focus of reviews on consumers' medicines use also varies widely. Such differences create challenges for decision makers seeking review-level evidence to inform decisions about medicines use. To synthesise the evidence from systematic reviews on the effects of interventions which target healthcare consumers to promote evidence-based prescribing for, and medicines use, by consumers. We sought evidence on the effects on health and other outcomes for healthcare consumers, professionals and services. We included systematic reviews published on the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. We identified relevant reviews by handsearching both databases from start date to Issue 3 2008. We screened and ranked reviews based on relevance to consumers' medicines use, using criteria developed for this overview. Standardised forms were used to extract data, and reviews were assessed for methodological quality using the AMSTAR instrument. We used standardised language to summarise results within and across reviews; and a further synthesis step was used to give bottom-line statements about intervention effectiveness. Two review authors selected reviews, extracted and analysed data. We used a taxonomy of interventions to categorise reviews. We included 37 reviews (18 Cochrane, 19 non-Cochrane), of varied methodological quality.Reviews assessed interventions with diverse aims including support for behaviour change, risk minimisation, skills acquisition and information provision. No reviews aimed to promote systems-level consumer participation in medicines-related activities. Medicines adherence was the most commonly reported outcome, but others such as clinical (health and wellbeing), service use and knowledge outcomes were also reported. Reviews rarely

  15. The Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR): Interventional Cardiology

    International Nuclear Information System (INIS)

    2014-02-01

    of safety standards for the protection of people against exposure to ionizing radiation. The publication details the results of the Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR) (2009-2012) and, in particular, the activities of the Working Group on Interventional Cardiology that culminated in the development of the ISEMIR international database for interventional cardiology (ISEMIR-IC). The ISEMIR project arose from the Occupational Radiation Protection International Action Plan (approved by the IAEA Board of Governors September in 2003), which identified the need for networks to be established to enable interested parties to exchange information, experiences and lessons learned

  16. Medicine and ionizing rays: a help sheet in analysing risks in intra-oral dental radiology and applicable texts

    International Nuclear Information System (INIS)

    Gauron, C.

    2009-01-01

    This document proposes a synthesis of useful knowledge for radioprotection in the case of intra-oral dental radiology. In the first part, several aspects are considered: the concerned personnel, the course of treatment procedures, the hazards, the identification of the risk associated with ionizing radiation, the risk assessment and the determination of exposure levels, the strategy to control the risks (reduction of risks, technical measures concerning the installation or the personnel, teaching and information, prevention and medical monitoring), and risk control assessment. A second part indicates the various applicable legal and regulatory texts (European directives, institutions in charge of radioprotection, general arrangements applicable to workers and patients, and regulatory texts concerning worker protection or patient protection against ionizing radiations)

  17. Real-time fluoroscopic needle guidance in the interventional radiology suite using navigational software for percutaneous bone biopsies in children

    Energy Technology Data Exchange (ETDEWEB)

    Shellikeri, Sphoorti; Srinivasan, Abhay; Krishnamurthy, Ganesh; Vatsky, Seth; Zhu, Xiaowei; Keller, Marc S.; Cahill, Anne Marie [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Setser, Randolph M. [Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States); Hwang, Tiffany J. [University of Southern California, Keck School of Medicine, Los Angeles, CA (United States); Girard, Erin [Siemens Medical Solutions USA, Inc., Princeton, NJ (United States)

    2017-07-15

    Navigational software provides real-time fluoroscopic needle guidance for percutaneous procedures in the Interventional Radiology (IR) suite. We describe our experience with navigational software for pediatric percutaneous bone biopsies in the IR suite and compare technical success, diagnostic accuracy, radiation dose and procedure time with that of CT-guided biopsies. Pediatric bone biopsies performed using navigational software (Syngo iGuide, Siemens Healthcare) from 2011 to 2016 were prospectively included and anatomically matched CT-guided bone biopsies from 2008 to 2016 were retrospectively reviewed with institutional review board approval. C-arm CT protocols used for navigational software-assisted cases included institution-developed low-dose (0.1/0.17 μGy/projection), regular-dose (0.36 μGy/projection), or a combination of low-dose/regular-dose protocols. Estimated effective radiation dose and procedure times were compared between software-assisted and CT-guided biopsies. Twenty-six patients (15 male; mean age: 10 years) underwent software-assisted biopsies (15 pelvic, 7 lumbar and 4 lower extremity) and 33 patients (13 male; mean age: 9 years) underwent CT-guided biopsies (22 pelvic, 7 lumbar and 4 lower extremity). Both modality biopsies resulted in a 100% technical success rate. Twenty-five of 26 (96%) software-assisted and 29/33 (88%) CT-guided biopsies were diagnostic. Overall, the effective radiation dose was significantly lower in software-assisted than CT-guided cases (3.0±3.4 vs. 6.6±7.7 mSv, P=0.02). The effective dose difference was most dramatic in software-assisted cases using low-dose C-arm CT (1.2±1.8 vs. 6.6±7.7 mSv, P=0.001) or combined low-dose/regular-dose C-arm CT (1.9±2.4 vs. 6.6±7.7 mSv, P=0.04), whereas effective dose was comparable in software-assisted cases using regular-dose C-arm CT (6.0±3.5 vs. 6.6±7.7 mSv, P=0.7). Mean procedure time was significantly lower for software-assisted cases (91±54 vs. 141±68 min, P=0

  18. S3 Guideline. Diagnosis and treatment of colorectal carcinoma. Relevance for radiologic imaging and interventions; Aktualisierte S3-Leitlinie zur Diagnostik und Therapie des kolorektalen Karzinoms. Bedeutung fuer die radiologische Diagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Fischer, S. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schmiegel, W.; Pox, C. [Bochum Univ. (Germany). Medizinische Universitaetsklinik; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin; Brambs, H.J. [Universitaetsklinikum Ulm (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lux, P. [Universitaetsklinikum Erlangen (Germany). Chirurgische Klinik

    2013-08-15

    The new German S3 guideline 'Colorectal Carcinoma' was created as part of the German Guideline Program in Oncology of the Association of the Scientific Medical Societies in Germany, the German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Diseases and replaces the guideline from 2008. With its evidence-based treatment recommendations, the guideline contains numerous updates and detailed definitions regarding the diagnosis and treatment of colon and rectal cancer. In particular, consensus-based recommendations regarding early detection, preoperative diagnostic method selection, and the use of interventional radiological treatment methods are detailed. The guideline also includes quality indicators so that standardized quality assurance methods can be used to optimize patient-related processes. The present article discusses the significance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and care by increasing distribution. (orig.)

  19. M{sup 2}IRAGE: Management of measurements during radiological interventions geographically assisted in the environment; M{sup 2}IRAGE management des mesures dans le cadre d'interventions radiologiques assistees geographiquement dans l'environnement

    Energy Technology Data Exchange (ETDEWEB)

    Gerphagnon, O. [SDIS, Service NRBC, 91 - Evry (France); Roche, H.; Lelache, H.; Guelin, M.; Fauquant, J.M. [CEA Saclay, Service de Protection contre les Rayonnements - SPR, 91 - Gif-sur-Yvette (France); Kacenelen, Y. [SDIS, Service C and IG, 91 (France); Armand, Y. [SDIS, SPV Expert Risques Technologiques, 91 (France)

    2010-07-01

    This report presents the M{sup 2}IRAGE software, a data processing tool designed to share radioactivity measurements and to give a schematised view of a radiological situation and of its evolution, while respecting different legal frameworks, notably the obligation to produce a radiological measurement programme. After a simplified recall of the crisis management organisation, the authors describe the M{sup 2}IRAGE software and hardware architecture, the functions of its main modules (presentation of radioprotection information during field intervention, field mission management, data browsing, and data transmission to field teams). While giving some display examples, the authors describe how an event is managed and processed by this tool: event creation, measurement acquisition, aid to decision, team management. They report and discuss the results of a national exercise which took place in September 2009 in Saclay with a prototype version of M{sup 2}IRAGE

  20. Teaching Emotional Intelligence: A Control Group Study of a Brief Educational Intervention for Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Diane L. Gorgas

    2015-11-01

    Full Text Available Introduction: Emotional Intelligence (EI is defined as an ability to perceive another’s emotional state combined with an ability to modify one’s own. Physicians with this ability are at a distinct advantage, both in fostering teams and in making sound decisions. Studies have shown that higher physician EI’s are associated with lower incidence of burn-out, longer careers, more positive patient-physician interactions, increased empathy, and improved communication skills. We explored the potential for EI to be learned as a skill (as opposed to being an innate ability through a brief educational intervention with emergency medicine (EM residents. Methods: This study was conducted at a large urban EM residency program. Residents were randomized to either EI intervention or control groups. The intervention was a two-hour session focused on improving the skill of social perspective taking (SPT, a skill related to social awareness. Due to time limitations, we used a 10-item sample of the Hay 360 Emotional Competence Inventory to measure EI at three time points for the training group: before (pre and after (post training, and at six-months post training (follow up; and at two time points for the control group: pre- and follow up. The preliminary analysis was a four-way analysis of variance with one repeated measure: Group x Gender x Program Year over Time. We also completed post-hoc tests. Results: Thirty-three EM residents participated in the study (33 of 36, 92%, 19 in the EI intervention group and 14 in the control group. We found a significant interaction effect between Group and Time (p<0.05. Post-hoc tests revealed a significant increase in EI scores from Time 1 to 3 for the EI intervention group (62.6% to 74.2%, but no statistical change was observed for the controls (66.8% to 66.1%, p=0.77. We observed no main effects involving gender or level of training. Conclusion: Our brief EI training showed a delayed but statistically significant

  1. Review of occupational medicine practice guidelines for interventional pain management and potential implications.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Singh, Vijay; Derby, Richard; Helm, Standiford; Trescot, Andrea M; Staats, Peter S; Prager, Joshua P; Hirsch, Joshua A

    2008-01-01

    In the modern day environment, workers' compensation costs continue to be a challenge, with a need to balance costs, benefits, and quality of medical care. The cost of workers' compensation care affects all stakeholders including workers, employers, providers, regulators, legislators, and insurers. Consequently, a continued commitment to quality, accessibility to care, and cost containment will help ensure that workers are afforded accessible, high quality, and cost-effective care. In 2004, workers' compensation programs in all 50 states, the District of Columbia, and federal programs in the United States combined received an income of $87.4 billion while paying out only $56 billion in medical and cash benefits with $31.4 billion or 37% in administrative expenses and profit. Occupational diseases represented only 8% of the workers' compensation claims and 29% of the cost. The American College of Occupational and Environmental Medicine (ACOEM) has published several guidelines; though widely adopted by WCPs, these guidelines evaluate the practice of medicine of multiple specialties without adequate expertise and expert input from the concerned specialties, including interventional pain management. An assessment of the ACOEM guidelines utilizing Appraisal of Guidelines for Research and Evaluation (AGREE) criteria, the criteria developed by the American Medical Association (AMA), the Institute of Medicine (IOM), and other significantly accepted criteria, consistently showed very low scores (pain management have no applicability in modern patient care due to lack of expertise by the developing organization (ACOEM), lack of utilization of appropriate and current EBM principles, and lack of significant involvement of experts in these techniques resulting in a lack of clinical relevance. Thus, they may result in reduced medical quality of care; may severely hinder access to appropriate, medically needed and essential medical care; and finally, they may increase costs for

  2. Animal-assisted interventions in internal and rehabilitation medicine: a review of the recent literature.

    Science.gov (United States)

    Muñoz Lasa, S; Ferriero, G; Brigatti, E; Valero, R; Franchignoni, F

    2011-06-01

    While conventional wisdom has always affirmed the value of animals in promoting human well-being, only recently has their therapeutic role in medicine become the focus of dedicated research. Therapeutic modalities that use animals as a tool for improving the physical, emotional, cognitive and/or social functioning of humans are called animal-assisted interventions (AAI), and are classified into: animal-assisted activities (AAA); animal-assisted therapy (AAT); and service animal programs (SAP). The aim of this review is to analyze the papers published between 2001 and 2010 in the most influential medical journals dealing with AAI, and discuss their findings in the light of what may be of interest for internal medicine and rehabilitation. A total of 35 articles met the strict inclusion criteria for this review: 18 papers dealing with AAA, 8 with AAT, and 9 with SAP. The therapeutic outcomes associated with AAA are: enhancement of socialization; reduction of stress, anxiety and loneliness; improvement in mood and general well-being; and development of leisure/recreation skills. Regarding AAT, horses are often used as a complementary strategy to facilitate the normalization of muscle tone and improve motor skills in children with cerebral palsy and persons with lower limb spasticity. Finally, most SAP utilize dogs, that assist people with various disabilities in performing everyday activities, thus reducing their dependence on other persons. Further studies are needed to better define the fields and programs for the therapeutic use of animals and to increase their utilization in medicine, as a promising, complementary and natural means to improve both functional autonomy and quality of life.

  3. Aging and Adipose Tissue: Potential Interventions for Diabetes and Regenerative Medicine

    Science.gov (United States)

    Palmer, Allyson K.; Kirkland, James L.

    2016-01-01

    Adipose tissue dysfunction occurs with aging and has systemic effects, including peripheral insulin resistance, ectopic lipid deposition, and inflammation. Fundamental aging mechanisms, including cellular senescence and progenitor cell dysfunction, occur in adipose tissue with aging and may serve as potential therapeutic targets in age-related disease. In this review, we examine the role of adipose tissue in healthy individuals and explore how aging leads to adipose tissue dysfunction, redistribution, and changes in gene regulation. Adipose tissue plays a central role in longevity, and interventions restricted to adipose tissue may impact lifespan. Conversely, obesity may represent a state of accelerated aging. We discuss the potential therapeutic potential of targeting basic aging mechanisms, including cellular senescence, in adipose tissue, using type II diabetes and regenerative medicine as examples. We make the case that aging should not be neglected in the study of adipose-derived stem cells for regenerative medicine strategies, as elderly patients make up a large portion of individuals in need of such therapies. PMID:26924669

  4. Transition of care: A set of pharmaceutical interventions improves hospital discharge prescriptions from an internal medicine ward.

    Science.gov (United States)

    Neeman, Marine; Dobrinas, Maria; Maurer, Sophie; Tagan, Damien; Sautebin, Annelore; Blanc, Anne-Laure; Widmer, Nicolas

    2017-03-01

    Continuity of care between hospitals and community pharmacies needs to be improved to ensure medication safety. This study aimed to evaluate whether a set of pharmaceutical interventions to prepare hospital discharge facilitates the transition of care. This study took place in the internal medicine ward and in surrounding community pharmacies. The intervention group's patients underwent a set of pharmaceutical