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Sample records for radiologic non-vascular intervention

  1. 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

  2. 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.

  3. Non-vascular interventional therapy for respiratory diseases

    International Nuclear Information System (INIS)

    Ji Hongjian; Chen Liping; Wang Hui; Cheng Yongde

    2009-01-01

    To review the recent literature relating to non-vascular interventional therapy of respiratory diseases. Metal airway stent insertion can immediately relieve tracheobronchial obstruction and improve pulmonary function. However, as there is a high occurrence of the restenosis after stent insertion, it should be very careful to use metal stenting to treat the benign airway obstruction. Compared with traditional lung volume reduction surgery in treating severe emphysema, bronchoscopic lung volume reduction appears to be effective, safe and less invasive, although its clinical usefullness need to be further proved. Endoscopic occlusion of bronchial fistula represents an effective alternative to surgical treatment. Percutaneous lung biopsy under ultrasound or CT guidance has been applied successfully in the management of both benign and malignant lesions. (authors)

  4. Pediatric interventional radiology: vascular interventions

    International Nuclear Information System (INIS)

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-01-01

    Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. (author)

  5. Recent advances in non-vascular interventional diagnosis and treatment of thyroid nodules

    International Nuclear Information System (INIS)

    Lu Liming; Zhou Weisheng

    2009-01-01

    Non-vascular interventional diagnostic methods of thyroid nodules include ultrasonography-guided fine-needle aspiration cytology (USgFNAC) and ultrasonography-guided core-needle biopsy (USgCNB). USgFNAC is a practical method used to select and to guide the treatment of various thyroid nodules, however, it is difficult to make a differentiation between benign and malignant lesions simply to rely on the findings of a small number of cells. USgCNB has the advantage of being able to obtain satisfactory specimen enough for making a histological diagnosis, although this procedure is contraindicated in some patients. Non-vascular interventional treatments of thyroid nodules include percutaneous ethanol injection (PEI) and ultrasonography-guided interstitial laser photocoagulation (USgILP). Both PEI and USgILP have fine effect on the benign thyroid nodules. Compared with PEI, laser-induced necrosis can be well controlled, thus, the adverse reactions, such as the formation of fibrosis adjacent to the nodule, vocal cord paralysis, etc. can be avoided.Non-vascular interventional treatments may cause some untoward effects. For the diagnosis and treatment of thyroid nodules, the non-vascular interventional procedure is simple, safe, effective and economic with less complications, therefore, this technique is worth being popularized in clinical practice. (authors)

  6. CT- and MR-guided interventions in radiology. 2. ed.

    International Nuclear Information System (INIS)

    Mahnken, Andreas H.; Wilhelm, Kai E.; Ricke, Jens

    2013-01-01

    Revised and extended second edition that covers a broad range of non-vascular interventions guided by CT or MR imaging. Discusses in detail indications, materials, techniques, and results. Includes a comprehensive section on interventional oncology. Richly illustrated source of information and guidance for all radiologists who deal with non-vascular procedures. Interventional radiology is an indispensable and still expanding area of modern medicine that encompasses numerous diagnostic and therapeutic procedures. Cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance (MR) have emerged as important techniques for non-vascular interventions, including percutaneous biopsy, drainage, ablation, and neurolysis. Various organs, diseases, and lesions can be approached in this way, permitting the treatment and management of tumors, fluid collections, and pain, the embolization of endoleaks, the provision of access to hollow organs, etc. Accordingly, interventional radiology is now an integral component of the interdisciplinary management of numerous disorders. The revised and significantly extended second edition of this volume covers a broad range of non-vascular interventions guided by CT or MR imaging. Indications, materials, techniques, and results are all carefully discussed. A particularly comprehensive section is devoted to interventional oncology as the most rapidly growing branch of interventional radiology. In addition, detailed information is provided that will assist in establishing and developing an interventional service. This richly illustrated book will be a most valuable source of information and guidance for all radiologists who deal with non-vascular procedures.

  7. 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)

  8. Interventional Radiology in Paediatrics.

    Science.gov (United States)

    Chippington, Samantha J; Goodwin, Susie J

    2015-01-01

    As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

  9. Guidelines for radiological interventions

    International Nuclear Information System (INIS)

    Kauffmann, G.W.

    1998-01-01

    The German Radiological Society, in cooperation with other German professional bodies, set up draft Guidelines for Radiological Interventions and submitted them to the professional community for discussion. The Guidelines are meant to assess the potential of radiological interventions as treatment alternatives to surgery or aggressive therapy such as chemotherapy. In fact, technical practicability on its own is insufficient to warrant intervention. The Guidelines are systematically compiled notions and recommendations whose aim it is to provide support to physicians and patients in choosing suitable medical care provisions (prevention, diagnosis, therapy, aftertreatment) in specific circumstances. A complete Czech translation of the Guidelines is given. (P.A.)

  10. Society of Interventional Radiology

    Science.gov (United States)

    ... Picture yourself in L.A. Register now SIR Essentials Purchase/register Search SIR's entire catalog for educational ... Quality Improvement Clinical practice MACRA Matters Health Policy, Economics, Coding Toolkits Society of Interventional Radiology 3975 Fair ...

  11. 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.

  12. 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.)

  13. 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

  14. Cardiovascular and interventional radiology

    International Nuclear Information System (INIS)

    White, R.I. Jr.

    1985-01-01

    A symposium of eight short but complete papers giving an overview of interventional radiology is presented. Organized by Dr. William Casarella, this symposium is certainly the most current review of the subject available. This year's cardiovascular section is again heavily weighted toward interventional radiology. Abrams and Doubilet's article on the underutilization of angioplasty is important because it describes the cost effectiveness of this method. Most health planners, right or wrong, have complained about overutilization of diagnostic radiology procedures. In general, the opposite is true for interventional procedures - they are underutilized. If the authors draw the attention of their hospital administrators to these approaches and also produce the data on long-term follow-up for our medical colleagues, interventional radiology may realize its full potential. Articles on cardiac magnetic resonance imaging are beginning to appear and this technique seems to have great potential. An important article, which is the first prospective study comparing lung scintigraphy and pulmonary angiography in the diagnosis of pulmonary embolism, supports the increased use of pulmonary angiography. Finally, an article on complications of percutaneous biliary drainage provokes some discussion of its value for routine preoperative use

  15. Paediatric interventional radiology

    International Nuclear Information System (INIS)

    McLaren, Clare

    2014-01-01

    Paediatric interventional radiology (PIR) is a rapidly-growing subspecialty, which offers a wide range of procedures applicable to almost all areas of hospital paediatrics. There are many important differences between paediatric and adult practice in interventional radiology, including disease processes and treatment goals, anatomical considerations, periprocedural patient management, radiation exposure optimisation and legal aspects. The use of retrievable or absorbable interventional devices such as stents will probably become more widespread in PIR practice. Recent advances in the technology of imaging equipment have been accompanied by an increase in the complexity of the work done by the radiographer. These developments present challenges and opportunities related to training and maintenance of skills, staffing arrangements, and the potential for advanced practice. It is likely that specialisation in PIR will become a more common role for radiographers in the future

  16. Angiography and interventional radiology

    International Nuclear Information System (INIS)

    Bundy, A.L.

    1988-01-01

    The decrease in angiographic procedures as a result of less invasive imaging modalities has been counterbalanced by the rise in interventional radiological techniques. Because the interventional radiologist behaves somewhat like a surgeon, his legal responsibilities also approach those of his surgical colleagues. The basic concerns of negligent malpractice are amplified by the issues of informed consent and vicarious liability. Also, damages resulting from these procedures are costly because of the severity of the injuries. The angiographer must become versed in medicolegal issues of this rapidly evolving specialty

  17. Interventional radiology and undesirable effects

    International Nuclear Information System (INIS)

    Benderitter, M.

    2009-01-01

    As some procedures of interventional radiology are complex and long, doses received by patients can be high and cause undesired effects, notably on the skin or in underlying tissues (particularly in the brain as far as interventional neuroradiology is concerned and in lungs in the case of interventional cardiology). The author briefly discusses some deterministic effects in interventional radiology (influence of dose level, delay of appearance of effects, number of accidents). He briefly comments the diagnosis and treatment of severe radiological burns

  18. 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

  19. 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....

  20. 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

  1. Occupational exposure in interventional radiology

    International Nuclear Information System (INIS)

    Oh, H.J.; Lee, K.Y.; Cha, S.H.; Kang, Y.K.; Kim, H.J.; Oh, H.J.

    2003-01-01

    This study was conducted to survey of radiation safety control and to measure occupational radiation exposure dose of staff in interventional radiology in Korea. Interventioanl radiology requires the operator and assisting personnel to remain close to the patient, and thus close to primary beams of radiation. Therefore exposure doses of these personnel are significant from a radiological protection point of view. We surveyed the status of radiation safety on interventional radiology of 72 hospitals. The result were that 119 radiation equipments are using in interventional radiology and 744 staffs are composed of 307 radiologists, 116 residents of radiology, 5 general physicians, 171 radiologic technologists and 145 nurses. 81.4% and 20.2 % of operating physicians are using neck collar protector and goggle respectively. The average radiation dose was measured 0.46±0.15 mSv/10 hours fluoroscopy inside examination room in radiation protection facilities. Occupational radiation exposure data on the staff were assessed in interventional radiology procedures from 8 interventional radiology equipments of 6 university hospitals. The dose measurements were made by placing a thermoluminesent dosimeter(TLD) on various body surface of operation and assistant staff during actual interventional radiology. The measured points were the corner of the eyes, neck(on the thyroid) , wrists, chest(outside and inside of the protector), and back. Average radiation equivalent dose of the corner of left eye and left wrist of operating physicians were 1.19 mSv(0.11∼4.13 mSv)/100 minutes fluoroscopy and 4.32 mSv(0.16∼11.0 mSv)/100 minutes fluoroscopy respectively. Average exposure dose may vary depending on the type of procedure, personal skills and the quality of equipment. These results will be contributed to prepare the guide line in interventional radiology in Korea

  2. The economics of interventional radiology

    International Nuclear Information System (INIS)

    Price, G.W.

    1988-01-01

    At a time when policy makers and regulators are scheming to reduce the costs and utilization of medical services, interventional radiology is poised for growth. Part of this potential for growth is based on wider acceptance of the procedures performed by interventional radiologists. A second factor in the growth potential is the relative value in cost of these procedures compared with alternative therapies. The author presents a discussion of the differences in the relative value of these procedures when performed by physicians of different specialties. This paper reviews the status of the economic climate in the health care delivery system and the role and potential growth of interventional radiology. This includes a review of current data on the utilization of interventional radiology procedures in the Medicare program. This overview includes a discussion of the initiatives of the federal government which directly impact interventional radiology

  3. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional biopsy or interventional therapy

    International Nuclear Information System (INIS)

    Li Zhen; Han Xinwei; Jiao Dechao; Ren Jianzhuang; Su Yu; Ye Hui

    2011-01-01

    Objective: to investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non, vascular interventional biopsy or interventional therapy. Methods: Thirty, one patients, who were encountered in authors' hospital during the period from July 2010 to September 2010, were involved in this study. C-arm CT-guided percutaneous targeted puncturing biopsy or interventional therapy was performed in all 31 patients. All patients had complete clinical data. The complications and positive rate of biopsy were recorded and analyzed. Results: Under C-arm CT-guidance, percutaneous interventional therapy was carried out in 13 patients. The interventional procedures included radiofrequency ablation therapy for hepatic cellular carcinoma (n=2), pelvic abscess draining (n=1), hepatic abscess draining (n=1), ethanol injection for liver cancer (n=4), sclerotic therapy with ethanol injection for renal cyst (n=2), sclerotic therapy with ethanol injection for liver cyst (n=2) and catheter-indwelling drainage for pancreatic pseudocyst (n=1). percutaneous interventional biopsy was performed in the remaining 18 cases, including liver (n=4), lung (n=7), mediastinum (n=2), bone and soft tissue (n=4) and neck mass (n=1). All the procedures were successfully accomplished, no technique, related complications occurred during the operation. For biopsy examination in 18 cases, the positive rate was 94.4% (17/18) and false, negative results was seen in one case with lung lesion. Conclusion: The percutaneous targeted puncturing technique with C, arm CT-guidance combines the advantages of both CT scanning and fluoroscopy. The use of real, time road, mapping function can effectively guide the puncturing and therapeutic management, which can not only optimize the workflow, save the operation time, but also improve the success rate and technical safety. Therefore, it is of great value to popularize this targeted puncturing technique. (authors)

  4. 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.

  5. 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.

  6. 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

  7. 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...

  8. [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.

  9. Microdialysis technique and interventional radiology

    International Nuclear Information System (INIS)

    An Xiao; Xiao Xiangsheng

    2007-01-01

    Basic research in interventional radiology, including transcatheter artery perfusion especially, is progressing slowly due to lack of proper method. Microdialysis technique, a kind of accurate sampling technique in vivo, may help to solve the problem. Just as its name implies, microdialysis means tiny dialysis with advantages of authenticity, exactness and less error. Furthermore it has been applied widely and should be received with great attention and popularity. (authors)

  10. 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)

  11. 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.

  12. Interventional radiology in pediatric oncology

    International Nuclear Information System (INIS)

    Hoffer, Fredric A.

    2005-01-01

    There are many radiological interventions necessary for pediatric oncology patients, some of which may be covered in other articles in this publication. I will discuss a number of interventions including percutaneous biopsy for solid tumor and hematological malignancy diagnosis or recurrence, for the diagnosis of graft versus host disease after stem cell or bone marrow transplantation, and for the diagnosis of complications of immunosuppression such as invasive pulmonary aspergillosis. In the past, tumor localization techniques have been necessary to biopsy or resect small lesions. However improved guidance techniques have allowed for more precise biopsy and the use of thermal ablation instead of excision for local tumor control. A percutaneously placed radio frequency, microwave, laser or cryogen probe can ablate the primary and metastatic tumors of the liver, lung, bone, kidney and other structures in children. This is an alternative treatment for the local control of tumors that may not be amenable to surgery, chemotherapy or radiotherapy. I will also describe how chemoembolization can be used to treat primary or metastatic tumors of the liver that have failed other therapies. This treatment delivers chemotherapy in the hepatic artery infused with emboli to increase the dwell time and concentration of the agents

  13. 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)

  14. 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.

  15. What Does Competence Entail in Interventional Radiology?

    International Nuclear Information System (INIS)

    Ahmed, Kamran; Keeling, Aoife N.; Khan, Reenam S.; Ashrafian, Hutan; Arora, Sonal; Nagpal, Kamal; Burrill, Joshua; Darzi, Ara; Athanasiou, Thanos; Hamady, Mohamad

    2010-01-01

    Interventional radiology is a relatively new speciality and may be referred to as 'image-guided surgery without a scalpel.' Training and accreditation bodies regard interventional radiology training as being 'different' from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along with a succinct introduction to methods of assessment of technical and non-technical skills.

  16. 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)

  17. Dosimetry in Interventional Radiology - Effective Dose Estimation

    International Nuclear Information System (INIS)

    Miljanic, S.; Buls, N.; Clerinx, P.; Jarvinen, H.; Nikodemova, D.; Ranogajec-Komor, M; D'Errico, F.

    2008-01-01

    Interventional radiological procedures can lead to significant radiation doses to patients and to staff members. In order to evaluate the personal doses with respect to the regulatory dose limits, doses measured by dosimeters have to be converted to effective doses (E). Measurement of personal dose equivalent Hp(10) using a single unshielded dosimeter above the lead apron can lead to significant overestimation of the effective dose, while the measurement with dosimeter under the apron can lead to underestimation. To improve the accuracy, measurements with two dosimeters, one above and the other under the apron have been suggested ( d ouble dosimetry ) . The ICRP has recommended that interventional radiology departments develop a policy that staff should wear two dosimeters. The aim of this study was to review the double dosimetry algorithms for the calculation of effective dose in high dose interventional radiology procedures. The results will be used to develop general guidelines for personal dosimetry in interventional radiology procedures. This work has been carried out by Working Group 9 (Radiation protection dosimetry of medical staff) of the CONRAD project, which is a Coordination Action supported by the European Commission within its 6th Framework Program.(author)

  18. Acute radiologic intervention in gastrointestinal bleeding

    International Nuclear Information System (INIS)

    Lesak, F.

    1986-01-01

    A case of embolization of the gastroduodenal artery in a 38-year old man with chronic pancreatitis and uncontrollable bleeding is presented. The advantage of this interventional radiologic procedure is discussed and in selective cases it seems to be the choice of treatment. (orig.) [de

  19. Acute radiologic intervention in gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Lesak, F.

    1986-01-01

    A case of embolization of the gastroduodenal artery in a 38-year old man with chronic pancreatitis and uncontrollable bleeding is presented. The advantage of this interventional radiologic procedure is discussed and in selective cases it seems to be the choice of treatment.

  20. 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)

  1. 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)

  2. Streamlining interventional radiology admissions: The role of the interventional radiology clinic and physician's assistant

    International Nuclear Information System (INIS)

    White, R.I. Jr.; Rizer, D.M.; Shuman, K.; White, E.J.; Adams, P.; Doyle, K.; Kinnison, M.

    1987-01-01

    During a 5-year period (1982-1987), 376 patients were admitted to an interventional radiology service where they were managed by the senior physician and interventional radiology fellows. Sixty-eight percent of patients were admitted for angioplasty and 32% for elective embolotherapy/diagnostic angiography. A one-half-day, twice weekly interventional radiology clinic and employment of a physician's assistant who performed preadmission history and physicals and wrote orders accounted, in part, for a decrease in hospital stay length from 3.74 days (1982-1983) to 2.41 days (1986-1987). The authors conclude that use of the clinic and the physician's assistant streamlines patient flow and the admitting process and is partially responsible for a decreased length of stay for patients admitted to an interventional radiology service

  3. 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

  4. 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.)

  5. 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.

  6. 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.

  7. Interventional Radiologic Treatment for Idiopathic Portal Hypertension

    International Nuclear Information System (INIS)

    Hirota, Shozo; Ichikawa, Satoshi; Matsumoto, Shinichi; Motohara, Tomofumi; Fukuda, Tetsuya; Yoshikawa, Takeshi

    1999-01-01

    Purpose: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. Results: In one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery

  8. 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)

  9. 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

  10. 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

  11. Non-vascular surgical mediastinum

    International Nuclear Information System (INIS)

    Schiavon, S.; Trenaghi, P.; Nardini, S.; Pagan, V.

    1989-01-01

    A review was made of the chest X-ray features of 120 patients who underwent surgical treatment for mediastinal non-vascular pathologies over the past 12 years in the Mestre Hospital. A method of analysis is proposed which takes into account not only the differences between the immediate post-operative period and the follow-up, but also the anatomotopographic partition and the surgical practice. Normal and pathological patterns for both of the above periods are described. The ''dimness'' of the arial tracheogram is emphasized as a usefull and early sign of mediastinal recurrence

  12. 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.

  13. 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)

  14. Preliminary exploration of the postgraduate education reform in interventional radiology

    International Nuclear Information System (INIS)

    Ni Caifang; Ouyang Yong

    2012-01-01

    Interventional radiology now is facing many challenges. The education quality has declined, and the high-level professional talents have been lost. This paper aims to analyze the present situation of the postgraduate education and the relevant issues in the field of interventional radiology, and to make a preliminary exploration into how we can train the postgraduates to become qualified interventional radiologists with high comprehensive quality in order to meet the urgent requirements demanded by the development of interventional radiology. (authors)

  15. 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

  16. 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.)

  17. 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

  18. 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)

  19. [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.

  20. Radiological findings and interventions for iatrogenic vascular injuries

    International Nuclear Information System (INIS)

    Lee, Kyoung Ho; Chung, Jin Wook; Kim, Tae Kyoung; Han, Sang Wook; Lee, Jong Seog; Park, Jae Hyung; Kim, Jong Hyo; Han, Man Chung

    1998-01-01

    The purpose of this study is to evaluate the radiological findings and effectiveness of radiological interventions in patients with iatrogenic vascular injuries. We analyzed 50 patients with iatrogenic vascular injuries treated with radiological intervention. The causes of injuries were surgery (n=20), cardiovascular intervention (n=15), non-cardiovascular radiological intervention (n=14), and endoscopic intervention (n=1). The injury had resulted in hemorrhage in 35 cases. The iliac and/or femoral, hepatic, and renal vessels were commonly injured. Angiography, ultrasonography with Doppler examination, CT, and CT angiography were performed to diagnose vascular injuries and guide the radiological intervention. The mean follow-up period was 23 months and in 16 cases was more than one year. the major radiological findings were extravasation, pseudoaneurysm, arteriovenous shunt, or vascular obstruction. To control these lesions, radiological interventions such as embolization (n=36), local urokinase administration, stent insertion, foreign body removal, ultrasonography-guided compression, or stent-graft insertion were performed. The clinical problems were immediately controlled by the single trials of radiological interventions and did not recur in 40 cases (80%). Radiological examinations and interventions are useful in cases with iatrogenic vascular injuries. (author). 14 refs., 4 figs

  1. Vascular Closure Devices in Interventional Radiology Practice

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Rafiuddin, E-mail: rafiuddin.patel@ouh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom); Muller-Hulsbeck, Stefan, E-mail: muehue@diako.de [Diakonissen Hospital, Diagnostic and Interventional Radiology/Neuroradiology (Germany); Morgan, Robert, E-mail: robert.morgan@stgeorges.nhs.uk [St George’s Hospital, Department of Radiology (United Kingdom); Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk [John Radcliffe Hospital, Department of Radiology (United Kingdom)

    2015-08-15

    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.

  2. Radiology

    International Nuclear Information System (INIS)

    Bigot, J.M.; Moreau, J.F.; Nahum, H.; Bellet, M.

    1990-01-01

    The 17th International Congress of Radiology was conducted in two separate scientific sessions, one for radiodiagnosis and one for radiation oncology. Topics covered are: Radiobiology -radioprotection; imaging and data processing; contrast media; MRI; nuclear medicine; radiology and disasters; radiology of tropical diseases; cardiovascular radiology; interventional radiology; imaging of trauma; imaging of chest, gastro-intestinal tract, breast and genito-urinary tract; imaging in gynecology;imaging in oncology; bone and joint radiology; head and neck-radiology; neuro-radiology. (H.W.). refs.; fig.; tabs

  3. 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)

  4. Slovenian experience from diagnostic angiography to interventional radiology

    International Nuclear Information System (INIS)

    Pavcnik, Dusan

    2014-01-01

    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. This depicted the important roles different people played at various times in the cardiovascular divisions inside and outside of the diagnostic and interventional radiology. Historical data show that Slovenian radiology has relatively immediately introduced the new methods of interventional radiology in clinical practice

  5. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    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

  7. 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

  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. Quality assurance measures in interventional radiology

    International Nuclear Information System (INIS)

    Heuser, L.

    1999-01-01

    The quality assurance of treatment measures is legally required but as yet not generally established in practice. For interventional radiology, the introduction of quality assurance for PTA of arteries of the lower limbs is planned for January 1999. It is reasonable to subject at least the most important and/or most frequently performed interventions to quality management. In the present article, the term quality in the management of diseases is defined and the system of total quality management discussed at the levels structure, process, and results. For its application, parameters of quality measurement in the form of standards, criteria, and characteristic values are necessary and must be laid down by a team of experts on the basis of subjective experience and/or results in the literature. Practical quality assurance takes place not only within a clinic but also externally by comparison with other centers. Data collection and evaluation requires high-performance software that will be continuously improved, expanded, and adapted to current needs during regular meetings between the various users. (orig.) [de

  10. 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

  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. Pediatric interventional radiology clinic - how are we doing?

    International Nuclear Information System (INIS)

    Rubenstein, Jonathan; Zettel, Julie C.; Lee, Eric; Cote, Michelle; Aziza, Albert; Connolly, Bairbre L.

    2016-01-01

    Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved. (orig.)

  13. 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.

  14. Angiography and interventional radiology of the kidneys

    International Nuclear Information System (INIS)

    Hansmann, J.; Richter, G.M.; Hallscheidt, P.; Duex, M.; Noeldge, G.; Kaufmann, G.W.

    1999-01-01

    For imaging of renal pathology a broad spectrum of radiologic diagnostic procedures are available which are, sometimes and particularly more recently, competing among each other in their diagnostic yield and relevance. For tumorous lesions ultrasound, computed tomography and magnetic resonance imaging are performed predominantly. Angiography is no longer required with the exception of highly selected cases and in some specific preoperative workup requirements. Until recently, catheter based digital subtraction angiography has been considered as gold standard. However, non-invasive techniques such as CT-angiography and MR-angiography are evolving parallel to their quantum leap of resolutions and readiness to use. Nevertheless, well accepted criteria for quality assessement of these new modalities are still lacking. More comparison studies are urgently warranted. Despite the availability of ultrashort pulse sequences applying the T1 relaxation reduction effect of gadolinium enhanced MR techniques overestimation of renal artery stenosis still poses a substantial problem. Renal intervention implies a variety of procedures such as plain angioplasty, stent placement, embolization of traumatic and both benign and malignant tumors. These methods have emerged over the last two decades from a more experimental nature to a fully accepted treatment option. When renal artery angioplasty is embedded in an aggressive approach including stenting as an adjunct for more complex cases, renal ostial lesions and a well organized follow-up regimen its therapeutic potential for treatment of renal insufficiency, malignant hypertension, for organ preservation bears a very high potential. Provided adequate periinterventional drug regimen restenosis rates may be as low as 10%. In highly selected cases capillary embolization might be used as an alternative to nephrectomy with a similar clinical outcome. Particularly the development of superselective small caliber embolization catheters

  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. Current radiologic interventions in hepatocellular carcinoma

    International Nuclear Information System (INIS)

    Masoud, I.; Naeem, M.Q.T.; Saeed, F.; Mirza, S.A.M.; Khan, A.; Bhatti, M.A.

    2006-01-01

    With the rising incidence of chronic liver disease caused by viral hepatitis, hepatocellular carcinoma is showing a corresponding rise worldwide. Surgery remains the mainstay of treatment, but patients unfit for surgery or liver transplantation form the bulk of those presenting with this disease. Palliative treatments are being used to treat those and radiological modalities form the mainstay of the treatment. Radiology plays a major role in the diagnosis, treatment and follow-up of hepatocellular carcinoma. Current radiological treatment modalities include percutaneous ethanol ablation, radiofrequency ablation and trans-arterial chemoembolization. This update highlights the recent advancements in the field and compares their relative merits and demerits. (author)

  17. 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...... and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping...

  18. Accidental exposures in interventional radiology: lessons learned by the ASN

    International Nuclear Information System (INIS)

    Marchal, C.; Valero, M.

    2009-01-01

    The authors outline that interventional radiology often requires long duration exposures of patients to ionizing radiations and thus stress that interventional radiology must be optimized to improve radioprotection of patients and operators. They notice that investigations performed by the ASN (the French Nuclear Safety Authority) on declared events revealed in some cases a lack of knowledge of devices by users, notably of functionalities allowing the applied doses to be controlled

  19. 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)

  20. Intervention levels for protective action in the radiological emergency

    International Nuclear Information System (INIS)

    Lee, G.Y.; Khang, B.O.; Lee, M.; Lee, J.T.

    1998-09-01

    In the event of nuclear accident or radiological emergency, the protective action based on intervention levels prepared in advance should be implemented in order to minimize the public hazard. There are several protective measures such as sheltering, evacuation, iodine prophylaxis, foodstuff restrictions, temporary relocation, permanent resettlement, etc. for protecting the public. The protective measures should be implemented on the basis of operational intervention level of action level. This report describes the basic principles of intervention and the methodology for deriving intervention levels, and also recommendations for the intervention levels suggested from IAEA, ICRP, WHO and EU are summarized to apply to the domestic radiological emergency. This report also contains a revision procedure of operational intervention levels to meet a difference accident condition. Therefore, it can be usefully applied to establish revised operational intervention levels considering or the regional characteristics of our country. (author). 20 refs

  1. The role of interventional radiology in obstetric and gynaecology practice

    International Nuclear Information System (INIS)

    Ganeshan, Arul; Nazir, Sarfraz Ahmed; Hon, Lye Quen; Upponi, Sara S.; Foley, Peter; Warakaulle, Dinuke R.; Uberoi, Raman

    2010-01-01

    Interventional radiology is continuing to reshape current practice in many specialties of clinical care. It is a relatively new and innovative branch of medicine in which physicians treat diseases non-operatively through small catheters guided to the target by fluoroscopic and other imaging modalities. The aim is to provide image-guided, minimally invasive alternatives to traditional surgical and medical procedures in suitable cohorts of patients. Procedures which previously required major surgery can now be performed by interventional radiologists, sometimes on an outpatient basis, with little patient discomfort. In this review, we highlight the importance of interventional radiology in treating a comprehensive range of obstetric and gynaecological pathologies.

  2. Physical and cognitive task analysis in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, S [School of Psychology, University of Liverpool, Liverpool (United Kingdom); Healey, A [Royal Liverpool University Hospital, Liverpool (United Kingdom); Evans, J [Royal Liverpool University Hospital, Liverpool (United Kingdom); Murphy, M [Royal Liverpool University Hospital, Liverpool (United Kingdom); Crawshaw, M [Department of Psychology, University of Hull, Hull (United Kingdom); Gould, D [Royal Liverpool University Hospital, Liverpool (United Kingdom)

    2006-01-15

    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.

  3. 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

  4. 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.

  5. Approaching the Practice Quality Improvement Project in Interventional Radiology.

    Science.gov (United States)

    Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

    2015-12-01

    An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  6. Promoting interventional radiology in clinical practice of emergency medicine

    International Nuclear Information System (INIS)

    Zhou Bing; Yuan Jianhua

    2009-01-01

    Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive, highly-effective and immediately-efficient, moreover, it integrates the diagnosis with the therapy perfectly. Besides, the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization, embolectomy, etc, but also the nonvascular interventions, such as tracheal s tent implantation, percutaneous vertebroplasty and so forth. However, importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice. (authors)

  7. Guide for intervention levels in radiological accidents

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tai; Khang, Byung Oui; Lee, Goan Yup; Han, Gee Yang [Korea Atomic Energy Resesrch Institute, Taejon (Korea, Republic of)

    2001-03-15

    Based on IAEA SS109 and ICRP63, intervention levels and action levels are derived using cost-benefit approach method. Intervention levels are optimized so that the net benefit from protective measures will be maximized. Evacuation, sheltering, relocation, permanent resettlement, administration of stable iodine and food restriction are included in protective measures. Intervention levels are calculated using site specific parameters in Korea. As a results of calculation, general intervention levels are similar to IAEA recommendation and action levels for food restriction are a little higher than IAEA recommendation and Japan guide. Guide on intervention levels in Korea is also suggested based on the calculated results.

  8. 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.

  9. 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.

  10. 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.

  11. 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)

  12. 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)

  13. 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.

  14. ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

    Science.gov (United States)

    López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C

    2018-03-01

    In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

  15. 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)

  16. 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.

  17. Interventional radiological treatment in complications of pancreatitis

    International Nuclear Information System (INIS)

    Memis, Ahmet; Parildar, Mustafa

    2002-01-01

    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

  18. Intercomparison of active personal dosemeters in interventional radiology

    International Nuclear Information System (INIS)

    Clairand, I.; Struelens, L.; Bordy, J. M.; Daures, J.; Debroas, J.; Denozieres, M.; Donadille, L.; Gouriou, J.; Itie, C.; Vaz, P.; D'Errico, F.

    2008-01-01

    The use of active personal dosemeters (APD) in interventional radiology was evaluated by Working Group 9 (Radiation protection dosimetry of medical staff) of the CONRAD project, which is a Coordination Action supported by the European Commission within its sixth Framework Programme. Interventional radiology procedures can be very complex and they can lead to relatively high doses to personnel who stand close to the primary radiation field and are mostly exposed to radiation scattered by the patient. For the adequate dosimetry of the scattered photons, APDs must be able to respond to low-energy [10-100 keV] and pulsed radiation with relatively high instantaneous dose rates. An intercomparison of five APD models deemed suitable for application in interventional radiology was organised in March 2007. The intercomparison used pulsed and continuous radiation beams, at CEA-LIST (Saclay (France)) and IRSN (Fontenay-aux-Roses (France)), respectively. A specific configuration, close to the clinical practice, was considered. The reference dose, in terms of Hp(10), was derived from air kerma measurements and from the measured and calculated energy distributions of the scattered radiation field. Additional Monte Carlo calculations were performed to investigate the energy spectra for different experimental conditions of the intercomparison. The results of this intercomparison are presented in this work and indicate which APDs are able to provide a correct response when used in the specific low-energy spectra and dose rates of pulsed X-rays encountered in interventional radiology. (authors)

  19. 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 < 0.050). 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.

  20. 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.

  1. 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.)

  2. 100 classic papers of interventional radiology: A citation analysis

    Science.gov (United States)

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

    2015-01-01

    AIM: To define the 100 citation classic papers of interventional radiology. METHODS: 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. RESULTS: The top paper received 2497 citations and the 100th 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. CONCLUSION: 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. PMID:25918585

  3. 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

  4. ICRP PUBLICATION 121: Radiological Protection in Paediatric Diagnostic and Interventional Radiology

    International Nuclear Information System (INIS)

    Khong, P-L.; Ringertz, H.; Donoghue, V.; Frush, D.; Rehani, M.; Appelgate, K.; Sanchez, R.

    2013-01-01

    Paediatric patients have a higher average risk of developing cancer compared with adults receiving the same dose. The longer life expectancy in children allows more time for any harmful effects of radiation to manifest, and developing organs and tissues are more sensitive to the effects of radiation. This publication aims to provide guiding principles of radiological protection for referring clinicians and clinical staff performing diagnostic imaging and interventional procedures for paediatric patients. It begins with a brief description of the basic concepts of radiological protection, followed by the general aspects of radiological protection, including principles of justification and optimisation. Guidelines and suggestions for radiological protection in specific modalities – radiography and fluoroscopy, interventional radiology, and computed tomography – are subsequently covered in depth. The report concludes with a summary and recommendations. The importance of rigorous justification of radiological procedures is emphasised for every procedure involving ionising radiation, and the use of imaging modalities that are non-ionising should always be considered. The basic aim of optimisation of radiological protection is to adjust imaging parameters and institute protective measures such that the required image is obtained with the lowest possible dose of radiation, and that net benefit is maximised to maintain sufficient quality for diagnostic interpretation. Special consideration should be given to the availability of dose reduction measures when purchasing new imaging equipment for paediatric use. One of the unique aspects of paediatric imaging is with regards to the wide range in patient size (and weight), therefore requiring special attention to optimisation and modification of equipment, technique, and imaging parameters. Examples of good radiographic and fluoroscopic technique include attention to patient positioning, field size and adequate collimation

  5. Traumatic injuries: radiological hemostatic intervention at admission

    Energy Technology Data Exchange (ETDEWEB)

    Dondelinger, R.F.; Trotteur, G.; Ghaye, B.; Szapiro, D. [Department of Medical Imaging, University Hospital Sart Tilman, Liege (Belgium)

    2002-05-01

    Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast medium extravasation observed on CT. In centers admitting polytrauma patients, the CT and angiography units should be installed together within the emergency environment. Trauma-dedicated interventional radiologists should be on call for optimal patient management. Posttraumatic retroperitoneal and pelvic bleeding is a primary indication for angiographic hemostasis, together with orthopedic fixation of pelvic bone fractures. Angiography should be carried out rapidly, before the patient decompensates for considerable blood loss. In patients with visceral bleeding, arterial embolization can obviate primary surgery or potentializes surgical intervention and contributes to changing hierarchy of injuries to be treated surgically. Failure to achieve primary hemostasis may occur according to the type of specific organ injury and coagulation and metabolic parameters of the patient. Postembolization complications are few and are usually non-life-threatening and rarely carry definitive sequelae. (orig.)

  6. Traumatic injuries: radiological hemostatic intervention at admission

    International Nuclear Information System (INIS)

    Dondelinger, R.F.; Trotteur, G.; Ghaye, B.; Szapiro, D.

    2002-01-01

    Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast medium extravasation observed on CT. In centers admitting polytrauma patients, the CT and angiography units should be installed together within the emergency environment. Trauma-dedicated interventional radiologists should be on call for optimal patient management. Posttraumatic retroperitoneal and pelvic bleeding is a primary indication for angiographic hemostasis, together with orthopedic fixation of pelvic bone fractures. Angiography should be carried out rapidly, before the patient decompensates for considerable blood loss. In patients with visceral bleeding, arterial embolization can obviate primary surgery or potentializes surgical intervention and contributes to changing hierarchy of injuries to be treated surgically. Failure to achieve primary hemostasis may occur according to the type of specific organ injury and coagulation and metabolic parameters of the patient. Postembolization complications are few and are usually non-life-threatening and rarely carry definitive sequelae. (orig.)

  7. Occupational hand doses in interventional radiology

    International Nuclear Information System (INIS)

    Spasic Jokic, V.; Djurovic, B.; Lukac, S.

    2001-01-01

    In this paper we present the case of a radiologist performing interventional procedures. The radiologist works for number of interventional procedures, but we reported only percutaneous nephrostomy and percutaneous biliary drainage which represent about 30% of his occupational exposure. The radiologist is occupationally exposed for eighteen years and from 1995 has radiation injuries. From 1999, art. hypertension, cataract complicata incip.ou., onychodystrophia and hyperceratosis mani bill. The most important are hands skin injuries. In ordinary dosimetric control low doses less than 10 mGy per year were recorded, so personal dosimetry results and biological results are not in accordance. For that reason we performed additional measurements during many procedures and in this paper we present results for two chosen procedures. Radiation exposure of the radiologist's hands during 200 percutaneous nephrostomy and 63 percutaneous biliary drainage per year are reported. Exposures were measured with thermoluminescent dosemeters (TLD) type CaF 2 :Mn. Hand doses of equivalent of 221 μSv in average per drainage and 31 μSv in average per nephrostomy were recorded. (author)

  8. Occupational exposure for workers in interventional radiological examination

    International Nuclear Information System (INIS)

    Suliman, E.E.

    2005-01-01

    Full text: An interventional radiological examination is a diagnostic or therapeutic in any organ or anatomical region using images acquired with ionizing radiation. Compared to other radiological acquisition, personnel who perform interventional procedures, which involve long fluoroscopy times and a high workload may receive radiation doses comparable to the dose limits. Therefore to ensure that no person be subjected to an unacceptable risk from radiation, that need for accurate individual monitoring has arisen. In this work, the doses received by physician in cardiac angiography were evaluated and the results of two months were presented. Only 7 physicians were monitored. Hence the data available is presented, and it is hoped to provide some information on the assessment of occupational exposure in interventional radiological examination. Measurements were done using Thermoluminescence dosimeters (TLD) and a calibrated Harshaw Reader. Two TLDs were used by each physician, one worn under a protective apron at the waist (H W ) and the other worn outside and above the apron at the neck (H N ). The effective dose E was estimated from the formula: E (estimated) = 0.5 H W + 0.025 H N . From the result obtained it was concluded that, the weak point of radiation protection philosophy in medical application is in the work of interventional physicians who have no full time decision like the radiologist physicians and therefore haven't enough knowledge about the radiation and radiation protection. So they are the highest risk group among physicians and to whom the efforts must be directed. (author)

  9. 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

  10. 2000 RSNA annual oration in diagnostic radiology: The future of interventional radiology.

    Science.gov (United States)

    Becker, G J

    2001-08-01

    Origins in imaging, procedural emphasis, and dependence on innovation characterize interventional radiology, which will continue as the field of image-guided minimally invasive therapies. A steady supply of innovators will be needed. Current workforce shortages demand that this problem be addressed and in an ongoing fashion. Interventional radiology's major identity problem will require multiple corrective measures, including a name change. Diagnostic radiologists must fully embrace the concept of the dedicated interventionalist. Interspecialty turf battles will continue, especially with cardiologists and vascular surgeons. To advance the discipline, interventional radiologists must remain involved in cutting-edge therapies such as endograft repair of aortic aneurysms and carotid stent placement. As the population ages, interventionalists will experience a shift toward a greater emphasis on cancer treatment. Political agendas and public pressure will improve access to care and result in managed health care reforms. Academic centers will continue to witness a decline in time and resources available to pursue academic missions. The public outcry for accountability will result in systems changes aimed at reducing errors and process changes in the way physicians are trained, certified, and monitored. Evidence-based medicine will be the watchword of this century. Interventional radiology will maintain its role through development of methods for delivery of genes, gene products, and drugs to specific target sites; control of angiogenesis and other biologic processes; and noninvasive image-guided delivery of various forms of energy for ablation.

  11. 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.

  12. 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.

  13. Occupational radiation exposure of the personnel due to interventional radiology

    International Nuclear Information System (INIS)

    Wucherer, M.; Schmidt, T.; Loose, R.

    2000-01-01

    Applications of interventional radiology continue to be on an upward trend, some countries reporting a 100% increase within 2-4 years, so that the resulting radiation exposure of both patients and personnel is an issue of increasing importance. Whereas those applications in general are of advantage for the patients, they mean just a further health hazard for the medical personnel. It is therefore necessary to exploit all available means to reduce the occupational doses. Modern interventional radiology systems offer a range of measures for this purpose, as e.g. last-image-hold, or pulsed modes. Special attention has to be given to the exposure of hand and head. Particularly the hand is closest to the useful beam, and it should be a mandatory requirement to wear film rings. (orig./CB) [de

  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. Broken Esophageal Stent Successfully Treated by Interventional Radiology Technique

    International Nuclear Information System (INIS)

    Zelenak, Kamil; Mistuna, Dusan; Lucan, Jaroslav; Polacek, Hubert

    2010-01-01

    Esophageal stent fractures occur quite rarely. A 61-year-old male patient was previously treated for rupture of benign stenosis, occurring after dilatation, by implanting an esophageal stent. However, a year after implantation, the patient suffered from dysphagia caused by the broken esophageal stent. He was treated with the interventional radiology technique, whereby a second implantation of the esophageal stent was carried out quite successfully.

  16. 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.)

  17. 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

  18. Practical aspects of radiation protection in interventional radiology

    International Nuclear Information System (INIS)

    Faulkner, K.; Vano, E.; Ortiz, P.; Ruiz, R.

    2000-01-01

    The rise in the frequency of interventional procedures over recent years is due to the significant benefits of interventional radiology in which the patient may often be treated as an out-patient for clinical conditions, which would have previously meant that the patient would need surgery, i.e., a more traumatic and expensive treatment. Patients and the public demand greater access to interventional radiology for the these reasons. In some circumstances, for example in neuroradiology the aneurysm may be inoperable surgically and interventional radiology is the only method of treatment. The growth in interventional radiology therefore reflects an drive towards better, safer and more cost effective medicine. Certain types of interventional radiology procedures are quite complicated and may involve the use of extended fluoroscopy times and the use of high dose rates. In some cases reappearance of the original disease may lead to repeated interventions. This combination together with a lack of quality control in x-ray systems, has led deterministic effects in the skin of patients ranging from transient erythema to necrosis. In a few cases, staff doses reached the levels of deterministic effects, such as dot-like sub-capsular opacities (cataracts) and small dot-like paranuclear opacities and discrete posterior sub-capsular condensations in both eyes. A close review of the reported cases reveals that the working conditions were extreme, mainly: a) very short distance from x-ray focus to the patient, collimator in direct contact with the skin, b) use of high dose rate mode for a time much longer than necessary, c) fixed projection exposing the same area of skin during the entire procedure and d) malfunction of automatic exposure control systems. From these lessons, measure for preventing deterministic effects are straightforward: a) placing the x-ray tube at a distance of 50 cm or more from the skin whenever possible, b) placing the image intensifier as close as possible

  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. The role of morbidity and mortality meetings in interventional radiology

    International Nuclear Information System (INIS)

    Mok, Philip S.; Tan, Eva Y.; Baerlocher, Mark O.; Athreya, Sriharsha

    2012-01-01

    Purpose: To understand the current practice of interventional radiology (IR) morbidity and mortality (M and M) meetings among interventional radiologists in Europe, and to develop a set of results-based recommendations to increase the prevalence of IR M and M meetings. Materials and methods: Online electronic surveys were sent to members of the Cardiovascular and Interventional Radiology Society of Europe (CIRSE). Each survey consisted of 18 questions pertaining to IR M and M meetings. Results: A total of 150 CIRSE members responded to the survey. Approximately 47% of respondents held IR M and M meetings in their departments. Among those who held IR M and M meetings, 42% held them monthly and 68% rated the quality of the meetings as good or excellent. Of those who did not have M and M meetings, 94% were interested in incorporating M and M meetings into their future practice. The most common reasons for not holding IR M and M meetings were lack of time (68%) and small IR practice groups (43%). A total of 85% were interested in learning more about IR M and M meetings. The preferred method of education about M and M meetings included annual radiology meetings (44%), peer-reviewed articles in radiology journals (31%), websites (26%), and newsletters (15%). Conclusions: The data demonstrate that although current practice of M and M meetings in European IR departments is limited, the majority of respondents believe that M and M meetings are beneficial to their practice. There is a need for guidelines or standards of practice to incorporate such meetings in IR departments to prevent medical errors, which may ultimately lead to enhanced patient safety and outcomes.

  2. 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)

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

    Science.gov (United States)

    Mori, Hiroshige

    2015-06-01

    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.

  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. 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.)

  6. 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.

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

    International Nuclear Information System (INIS)

    Durran, Alexandra C.; Watts, Christopher

    2012-01-01

    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 ∼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. Radiation dose to physicians’ eye lens during interventional radiology

    International Nuclear Information System (INIS)

    Bahruddin, N A; Hashim, S; Karim, M K A; Ang, W C; Salehhon, N; Sabarudin, A; Bakar, K A

    2016-01-01

    The demand of interventional radiology has increased, leading to significant risk of radiation where eye lens dose assessment becomes a major concern. In this study, we investigate physicians' eye lens doses during interventional procedures. Measurement were made using TLD-100 (LiF: Mg, Ti) dosimeters and was recorded in equivalent dose at a depth of 0.07 mm, Hp(0.07). Annual Hp(0.07) and annual effective dose were estimated using workload estimation for a year and Von Boetticher algorithm. Our results showed the mean Hp(0.07) dose of 0.33 mSv and 0.20 mSv for left and right eye lens respectively. The highest estimated annual eye lens dose was 29.33 mSv per year, recorded on left eye lens during fistulogram procedure. Five physicians had exceeded 20 mSv dose limit as recommended by international commission of radiological protection (ICRP). It is suggested that frequent training and education on occupational radiation exposure are necessary to increase knowledge and awareness of the physicians’ thus reducing dose during the interventional procedure. (paper)

  10. 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

  11. Value of levels of complexity in the estimation of the risk in interventional radiology procedures; Valor de los indices de complejidad en la estimacion del riesgo en procedimientos de radiologia intervencionista

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Cruces, R.; Vano, E.; Hernandez Armas, J.; Carrera Magarino, F.; Rosales, F.; Galan, P.; Solar, M. M.; Perez Martinez, M.; Sanchez Casanueva, R.; Moreno Saiz, C.; Caudepon, F.; Diaz, F.; Gallego Solar, J. J.; Martin-Palanca, A.; Ruiz Munoz-Canela, J. J.; Moreno Rodriguez, F.; Gonzalez de Garay, M.; Canis, M.; Lopez Medina, A.; Moreno Sachez, T.; Pastor Vega, J. M.

    2013-07-01

    The interventional Radiology (IR) refers to guided procedures with X rays, to develop a diagnostic and/or therapeutic action both in vascular diseases as non-vascular. The progressive increase in the complexity and diversity of interventional procedures make it difficult to objectify the criteria about the dosage provided to patients who are these techniques. Control of radiation doses administered to patients to limit the risks associated with the use of x-rays is not more than one way of improving procedures. For this reason, already completed the ERRAPRI project, we have developed complexity rates to better assess the radiological risk associated with the procedures carried out in a sample of Spanish hospitals. (Author)

  12. Estimate of dose in interventional radiology: a study of cases

    International Nuclear Information System (INIS)

    Pinto, N.; Braz, D.; Lopes, R.; Vallim, M.; Padilha, L.; Azevedo, F.; Barroso, R.

    2006-01-01

    Values of absorbed dose taken by patients and professionals involved in interventional radiology can be significant mainly for the reason of these proceedings taking long time of fluoroscopy There are many methods to estimate and reduce doses of radiation in the interventional radiology, particularly because the fluoroscopy is responsible for the high dose contribution in the patient and in the professional. The aim of this work is the thermoluminescent dosimetry to estimate the dose values of the extremities of the professionals involved in the interventional radiology and the product dose-area was investigated using a Diamentor. This evaluation is particularly useful for proceedings that interest multiple parts of the organism. In this study were used thermoluminescent dosimeters (LiF:Mg, Ti - Harshaw) to estimate the dose values of the extremities of the professionals and to calibrate them. They were irradiated with X rays at 50 mGy, in Kerma in air and read in the reader Harshaw-5500. The product dose-area (D.A.P.) were obtained through the Diamentor (M2-P.T.W.) calibrated in Cgy.cm 2 fixed in the exit of the X-rays tube. The patients of these study were divided in three groups: individuals submitted to proceedings of embolization, individuals submitted to cerebral and renal arteriography and individuals submitted to proceedings of Transjungular Inthahepatic Porta Systemic Stent Shunt (TIPS). The texts were always carried out by the same group: radiologist doctor), an auxiliary doctor and a nursing auxiliary. The section of interventional radiology has an Angiostar Plus Siemens equipment type arc C, in which there is trifocal Megalix X-ray tube and a intensifier of image from Sirecon 40-4 HDR/33 HDR. In this work the dose estimated values were 137.25 mSv/year for the doctors, 40.27 mSv/year for the nursing and 51.95 mSv/year for the auxiliary doctor and they are below the rule, but in this study it was not taken in consideration the emergency texts as they were

  13. A mobile interventional radiology unit: innovation and social responsibility

    Directory of Open Access Journals (Sweden)

    Nestor Hugo Kisilevzky

    2010-03-01

    Full Text Available Objective: To present the preliminary results of a feasibility study performed to determine the value of a mobile interventional radiology unit used to promote a uterine embolization program for low-income patients. Methods: Forty patients with symptomatic fibroids were treated with uterine embolization. Procedures were performed in four public hospitals in the metropolitan area of Sao Paulo. This study was approved by the institutional research ethics committee and all patients signed an informed consent form. A mobile interventional radiology unit, named ANGIOMOVEL, was conceived and implemented utilizing a small truck to transport one mobile C arm, one radiological table, protection aprons and a small trolley containing specific supplies for the procedures. The ANGIOMOVEL team consisted of two interventional radiologists, one nurse, one driver and one assistant. The unit visited one hospital per week during a three-month period. Patient inclusion was contingent upon several factors, such as evaluation by a trained gynecologist, completion of a pelvic MRI, routine serological laboratory tests and completion of a quality of life questionnaire (QOL. Outcomes, MRI and QOL were evaluated. Data obtained after 12 weeks were collected and analyzed. Results: Technical success was achieved in 100% of cases, with a mean procedure time of 43 minutes and a mean fluoroscopic time of 24 minutes. The mean hospital stay was 1.07 day and the mean time for recovery and return to normal activities was 10 days. After 12 weeks, 36 (90% of patients noticed improvement of their symptoms and 4 (10% did not notice any improvement. Thirty-eight patients (95% were satisfied or very satisfied and 39 (97.5% said they would recommend the procedure. Pre- and post-procedure magnetic resonance imaging analysis showed that complete fibroid ischemia was achieved in 92.5% of cases with a mean uterine volume reduction of 38% and a mean fibroid volume reduction of 52%. Health

  14. 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

  15. 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.

  16. Interventional radiological management of complications in renal transplantation

    International Nuclear Information System (INIS)

    Popovic, P.; Surlan, M.

    2004-01-01

    Background. The most frequent radiologically evaluated and treated complications in renal transplantation are perirenal and renal fluid collection and abnormalities of the vasculature and collecting system. Renal and perirenal fluid collection is usually treated successfully with percutaneous drainage. Doppler US, MRA and digital subtraction angiography (DSA) are most important in the evaluation of vascular complications of renal transplantation and management of the endovascular therapy. Conclusions. Stenosis, the most common vascular complication, occurs in 1% to 12% of transplanted renal arteries and represents a potentially curable cause of hypertension following transplantation and/or renal dysfunction. Treatment with percutaneous transluminal renal angioplasty (PTRA) or PTRA with stent has been technically successful in 82 to 92% of the cases, and graft salvage rate has ranged from 80-100%. Complications such as arterial and vein thrombosis are uncommon. Intrarenal A/V fistulas and pseudoaneurysms are occasionally seen after biopsy, the treatment requires superselective embolisation. Urologic complications are relatively uncommon; they consist predominantly of the urinary leaks and urethral obstruction. Interventional treatment consists of percutaneous nephrostomy, balloon dilation, insertion of the double J stents, metallic stent placement and external drainage of the extrarenal collections. The aim of the paper is to review the role of interventional radiology in the management of complications in renal transplantation. (author)

  17. 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

  18. 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

  19. 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.)

  20. The Interventional Radiology (IR) Gender Gap: A Prospective Online Survey by the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

    Science.gov (United States)

    Wah, Tze Min; Belli, Anna Maria

    2018-05-22

    A prospective online survey was conducted by the Cardiovascular Interventional Radiological Society of Europe (CIRSE) to evaluate the gender gap within interventional radiology (IR) and the barriers facing women in IR. A questionnaire ("Appendix") was devised by the authors and the CIRSE communication and publication team and sent electronically to 750 identifiable female members of CIRSE. Responses were collected from 7 August to 24 August 2017. The response rate was 19.9% (n = 149) with highest responses from UK (18%), Italy (11%), Germany (11%), Spain (7%), Netherlands (5%), France (5%), Sweden (4%), USA (4%). 91% of the respondents were between 31 and 46 years, 83% work full time, 62% spend > 50% of their working time in IR, and 67% practice in a university or tertiary referral institution. 85% were in the minority in their department. 52% had no leadership role in their department, but 67% expressed willingness to consider a leadership position. Their main concerns were work/family life balance, the risks of radiation exposure, the effect of pregnancy on training and practice and the male-dominated work environment. This survey highlights issues experienced by women in IR. Clear guidance on concerns regarding radiation exposure particularly during pregnancy is needed. Structured and supportive training is required for female IRs who may wish to train or work flexibly. The male-dominated environment is discouraging, and a scheme to promote female IRs would encourage women to take on senior leadership positions and attract more women into the specialty.

  1. 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)

  2. 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

  3. 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)

  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. 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)

  6. 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.)

  7. 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.)

  8. 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.

  9. Interventional Radiological Management of Prehepatic Obstruction the Splanchnic Venous System

    International Nuclear Information System (INIS)

    Semiz-Oysu, Aslihan; Keussen, Inger; Cwikiel, Wojciech

    2007-01-01

    Purpose. The purpose of this study was to retrospectively evaluate interventional radiological management of patients with symptomatic portal hypertension secondary to obstruction of splanchnic veins. Material and Methods. Twenty-four patients, 15 males and 9 females, 0.75 to 79 years old (mean, 36.4 years), with symptomatic portal hypertension, secondary to splanchnic venous obstruction, were treated by percutaneous methods. Causes and extent of splanchnic venous obstruction and methods are summarized following a retrospective evaluation. Results. Obstructions were localized to the main portal vein (n = 22), intrahepatic portal veins (n = 8), splenic vein (n = 4), and/or mesenteric veins (n = 4). Interventional treatment of 22 (92%) patients included recanalization (n = 19), pharmacological thrombolysis (n = 1), and mechanical thrombectomy (n = 5). Partial embolization of the spleen was done in five patients, in two of them as the only possible treatment. TIPS placement was necessary in 10 patients, while an existing occluded TIPS was revised in two patients. Transhepatic embolization of varices was performed in one patient, and transfemoral embolization of splenorenal shunt was performed in another. Thirty-day mortality was 13.6% (n=3). During the follow-up, ranging between 2 days and 58 months, revision was necessary in five patients. An immediate improvement of presenting symptoms was achieved in 20 patients (83%). Conclusion. We conclude that interventional procedures can be successfully performed in the majority of patients with obstruction of splanchnic veins, with subsequent improvement of symptoms. Treatment should be customized according to the site and nature of obstruction

  10. 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)

  11. Interventional radiology in benign diseases of the biliary tract

    International Nuclear Information System (INIS)

    Juliani, G.; Gandini, G.

    1986-01-01

    Most references in the literature on interventional radiology of the biliary tract refer to the treatment of cancer; only occasionally are benign conditions mentioned. An updated list of radiosurgical instruments on the market in Italy is presented. The operating technique from the preparation of the patient to the performance of percutaneous transhepatic cholangiography (PTC), biliary drainage, transhepatic bilioplasty, percutaneous extraction and chemical cholelitholisis of biliary calculi and drainage of biliary collections is then described. A personal series is then presented. It consist of 93 patients in whom one or more of the following conditions were diagnosed: exclusively intrahepatic calculosis (3 cases), calculosis of the common bile duct (23 percutaneous treatments), empyema of the gallbladder (6 cases), suppurating cholangitis (46 cases), sclerotic or inflammatory stenosis (16 cases), biliary collections (14 cases). Results are reported and commented on

  12. Celiac artery stenosis/occlusion treated by interventional radiology

    International Nuclear Information System (INIS)

    Ikeda, Osamu; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki

    2009-01-01

    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.

  13. 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.

  14. 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

  15. 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

    Full text: Interventional Radiologists (IRs) are medical doctors who are trained in imaging but have undergone additional specialist training in highly demanding image-guided techniques. For this reason they play an increasingly important clinical role which is expanding beyond IR/angiography suite. As IR practice is fundamentally different from diagnostic imaging, the Radiology departments should be adapted to facilitate this special task. Interventional Radiologists should be able to fulfil their task as patient’s primary doctor and exert direct clinical responsibility for the patient under their care. They should be able to clinically assess and counsel patients before a procedure, inform them about the risks of the procedure and possible alternative treatment options, obtain valid consent and follow-up them after the procedure. they should also effectively communicate with referring physicians and develop strategies to deal with complex clinical situations and difficult clinical scenarios. In this context it is imperative for IRs to participate regularly in multidisciplinary clinical meetings and multidisciplinary forums to ensure optimum care. As clinicians, IR’s must be involved with the day to day management of their patients’ care to ensure optimal outcomes for patients. This may involve shared care with a broad range of specialists, however IR’s should aim to have direct access to inpatients beds where they can admit and discharge patients as necessary, with sufficient time allocated for this activity. As the number and demand of IR day cases steadily increases, IR units should organize day case facilities staffed with nursing and clerical staff which can result in major cost savings to hospitals. In this context the Head of Radiology department should convince hospital authorities to establish outpatient clinic facilities with nursing and clerical support where referred patients can be counselled and reviewed in a quiet environment. In order to

  16. 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

  17. Analysis of occupational doses in interventional radiology and cardiology installations

    International Nuclear Information System (INIS)

    Vano, E.; Gonzalez, L.; Ten, J.I.; Guibelalde, E.; Fernandez, J.M.

    1997-01-01

    The relationship between patient dose (PD) and occupational dose (OD) is not easily predictable in interventional radiology installations due to a large number of factors which can modify the occupational risk (OR). In the present work an analysis is made of the four main aspects which influence OR, namely, x-ray beam used, radiation protection (RP) tools available (aprons, thyroid protectors, gloves, screens, etc) and their regular use, type and number of procedures performed (diagnostic or therapeutic, complexity level, etc), and RP training level of the specialists. High filtration x-ray beams can entail a decrease of 20% in OD. A regular use of ceiling mounted faceplates can involve dose savings up to 65%. Mean values of dose per procedure for interventional radiologists are something greater (about 15%) than those recorded for cardiologists, except for the dosimeters placed on left forearm and shoulder. The ratio between OD and PD range around 100 μSv/1,000 cGy.cm 2 . The influence of the staff RP training level on OD is difficult to assess. In the IC Service from the Madrid San Carlos University Hospital (SCUH), PD have been reduced in above 30% and OD in a factor of 3, after running some training programmes. (author)

  18. 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)

  19. 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.

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

    International Nuclear Information System (INIS)

    Zvavanjanja, R.C.; Odetoyinbo, T.O.; Rowlands, P.C.; Healey, A.; Abdelsalam, H.; Powell, S.; Evans, J.C.; Hughes, M.L.; Gould, D.A.; McWilliams, R.G.

    2012-01-01

    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 © (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.

  1. 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.

  2. 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.

  3. Readability of informed consent forms in vascular and interventional radiology

    International Nuclear Information System (INIS)

    Pinto, I.; Vigil, D.

    1998-01-01

    To evaluate the readability of the informed consent forms prepared for vascular and interventional radiology. The 18 informed consent forms were analyzed using the Gramatica tool employed in Microsoft Word 97 For Windows which combines the statistics on legibility in terms of three sections: scores, averages and legibility (Flech index, passive voice, sentence complexity and vocabulary complexity). For each, the integrated readability index was also manually calculated. All the documents present a Flesch index of over 10; the sentence complexity indexes are less than or equal to 20, demonstrating that the sentences are not long or complicated in structure. Finally, the integrated readability index of all of them is well over 70. The forms posses acceptable legibility indexes, but their evaluation should be completed by an opinion poll of the patients for whom they are written. Moreover, it must be kept in mind that these documents, like the procedures performed, are changing continually. Thus, it is necessary to update and modify the information to be provided to the patients. (Author) 11 refs

  4. 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.)

  5. 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.

  6. A real-time haptic interface for interventional radiology procedures.

    Science.gov (United States)

    Moix, Thomas; Ilic, Dejan; Fracheboud, Blaise; Zoethout, Jurjen; Bleuler, Hannes

    2005-01-01

    Interventional Radiology (IR) is a minimally-invasive surgery technique (MIS) where guidewires and catheters are steered in the vascular system under X-ray imaging. In order to perform these procedures, a radiologist has to be correctly trained to master hand-eye coordination, instrument manipulation and procedure protocols. This paper proposes a computer-assisted training environment dedicated to IR. The system is composed of a virtual reality (VR) simulation of the anatomy of the patient linked to a robotic interface providing haptic force feedback.The paper focuses on the requirements, design and prototyping of a specific part of the haptic interface dedicated to catheters. Translational tracking and force feedback on the catheter is provided by two cylinders forming a friction drive arrangement. The whole friction can be set in rotation with an additional motor providing torque feedback. A force and a torque sensor are integrated in the cylinders for direct measurement on the catheter enabling disturbance cancellation with a close-loop force control strategy.

  7. 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

  8. 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.

  9. Radiological safety for the public during nuclear emergencies: application of intervention levels and derived intervention levels

    International Nuclear Information System (INIS)

    Thomas, G.; Kumar, K.S.

    2006-01-01

    public from a practice is relatively small, the intervention level based on averted dose may have to be high, as significant reduction in exposure is required to justify the intervention. For intervention after a major nuclear / radiological accident, the non-radiological risk could be much larger, particularly if it is necessary to evacuate a large number of people. The variation between intervention levels for different nuclear/ radiological emergency situation could also differ quite significantly. In case of intervention, the doses received before the countermeasures are implemented should not be counted for balancing the detriment and benefit as these doses will be received whether or not the intervention is carried out. At the same time, applying the concept of averted dose involves lot of uncertainty in predicting and advising the time of intervention. The initial planning for various emergencies should include a choice of intervention levels, as discussed in this paper, in terms of averted doses, that will be justified and reasonably well optimized. Each protective action should therefore be considered on its own merits and the doses that would be incurred via all relevant pathways of exposure should also be assessed. (authors)

  10. 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

  11. 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)

  12. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values

    International Nuclear Information System (INIS)

    Vano, E; Fernandez, J M; Sanchez, R M; Resel, L E; Moreno, J

    2016-01-01

    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm 2 ; personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures. (paper)

  13. The Clinical Practice of Interventional Radiology: A European Perspective

    International Nuclear Information System (INIS)

    Keeling, Aoife N.; Reekers, Jim A.; Lee, Michael J.

    2009-01-01

    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.

  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. Fast skin dose estimation system for interventional radiology.

    Science.gov (United States)

    Takata, Takeshi; Kotoku, Jun'ichi; Maejima, Hideyuki; Kumagai, Shinobu; Arai, Norikazu; Kobayashi, Takenori; Shiraishi, Kenshiro; Yamamoto, Masayoshi; Kondo, Hiroshi; Furui, Shigeru

    2018-03-01

    To minimise the radiation dermatitis related to interventional radiology (IR), rapid and accurate dose estimation has been sought for all procedures. We propose a technique for estimating the patient skin dose rapidly and accurately using Monte Carlo (MC) simulation with a graphical processing unit (GPU, GTX 1080; Nvidia Corp.). The skin dose distribution is simulated based on an individual patient's computed tomography (CT) dataset for fluoroscopic conditions after the CT dataset has been segmented into air, water and bone based on pixel values. The skin is assumed to be one layer at the outer surface of the body. Fluoroscopic conditions are obtained from a log file of a fluoroscopic examination. Estimating the absorbed skin dose distribution requires calibration of the dose simulated by our system. For this purpose, a linear function was used to approximate the relation between the simulated dose and the measured dose using radiophotoluminescence (RPL) glass dosimeters in a water-equivalent phantom. Differences of maximum skin dose between our system and the Particle and Heavy Ion Transport code System (PHITS) were as high as 6.1%. The relative statistical error (2 σ) for the simulated dose obtained using our system was ≤3.5%. Using a GPU, the simulation on the chest CT dataset aiming at the heart was within 3.49 s on average: the GPU is 122 times faster than a CPU (Core i7-7700K; Intel Corp.). Our system (using the GPU, the log file, and the CT dataset) estimated the skin dose more rapidly and more accurately than conventional methods.

  16. Is Your Interventional Radiology Service Ready for SARS?: The Singapore Experience

    International Nuclear Information System (INIS)

    Lau, Te-Neng; Teo, Ngee; Tay, Kiang-Hiong; Chan, Ling-Ling; Wong, Daniel; Lim, Winston E.H.; Tan, Bien-Soo

    2003-01-01

    The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR

  17. 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.)

  18. Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard.

    Science.gov (United States)

    Charalel, Resmi A; McGinty, Geraldine; Brant-Zawadzki, Michael; Goodwin, Scott C; Khilnani, Neil M; Matsumoto, Alan H; Min, Robert J; Soares, Gregory M; Cook, Philip S

    2015-05-01

    Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative and effective minimally invasive treatments, which have decreased morbidity, mortality, and overall cost. The clinical practice of interventional radiology embodies many of the features of Imaging 3.0, the program recently launched by the ACR. We provide a review of some of the major contributions made by interventional radiology and offer general principles from that experience, which are applicable to all radiologists. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. 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)

  20. Imaging and radiology

    Science.gov (United States)

    Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

  1. 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.)

  2. Role of interventional radiology in the management of acute gastrointestinal bleeding

    Science.gov (United States)

    Ramaswamy, Raja S; Choi, Hyung Won; Mouser, Hans C; Narsinh, Kazim H; McCammack, Kevin C; Treesit, Tharintorn; Kinney, Thomas B

    2014-01-01

    Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB. PMID:24778770

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

    International Nuclear Information System (INIS)

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

    2015-01-01

    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. (authors)

  4. Patients and personnel radiation protection in interventional radiology and in surgery

    International Nuclear Information System (INIS)

    Menechal, P.; Valero, M.; Godet, J.L.

    2009-01-01

    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.)

  5. Central venous catheterization: comparison between interventional radiological procedure and blind surgical reocedure

    International Nuclear Information System (INIS)

    Song, Won Gyu; Jin, Gong Yong; Han, Young Min; Yu, He Chul

    2002-01-01

    To determine the usefulness and safety of radiological placement of a central venous catheter by prospectively comparing the results of interventional radiology and blind surgery. For placement of a central venous catheter, the blind surgical method was used in 78 cases (77 patients), and the interventional radiological method in 56 cases (54 patients). The male to female ratio was 66:68, and the patients' mean age was 48 (range, 18-80) years. A tunneled central venous catheter was used in 74 cases, and a chemoport in 60. We evaluated the success and duration of the procedures, the number of punctures required, and ensuing complications, comparing the results of the two methods. The success rates of the interventional radiological and the blind surgical procedure were 100% and 94.8%, respectively. The duration of central catheterization was 3-395 (mean, 120) day, that of chemoport was 160.9 days, and that of tunneled central venous catheter was 95.1 days. The mean number of punctures of the subclavian vein was 1.2 of interventional radiology, and 2.1 for blind surgery. The mean duration of the interventional radiology and the blind surgical procedure was, respectively, 30 and 40 minutes. The postprocedure complication rate was 27.6% (37 cases). Early complications occurred in nine cases (6.7%): where interventional radiology was used, there was one case of hematoma, and blind surgery gave rise to hematoma (n=2), pneumothorax (n=2), and early deviation of the catheter (n=4). Late complications occurred in 32 cases (23.9%). Interventional radiology involved infection (n=4), venous thrombosis (n=1), catheter displacement (n=2) and catheter obstruction (n=5), while the blind surgical procedure gave rise to infection (n=5), venous thrombosis (n=3), catheter displacement (n=4) and catheter obstruction (n=8). The success rate of interventional radiological placement of a central venous catheter was high and the complication rate was low. In comparison with the blind

  6. Interventional Radiology Techniques for Provision of Enteral Feeding

    International Nuclear Information System (INIS)

    Given, M.F.; Hanson, J.J.; Lee, M.J.

    2005-01-01

    Gastrostomy placement in patients who are unable to maintain their nutrition orally has been attempted using a variety of techniques over the past century. This includes surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy placement was the method of choice for almost a century, but has since been superseded by both endoscopic and radiological placement. There are a number of indications for gastrostomy placement in clinical practice today, with fewer contraindications due to the recent innovations in technique placement and gastrostomy catheter type. We describe the technique of gastrostomy placement, which we use in our institution, along with appropriate indications and contraindications. In addition, we will discuss the wide variety of catheter types available and their perceived advantages. There remains some debate with regard to gastropexy performance and the use of primary gastrojejunal catheters, which we will address. In addition, we will discuss the advantages and disadvantages of the three major types of gastrostomy placement currently available (i.e., surgical, endoscopic, and radiological) and their associated complications

  7. 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

  8. 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.

  9. 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.

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

    International Nuclear Information System (INIS)

    Belli, Anna-Maria; Reekers, Jim A.; Lee, Michael

    2014-01-01

    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

  11. 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)

  12. 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.)

  13. Derivation of Intervention levels for Protection of the Public in a Radiological Emergency in Korea

    International Nuclear Information System (INIS)

    Lee, Jong Tai; Lee, Goan Yup; Khang, Byung Oui; Oh, Ki Hoon; Kim, Chang Kyu

    2001-01-01

    Intervention levels for protection of the public in a radiological emergency are theoretically derived by the cost-benefit approach with the concept of justification and optimization. Intervention levels on the sheltering, evacuation, temporary relocation and permanent resettlement for protection of the public are estimated with the cost to protective countermeasures and the value from dose averted which are the site specific parameters. As a result, it is confirmed that IAEA guidelines for intervention levels are applicable to the radiological emergency in Korea. Optimum ranges of 5 - 10 mSv/2days for sheltering, 25 - 130 mSv/week for evacuation, 15 - 90 mSv/month for temporary relocation and 600 - 3,500 mSv/lifetime for permanent resettlement for intervention levels are also provided. The result can be applied as useful data to update intervention levels under the theoretical background in Korea

  14. Sedation and patient monitoring in vascular and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    McDermott, V G.M.; Chapman, M E; Gillespie, I [Royal Infirmary, Edinburgh (United Kingdom)

    1993-08-01

    A postal survey of British and Irish interventional radiologists was carried out in 1991 to assess current practice with respect to sedation and monitoring of patients during angiography and interventional procedures. The response rate was 65%, 49% of patients are fasted prior to angiography and 68% prior to interventional procedures. Radiologists participate in obtaining consent in 60% of cases. Patients are often (50%) sedated for angiography and usually (62-94% depending on the procedure) sedated for interventional procedures. Nurses are present for most procedures, but are given the task of monitoring the patient's vital signs in only 49% of cases. Anaesthetists are present for less than 10% of interventional procedures. The findings indicate a wide variation in practice and a need to standardize practice at a uniform high level. (author).

  15. 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.

  16. 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

  17. Contemporary imaging: Magnetic resonance imaging, computed tomography, and interventional radiology

    International Nuclear Information System (INIS)

    Goldberg, H.I.; Higgins, C.; Ring, E.J.

    1985-01-01

    In addition to discussing the most recent advances in magnetic resonance imaging (MRI), computerized tomography (CT), and the vast array of interventional procedures, this book explores the appropriate clinical applications of each of these important modalities

  18. Interventional radiology in the management of portal hypertension

    International Nuclear Information System (INIS)

    Punamiya, Sundeep J

    2008-01-01

    From being a mere (though important) diagnostic tool, radiology has evolved to become an integral part of therapy in portal hypertension today. Various procedures are currently available, the choice depending on the etiology and location of disease, the pathoanatomy, and the symptomatology. The main aim of any procedure is to reduce the portal pressure by either direct or indirect methods. This can be achieved with transjugular intrahepatic portosystemic shunt (TIPS), recanalization of the hepatic vein outflow, recanalization of the portal vein and its tributaries, recanalization of dysfunctional portosystemic shunts, partial splenic embolization, and embolization of arterioportal shunts. When any of these procedures cannot be performed due to anatomical or physiological reasons, the symptoms can often be controlled effectively with embolization of varices or balloon-occluded retrograde transvenous obliteration of varices (BRTO). This article briefly describes the procedures, their results, and their current status in the treatment of portal hypertension

  19. Manipulation of mental models of anatomy in interventional radiology and its consequences for design of human–computer interaction

    NARCIS (Netherlands)

    Varga, E.; Pattynama, P.M.T.; Freudenthal, A.

    2012-01-01

    Interventional radiology procedures require extensive cognitive processing from the physician. A set of these cognitive functions are aimed to be replaced by technology in order to reduce the cognitive load. However, limited knowledge is available regarding mental processes in interventional

  20. In the Lead Again Horizontal-Ellipsis [Journal of Cardiovascular and Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vorwerk, Dierk, E-mail: dierk.vorwerk@klinikum-ingolstadt.de [Ingolstadt Hospital, Department of Diagnostic and Interventional Radiology (Germany)

    2013-10-15

    The 2013 ISI journal rankings are out and it is my pleasure to inform our readership that CVIR ranks 43/120 (2012: 46/118) journals in the field of radiology. The 2013 impact factor further improved to 2.138 (2012: 2.093). This means that Cardiovascular and Interventional Radiology again continues to be the highest ranked journal dedicated to the field of interventional radiology in 2013.This is mainly due to the great support we achieve by you as authors and readers of CVIR, your dedication to the profession, and your loyalty both to the journal and to CIRSE. For all of this, we owe you our thanks and respect.

  1. 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.

  2. 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

  3. Computer-based information management system for interventional radiology

    International Nuclear Information System (INIS)

    Forman, B.H.; Silverman, S.G.; Mueller, P.R.; Hahn, P.F.; Papanicolaou, N.; Tung, G.A.; Brink, J.A.; Ferrucci, J.T.

    1989-01-01

    The authors authored and implemented a computer-based information management system (CBIMS) for the integrated analysis of data from a variety of abdominal nonvascular interventional procedures. The CBIMS improved on their initial handwritten-card system (which listed only patient name, hospital number, and type of procedure) by capturing relevant patient data in an organized fashion and integrating information for meaningful analysis. Advantages of CBIMS include enhanced compilation of monthly census, easy access to a patient's interventional history, and flexible querying capability that allows easy extraction of subsets of information from the patient database

  4. 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.

  5. Health literacy in vascular and interventional radiology: a comparative analysis of online patient education resources.

    Science.gov (United States)

    Hansberry, David R; Kraus, Carl; Agarwal, Nitin; Baker, Stephen R; Gonzales, Sharon F

    2014-08-01

    The Internet is frequently accessed by patients as a resource for medical knowledge. However, the provided material is typically written at a level well above the recommended 7th grade level. A clear understanding of the capabilities, limitations, risks, and benefits of interventional radiology by patients, both current and prospective, is hindered when the textual information offered to the public is pitched at a level of sophistication too high for general comprehension. In January 2013, all 25 patient education resources from the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) Web site ( http://www.cirse.org ) and all 31 resources from the Society of Interventional Radiology (SIR) Web site ( http://www.sirweb.org ) were analyzed for their specific level of readability using ten quantitative scales: Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning fog index, New Fog Count, Coleman-Liau index, FORCAST formula, Fry graph, Raygor Readability Estimate, and New Dale-Chall. Collectively, the patient education resources on the CIRSE Web site are written at the 12.3 grade level, while the resources on the SIR Web site are written at the 14.5 grade level. Educational health care materials available on both the CIRSE and the SIR Web sites are presented in language in the aggregate that could be too difficult for many lay people to fully understand. Given the complex nature of vascular and interventional radiology, it may be advantageous to rewrite these educational resources at a lower reading level to increase comprehension.

  6. 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)

  7. 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.)

  8. 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.

  9. Radiology

    International Nuclear Information System (INIS)

    Meyers, M.A.

    1989-01-01

    This paper reports on disease processes originating within the alimentary tract, may extend through the extraperitoneal spaces, and abnormalities primarily arising within other extraperitoneal sites may significantly affect the bowel. Symptoms and signs may be obscure, delayed, or nonspecific, and the area is generally not accessible to auscultation, palpation, or percussion. Radiologic evaluation thus plays a critical role

  10. 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

  11. STRAPIR, an European initiative for optimizing radiation protection in interventional radiology

    International Nuclear Information System (INIS)

    Vano, E.; Gonzalez, L.; Loon, R. van; Padovani, R.; Maccia, C.; Eggermont, G.

    1997-01-01

    In 1995, a European initiative for optimizing radiation protection in interventional radiology was proposed by 8 research groups. The project acronym was STPAPIR (Staff Radiation Protection in Interventional Radiology). Interventional Radiology involves an important number of specialists and their risk level is not well known, since dosimetric records exhibit important discrepancies. Many professionals using these techniques are not radiologists and the basic rules of radiation protection, known by radiologists, are not always correctly and completely followed, hence the use of protection devices is not as regular as desirable. Additionally, x-ray systems not specifically designed for interventional procedures are still used in many hospitals, what entails a significant occupational risk increase to the specialists. Some relevant questions for regulatory bodies are presented, namely, reliability of the actual data banks for occupational dosimetry, use of two personal dosimeters for assessing effective dose, actions to strengthen the systematic use of personal dosimeters and protection tools, proposals for specific training in radiation protection and use of x-ray systems specifically designed for interventional procedures, publication of reports about accidents and incidents, are also discussed. (author)

  12. 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

  13. Pediatric interventional radiology with 3D rotational angiography

    International Nuclear Information System (INIS)

    Racadio, J.M.

    2004-01-01

    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.)

  14. 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.

  15. [Interventional radiology in treatment of biliodigestive anastomoses strictures].

    Science.gov (United States)

    Okhotnikov, O I; Yakovleva, M V; Grigoriev, S N

    2016-01-01

    To analyze efficacy of interventional methods via antegrade transhepatic approach in treatment of patients with strictures of biliodigestive anastomoses. 24 patients aged 47.2 years were treated for the period 2002-2015. Average time from extrahepatic biliary reconstruction using transhepatic stented tubes to strictures appearance varied from 9 months to 12 years. One- and double-sided percutaneous transhepatic cholangiostomy was performed to abort biliary hypertension. Stricture recanalization was achieved using «catheter-wire» system. Antegrade dilatation of stricture was made using balloon catheter 8 mm and pressure up to 6 atm and stage exposition up to 10 minutes. Balloon repair of anastomosis was supplemented by stented outer-inner drainage of the area of stricture. Restoration of patency of stricture area using antegrade interventional methods was effective in 22 patients. Recurrent stricture occurred in 2 cases within 1.5 years that required repeated biliary reconstruction including antegrade extraction of blocked uncovered stent in 1 patient. There were no major postoperative complications and deaths. Maximal recurrence-free follow-up after stent installation was 11 years.

  16. 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)

  17. 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.

  18. Evaluation of medical and occupational exposures in interventional radiology

    International Nuclear Information System (INIS)

    Maekoshi, Hisashi; Ishiguchi, Tsuneo; Tsuzaka, Masatoshi; Tamiya, Tadashi; Nakamura, Kiyoko.

    1992-01-01

    Absorbed radiation doses received by patients and personnel during interventional procedures were estimated in this study. An Angiostar, a fluoroscopy x-ray unit, made by Siemens Co. Ltd. was used. Fluoroscopic conditions were 82 to 112 kV of tube voltage and 2.5 to 4.3 mA of tube current. The absorbed doses to the ovaries were measured in a Mix-Dp phantom after the image intensifier's field size was changed from 40 cm to 14 cm in diameter. X-ray scattering dose distributions in the vicinity of the fluoroscopy table were measured by an ionization survey meter. This measurement was carried out concurrently with the above x-ray exposure conditions. Patient and personnel exposure increased in relation to the decreased field size. These medical and occupational exposures increases were the result of the x-ray output gradually increasing as the image intensifier's field was progressively decreased. This condition was caused by the automatic brightness control circuits of the x-ray unit. When the smallest field size of the image intensifier (I.I.) was employed the exposure doses absorbed by both patients and personnel were about three times larger than the doses received in the largest field size. (author)

  19. 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

  20. A Survey of Interventional Radiology Awareness Among Final-Year Medical Students in a European Country

    International Nuclear Information System (INIS)

    Leong, Sum; Keeling, Aoife N.; Lee, Michael J.

    2009-01-01

    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

  1. 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.

  2. Interventional radiography and mortality risks in U.S. radiologic technologists

    Energy Technology Data Exchange (ETDEWEB)

    Linet, Martha S.; Freedman, D.M.; Sigurdson, Alice J.; Doody, Michele M. [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Hauptmann, Michael [National Cancer Institute, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Alexander, Bruce H. [University of Minnesota, Division of Environmental Health Sciences, Minneapolis, MN (United States); Miller, Jeremy [Information Management Services, Inc., Rockville, MD (United States)

    2006-09-15

    With the exponential increase in minimally invasive fluoroscopically guided interventional radiologic procedures, concern has increased about the health effects on staff and patients of radiation exposure from these procedures. There has been no systematic epidemiologic investigation to quantify serious disease risks or mortality. To quantify all-cause, circulatory system disease and cancer mortality risks in U.S. radiologic technologists who work with interventional radiographic procedures, we evaluated mortality risks in a nationwide cohort of 88,766 U.S. radiologic technologists (77% female) who completed a self-administered questionnaire during 1994-1998 and were followed through 31 December 2003. We obtained information on work experience, types of procedures (including fluoroscopically guided interventional procedures), and protective measures plus medical, family cancer history, lifestyle, and reproductive information. Cox proportional hazards regression models were used to compute relative risks (RRs) with 95% confidence intervals (CIs). Between completion of the questionnaire and the end of follow-up, there were 3,581 deaths, including 1,209 from malignancies and 979 from circulatory system diseases. Compared to radiologic technologists who never or rarely performed or assisted with fluoroscopically guided interventional procedures, all-cause mortality risks were not increased among those working on such procedures daily. Similarly, there was no increased risk of mortality resulting from all circulatory system diseases combined, all cancers combined, or female breast cancer among technologists who daily performed or assisted with fluoroscopically guided interventional procedures. Based on small numbers of deaths (n=151), there were non-significant excesses (40%-70%) in mortality from cerebrovascular disease among technologists ever working with these procedures. The absence of significantly elevated mortality risks in radiologic technologists reporting the

  3. 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.)

  4. Cost analysis in interventional radiology-A tool to optimize management costs

    International Nuclear Information System (INIS)

    Clevert, D.-A.; Stickel, M.; Jung, E.M.; Reiser, M.; Rupp, N.

    2007-01-01

    Objective: The objective of the study was to analyze the methods to reduce cost in interventional radiology departments by reorganizing procurement. Materials and methods: All products used in Department of Interventional Radiology were inventoried. An ABC-analysis was completed and A-products (high-value and high turnover products) underwent a XYZ-analysis which predicted demand on the basis of ordering frequency. Then criteria for a procurement strategy for the different material categories were fixed. The net working capital (NWC) was calculated using an interest rate of 8%/year. Results: Total annual material turnover was 353,000 Euro . The value of all A-products determined by the inventory was 260,000 Euro . Changes in the A-product procurement strategy tapped a cost reduction potential of 14,500/year Euro . The resulting total saving was 17,200 Euro . Improved stores management added another 37,500 Euro. The total cost cut of 52,000 Euro is equivalent to 14.7% of annual expenses. Conclusion: A flexible procurement strategy helps to reduce the storage and capital tie-up costs of A-products in interventional radiology without affecting the quality of service provided to patients

  5. 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

  6. 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.)

  7. 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.)

  8. 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.

  9. 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

  10. 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

  11. Further promoting the clinical application and fundamental research for interventional radiology of urinary system

    International Nuclear Information System (INIS)

    Liang Huimin; Feng Gansheng

    2008-01-01

    Along with the rapid development of interventional radiology, a simultaneous increase of the treatment was carried out for diseases of urinary system, including nephrostomy, balloon dilatation and stenting for uninary tract obstruction, calculus removing techniques, stenting for prostatic hypertrophy; TAE/TACE and ablation therapy for benign/malignant tumors; angioplasty with balloon or stent for stenosis of renal artery or vein; embolotherapy for hemorrhagic diseases; interventional treatment for complications after renal transplantation, and so on. All the above mentioned techniques for urinary diseases have already provided with good results and futher research will bring a promising future. (authors)

  12. Radiology

    International Nuclear Information System (INIS)

    Lissner, J.

    1985-01-01

    Diagnostic radiology is still the foremost of all innovative medical disciplines. This has many advantages but also some handicaps, e.g. the siting problem of medical equipment whose clinical potential is not fully known. This applies in particular to nuclear spin tomography, where the Laender governments and the Scientific Council seen to agree that all universities should have the appropriate equipment as soon as possible in order to intensify interdisciplinary research. Formerly, in the case of computerized tomography, there was less readiness. As a result, the siting of CT equipment is less organically structured. A special handicap of innovative fields is the problem of training and advanced training. The Chamber of Medicine and the Association of Doctors Participating in the Health Insurance Plan have issued regulations aimed at a better standardisation in this field. (orig.) [de

  13. 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

  14. Assessment of Patients Radiation Dose During Interventional Radiological Procedure in PPUKM

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Muhammad Isa

    2014-01-01

    Interventional Radiology (IR) is a relatively new subspecialty of radiology. It is subspecialty where minimally invasive procedures are performed under radiological guidance using X-ray. This procedure can deliver high radiation doses compared with other radiological method due to long screening time. Because of these it is important to determine radiation doses received by patients undergoing IR procedures. It is to ensure that the dose is within the range deemed to be saved. A total of 128 patients undergoing IR procedures in PPUKM between 2012 and 2013 were study retrospectively. Dose area product (DAP) meter were used to measure the integral dose for the whole procedures. Mean kerma-area products for abdomen, head, pelvis, and thorax were 243.1, 107.3, 39.05 and 45.7 Gycm 2 , respectively. This study may provide the useful information which can be use to establish baseline patient dose data for dose optimizing study and carried out a recommendation on effective method of patient dose reduction during IR procedures. A more detail results of this study are presented in this paper. (author)

  15. 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

  16. 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)

  17. 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

  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. 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

  20. Automatic management system for dose parameters in interventional radiology and cardiology

    International Nuclear Information System (INIS)

    Ten, J. I.; Fernandez, J. M.; Vano, E.

    2011-01-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions. (authors)

  1. Automatic management system for dose parameters in interventional radiology and cardiology.

    Science.gov (United States)

    Ten, J I; Fernandez, J M; Vaño, E

    2011-09-01

    The purpose of this work was to develop an automatic management system to archive and analyse the major study parameters and patient doses for fluoroscopy guided procedures performed in cardiology and interventional radiology systems. The X-ray systems used for this trial have the capability to export at the end of the procedure and via e-mail the technical parameters of the study and the patient dose values. An application was developed to query and retrieve from a mail server, all study reports sent by the imaging modality and store them on a Microsoft SQL Server data base. The results from 3538 interventional study reports generated by 7 interventional systems were processed. In the case of some technical parameters and patient doses, alarms were added to receive malfunction alerts so as to immediately take appropriate corrective actions.

  2. Double dosimetry procedures for the determination of occupational effective dose in interventional radiology

    International Nuclear Information System (INIS)

    Jaervinen, H.; Buls, N.; Clerinx, P.; Miljanic, S.; Ranogajec-Komor, M.; Nikodemova, D.; D'Errico, F.

    2008-01-01

    Full text: In interventional radiology, for an accurate determination of occupational effective dose, measurements with two dosemeters ('double dosimetry', DD) have been recommended, one dosemeter located above and one under the protective apron. In this paper, based on an extensive literature search, the most recent algorithms developed for the determination of effective dose from the dosimeter readings have been compared for a few practical interventional procedures. Recommendations on the practices and algorithms are given on the basis of the results. For the comparison of algorithms, dosemeter readings and the effective dose were obtained both experimentally and by calculation. Further, data from published Monte Carlo calculations have been applied. The literature review has indicated that very few regulations for DD exist and the DD practices have not been harmonized. There is no firm consensus on the most suitable calculation algorithms. Single dosemeter (SD) measurements are still mostly used for the calculation of effective dose. Most DD and SD algorithms overestimate effective dose significantly, sometimes by over ten times. However, SD algorithms can significantly underestimate effective dose in certain interventional radiology conditions. Due to the possibility of underestimating effective dose, DD is generally recommended. The results suggest that there might not be a single DD algorithm which would be optimum for all interventional radiology procedures. However, the selection of a precise DD algorithm for each individual condition is not practical and compromises must be made. For accurate personnel dosimetry, the accuracy of the algorithm selected should be tested for typical local interventional radiology condition. Personnel dosemeters should be used in the recommended positions. The dosemeter above the apron should be on a collar and its reading also used to assess the risk of lens injuries. The dosemeter under the apron can be on the chest or

  3. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 2: Patient Preparation and Medications)

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology (United States); Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)

    2016-04-15

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care. Patient care before and after an interventional procedure, identification, and management of early and delayed complications of various procedures are equal in importance to the procedure itself. In this second part, we complete the comprehensive, methodical review of pre-procedural care and patient preparation before vascular and interventional radiology procedures.

  4. 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)

  5. 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)

  6. Estimating effective dose to pediatric patients undergoing interventional radiology procedures using anthropomorphic phantoms and MOSFET dosimeters.

    Science.gov (United States)

    Miksys, Nelson; Gordon, Christopher L; Thomas, Karen; Connolly, Bairbre L

    2010-05-01

    The purpose of this study was to estimate the effective doses received by pediatric patients during interventional radiology procedures and to present those doses in "look-up tables" standardized according to minute of fluoroscopy and frame of digital subtraction angiography (DSA). Organ doses were measured with metal oxide semiconductor field effect transistor (MOSFET) dosimeters inserted within three anthropomorphic phantoms, representing children at ages 1, 5, and 10 years, at locations corresponding to radiosensitive organs. The phantoms were exposed to mock interventional radiology procedures of the head, chest, and abdomen using posteroanterior and lateral geometries, varying magnification, and fluoroscopy or DSA exposures. Effective doses were calculated from organ doses recorded by the MOSFET dosimeters and are presented in look-up tables according to the different age groups. The largest effective dose burden for fluoroscopy was recorded for posteroanterior and lateral abdominal procedures (0.2-1.1 mSv/min of fluoroscopy), whereas procedures of the head resulted in the lowest effective doses (0.02-0.08 mSv/min of fluoroscopy). DSA exposures of the abdomen imparted higher doses (0.02-0.07 mSv/DSA frame) than did those involving the head and chest. Patient doses during interventional procedures vary significantly depending on the type of procedure. User-friendly look-up tables may provide a helpful tool for health care providers in estimating effective doses for an individual procedure.

  7. 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)

  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. 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)

  10. Interventional radiological therapy of benign low back pain syndromes; Interventionell radiologische Therapie benigner lumbaler Schmerzsyndrome

    Energy Technology Data Exchange (ETDEWEB)

    Huegli, R.W.; Jacob, A.L.; Steinbrich, W. [Universitaetsspital Basel (Switzerland). Interventionelle Radiologie

    2007-03-15

    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.

  11. On-field evaluation of operator lens protective devices in interventional radiology

    International Nuclear Information System (INIS)

    Strocchi, S.; Chiaravalli, A.; Veronese, I.; Novario, R.

    2016-01-01

    The recent publication of the Euratom Directive 2013/59, adopting the reduction of eye lens dose limits from 150 to 20 mSv y"-"1, calls for the development of new tools and methodologies for evaluating the eye lens dose absorbed by the medical staff involved in interventional radiology practices. Moreover, the effectiveness of the protective devices, like leaded glasses, which can be employed for radiation protection purposes, must be tested under typical exposure scenarios. In this work, eye lens dose measurements were carried out on an anthropomorphic phantom simulating a physician bound to perform standard interventional neuroradiology angiographic procedures. The correlation between eye lens doses, in terms of Hp(0.07), and the equivalent dose [again in terms of Hp(0.07)] monthly measured with thermoluminescent dosemeters placed above the lead apron at the chest level was studied, in the presence and in the absence of different types of leaded glasses. (authors)

  12. Assessment of eye lens doses for workers during interventional radiology procedures

    International Nuclear Information System (INIS)

    Urboniene, A.; Sadzeviciene, E.; Ziliukas, J.

    2015-01-01

    The assessment of eye lens doses for workers during interventional radiology (IR) procedures was performed using a new eye lens dosemeter. In parallel, the results of routine individual monitoring were analysed and compared with the results obtained from measurements with a new eye lens dosemeter. The eye lens doses were assessed using H p (3) measured at the level of the eyes and were compared with H p (10) measured with the whole-body dosemeter above the lead collar. The information about use of protective measures, the number of performed interventional procedures per month and their fluoroscopy time was also collected. The assessment of doses to the lens of the eye was done for 50 IR workers at 9 Lithuanian hospitals for the period of 2012-2013. If the use of lead glasses is not taken into account, the estimated maximum annual dose equivalent to the lens of the eye was 82 mSv. (authors)

  13. 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

  14. 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

  15. Radiation exposures received by the staff in the interventional radiology unit

    International Nuclear Information System (INIS)

    Vekic, Branko; Miljanic, S.; Ban, R.; Ranogajec-Komor, M.; Stern-Padovan, R.; Basic, B.

    2008-01-01

    Full text: As a consequence of the highly nonuniform exposure conditions in the interventional radiology, a reliable estimation of the effective dose for occupationally exposed persons requires a number of dose measurements at various locations of the body. The nonuniform occupational exposure is mainly associated with the relatively short distance to the radiation source (the scattered radiation from the patient) and the attenuation of the scattered radiation by protective clothing and shielding. The staff who undertake these procedures may receive radiation doses approaching the dose limits suggested by International Commission on Radiological Protection (ICRP 1991) if there is a high patient workload, for extended period of time. According to the Croatian radiation protection regulations for the effective dose estimation it is mandatory to use one dosimeter placed at the left side of the chest under the protective apron. From the dosimeter reading (dosimeter is calibrated in term of H p (10)) the effective dose is estimated. If additional dosimeters are worn on different parts of the body, their results have to be recorded, but they are not used for effective dose estimations. In the University Hospital Zagreb the personnel performing interventional radiology procedures in addition to the dosimeter placed under the apron always wear another dosimeter placed on the apron at the neck or shoulder position. In this work, the results of recorded dosimetry measurements performed during the period of 10 years were analysed. Special attention was given to the evaluation of the effective dose. The results of only one dosimeter are compared with the results obtained with two dosimeters. In the later case the effective dose was evaluated using some proposed algorithms for double dosimetry. Since it is well known that the evaluation of effective dose from the reading (without any correction) of only one dosimeter placed under the apron usually underestimate the effective

  16. 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.

  17. Control development of radiation protection and safety on personnel eye lens of interventional radiology

    International Nuclear Information System (INIS)

    Titik Kartika; Ishak

    2013-01-01

    The review on radiation protection and safety to the lens of personnel especially in interventional radiology activities has been carried out. The use of radiation in interventional radiology installations provide significant exposure to the lens of the eye, especially personnel. The results of the latest various surveys and researches on the effects of low dose radiation to the eye lens indicates that the eye lens dose threshold is less than the preconceived values. Based on these facts, recently, ICRP and IAEA provides recommendations regarding the reduction of the value of the eye lens dose limit for personnel. BAPETEN have adopted the value of the eye lens dose limit in the development of new regulations on radiation protection and safety. However, the application of this provision has various challenges that BAPETEN provide 3 (three) years transitional period. These challenges include the problem of monitoring the eye lens dose, the eye lens protective equipment which is not adequate, the lack of understanding of personnel related to the risk of low radiation to the eye lens, as well as the proper procedures to mitigate those risks. BAPETEN as a regulatory agency is expected to provide solutions to the problems faced by the stake holders. Therefore, to answer the challenge, it is necessary to develop better monitoring of radiation protection and safety. (author)

  18. 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.

  19. A feasibility inquiry on the radiodermatitis secondary to an interventional radiology act

    International Nuclear Information System (INIS)

    Roudier, C.; Pirard, Ph.; Donadieu, J.

    2006-01-01

    The radiodermatitis is a burning of skin tissue and subcutaneous tissue in relation with ionizing radiation. In the medical practice, outside radiotherapy excluded of our study, it is observed only with acts of interventional radiology. The consequences of a radiodermatitis can be aesthetic, with appearance of a scar or a definitive alopecia, functional with loss of substance needing sometimes a remedial surgical act and finally oncologic with a risk of localised skin cancer. A radiodermatitis can appear with a radiation dose of 2 grays and its intensity worsens with the dose. Since the late 1970's about 200 cases of radiodermatitis have been reported. the most of cases have been reported between 1993 and 2000 and less than ten cases have been reported since 2000, suggesting a possible reduction of incidence explainable by a concomitant improvement of technological quality of the equipment. In order to confirm this eventual trend az feasibility study has been organised and is reported in this article. Given the results, this complication is still existing. In spite of the small number of observed cases, it is to notice that every procedures of interventional radiology are concerned. The preliminary character of this study encourages the institute of Health surveillance to work on the elaboration of a program of radiodermatitis surveillance. It could be associated to actions of improvement of the prevention and follow-up of patients, of feedback, and making easy an optimization of the practices. (N.C.)

  20. 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

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

    Science.gov (United States)

    NeMoyer, Rachel E; Shah, Mihir M; Hasan, Omar; Nosher, John L; Carpizo, Darren R

    2018-01-01

    Benign strictures of the biliary system are challenging and uncommon conditions requiring a multidisciplinary team for appropriate management. 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). 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. Here we describe an innovative multi-disciplinary approach to the repair of this rare injury. Copyright © 2018. Published by Elsevier Ltd.

  2. The availability of appropriately fitting personal protective aprons and jackets for angiographic and interventional radiology personnel

    International Nuclear Information System (INIS)

    Cremen, S.A.; McNulty, J.P.

    2014-01-01

    Purpose: This study explored the availability of personal protective equipment, lead or lead-free aprons or jackets, in angiographic and interventional radiology suites in the Republic of Ireland with a focus on the sizes available, appropriateness of fit and purchasing practices. Methods: All centres providing an angiographic or interventional radiology service in the Republic of Ireland were invited to participate with data being collected by means of a postal questionnaire exploring the above issues. Results: The mean number of aprons or jackets available across the centres who responded to the survey was 18.4 with the majority of these, 72%, being medium or large in size. Clinical specialists in three centres identified that there were insufficient aprons or jackets sized extra small or extra large within their departments and only one centre had a purchasing policy in place where individual staff were assigned a personal apron or jacket. Conclusion: Ill-fitting aprons or jackets will reduce the shielding provided to certain body regions by personal protective equipment. The use of over-sized aprons or jackets by staff is of particular concern based on the potential for inadvertent exposure to tissues where cancers may potentially be induced due to poor armhole fit. It is important to carefully consider purchasing practices and range of personal protective equipment sizes available in order to ensure that all staff receive the greatest possible protection from occupational radiation exposure

  3. Characterization of workplaces in interventional radiology using active dosemeters ALARA OD

    International Nuclear Information System (INIS)

    Prlic, I.; Milkovic-Kraus, S.; Mestrovic, T.; Suric-Mihic, M.; Vrtar, M.

    2005-01-01

    Full text: Because of progressive development and extended use of interventional radiology procedures it is highly recommended that all individuals involved in the process should be aware of the potential for both stochastic and deterministic effects due to occupational exposure. Interventional radiology procedures are essentially therapeutic and are performed by various medical specialists, not only by properly educated radiologists. As the procedures are performed in such a manner that certain number of medical staff are always needed near the patient, near the x- ray unit, ensuring 'safe' working environment in such radiation x-ray field geometry is a new challenge to regular radiation protection. In this work we are not primary concerned in relatively high doses delivered to patients undergoing interventional procedures. The patient is rather regarded as a secondary radiation source which emits scattered x-rays. The working staff, moving in mixed, primary and scattered x-ray field, is expected to be exposed to higher occupational doses due to combination of extended fluoroscopy times, elevated fluoroscopy currents and larger amount of radiographic images required. The protection of both patients and staff is to be upgraded. As passive dosemetes will give us clear knowledge only about the monthly integrated occupational dose, a reasonable doubt exists about the frequency and duration, of receiving the dose. Measuring dose rate is not a part of regular passive dosemeters monitoring systems. This is why we have developed active - electronic dosemeter device which provides us with additional dosimetry data about the frequency and duration of professional exposure burden. Digital dosemeter ALARA OD will record and integrate any occupational dose including the normal radiation background in the working area. It will record the time and duration of any fluoroscopic exposure done. This gives us the data about the dose rate of occupational radiation and frequency of

  4. Interventional radiology in cardiov ascular division of radiology department S.N.U hospital{sub s}taff roles and departmental management

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Ki Chul; Cheung, Hwan [Seoul National University Hospital, Seoul (Korea, Republic of)

    1986-11-15

    As the angiography in the field of radiological sciences is being increasingly diversified in its techniques, clinical applications of interventional radiology are rapidly increasing not only for its usefulness in simple diagnosis but for its capabilities of affording, by means of radiological surveillance, biological data such as those concerning tissues which are even substitutionary or supplementary to treatment of diseases. During the last 5 years from July 1980 to 1984 such applications in the cardiovascular division showed a trend of radical increase and thus emerging as a new domain of radiological medicine which has vast influence on diagnosis and treatment. The present treatise presents the results of research performed on the following: 1) Need for close coordination among physicians, radiologists, and nurses in the radiology department. 2) Need for prior explanation to the patient of the procedure to be followed to relieve his anxiety. 3) Checking of the angiographic equipment and selection of technical factors. 4) Proper management of manpower including medical radiologists and assistant radiologists. 5) Sterilization of auxiliary equipment required for surgical operation. 6) Selection of a catheter and control of clinical materials such as contrast agents. 7) Supplementary arrangements for speedy performance of clinical services.

  5. Differential kinetics of response and toxicity using stereotactic radiation and interventional radiological coiling for pulmonary arterio-venous shunting from metastatic leiomyosarcoma

    International Nuclear Information System (INIS)

    Wong, Annie Ngai Man; Siva, Shankar; Chin, Kwang; Manser, Renee; Antippa, Phillip; Dowling, Richard; Mileshkin, Linda Rose

    2015-01-01

    Case report demonstrating the differential kinetics of response and toxicity using stereotactic radiation and interventional radiological coiling for pulmonary arterio-venous shunting from leiomyosarcoma pulmonary metastases.

  6. Qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins

    International Nuclear Information System (INIS)

    Buecker, A.; Gross-Fengels, W.; Haage, P.; Huppert, P.; Landwehr, P.; Loose, R.; Reimer, P.; Tacke, J.; Vorwerk, D.; Fischer, J.

    2012-01-01

    The topics covered in the qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins are the following: Practical qualification: aorta iliac vessels and vessels in the upper and lower extremities, kidney and visceral arteries, head and neck arteries, dialysis shunts, veins and pulmonary arteries, aorta aneurysms and peripheral artery aneurysms. Knowledge acquisition concerning radiation protection: legal fundamentals, education and training, knowledge actualization and quality control, definition of the user and the procedure, competence preservation.

  7. Dosimetric studies of the eye lens using a new dosemeter – Surveys in interventional radiology departments

    International Nuclear Information System (INIS)

    Pirchio, R.; Sánchez, H.; Domazet, W.

    2014-01-01

    During interventional radiology (IR) and cardiology (IC) procedures, medical staff can receive high doses to their eye lenses. The Retrospective Evaluation of Lens Injuries and Dose study organized in Argentina in 2010 found incipient opacity in 50% of IC physicians and 41% of IC technicians/nurses. These results, added to the recommendations of the International Commission on Radiological Protection, which lowered their former occupational equivalent dose limit for the lens, led us to assess the eye lens dose, Hp(3), during interventional procedures. To this end, a new dosemeter was designed and calibrated at the National Atomic Energy Commission of Argentina to evaluate Hp(3). Personal dose equivalent (Hp(10)), and Hp(3) were assessed for 3 months in two IC and IR departments. An Alderson phantom was used to simulate monthly exposures of five occupational staff members. Hp(3) and Hp(10) were obtained monthly for 14 occupational staff members exposed to 121 IR and IC procedures. We concluded that the annual effective dose and Hp(3) were lower than 0.3 and 10 mSv, respectively and the average cumulative Hp(3) for working life was lower than 400 and 200 mSv for physicians and technicians/scrub nurse, respectively. An occupational annual dose constraint of 0.3 mSv was calculated. - Highlights: • An eye lens dosimeters was designed at the Personal Dosimetry Laboratory of CNEA. • A successful dosimetric survey in two interventional departments was done. • The annual effective dose and the annual eye lens dose are lower than the ICRP dose thresholds. • In order to reduce doses actions should be promoted to maximize radiation protection

  8. 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

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

    Science.gov (United States)

    Lemke, Heinz U; Berliner, Leonard

    2011-05-01

    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

  10. Cost and Morbidity Analysis of Chest Port Insertion: Interventional Radiology Suite Versus Operating Room.

    Science.gov (United States)

    LaRoy, Jennifer R; White, Sarah B; Jayakrishnan, Thejus; Dybul, Stephanie; Ungerer, Dirk; Turaga, Kiran; Patel, Parag J

    2015-06-01

    To compare complications and cost, from a hospital perspective, of chest port insertions performed in an interventional radiology (IR) suite versus in surgery in an operating room (OR). This study was approved by an institutional review board and is HIPAA compliant. Medical records were retrospectively searched on consecutive chest port placement procedures, in the IR suite and the OR, between October 22, 2010 and February 26, 2013, to determine patients' demographic information and chest port-related complications and/or infections. A total of 478 charts were reviewed (age range: 21-85 years; 309 women, 169 men). Univariate and bivariate analyses were performed to identify risk factors associated with an increased complication rate. Cost data on 149 consecutive Medicare outpatients (100 treated in the IR suite; 49 treated in the OR) who had isolated chest port insertions between March 2012 and February 2013 were obtained for both the operative services and pharmacy. Nonparametric tests for heterogeneity were performed using the Kruskal-Wallis method. Early complications occurred in 9.2% (22 of 239) of the IR patients versus 13.4% (32 of 239) of the OR patients. Of the 478 implanted chest ports, 9 placed in IR and 18 placed in surgery required early removal. Infections from the ports placed in IR versus the OR were 0.25 versus 0.18 infections per 1000 catheters, respectively. Overall mean costs for chest port insertion were significantly higher in the OR, for both room and pharmacy costs (P chest ports in an OR setting was almost twice that of placement in the IR suite. Hospital costs to place a chest port were significantly lower in the IR suite than in the OR, whereas radiology and surgery patients did not show a significantly different rate of complications and/or infections. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  11. 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)

  12. 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)

  13. 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

  14. Individual monitoring of medical staff working in interventional radiology in Switzerland using double dosimetry

    International Nuclear Information System (INIS)

    Damet, J.; Bailat, C.; Bize, P.; Buchillier, Th.; Tosic, M.; Verdun, F.R.; Baechler, S.

    2011-01-01

    Physicians who frequently perform fluoroscopic examinations are exposed to high intensity radiation fields. The exposure monitoring is performed with a regular personal dosimeter under the apron in order to estimate the effective dose. However, large parts of the body are not protected by the apron (e.g. arms, head). Therefore, it is recommended to wear a supplemental dosimeter over the apron to obtain a better representative estimate of the effective dose. The over-apron dosimeter can also be used to estimate the eye lens dose. The goal of this study was to investigate the relevance of double dosimetry in interventional radiology. First the calibration procedure of the dosimeters placed over the apron was tested. Then, results of double dosimetry during the last five years were analyzed. We found that the personal dose equivalent measured over a lead apron was underestimated by ∼20% to ∼40% for X-ray beam qualities used in radiology. Measurements made over five-year period confirm that the use of a single under-apron dosimeter is inadequate for personnel monitoring. Relatively high skin dose (>10 mSv/month) would have remained undetected without a second dosimeter placed on the apron.

  15. Conclusions and recommendations of the European ORAMED project for practical interventional radiology and nuclear medicine

    International Nuclear Information System (INIS)

    Nikodemova, Denisa; Fueloep, Marko; Cabanekova, Helena

    2012-01-01

    The results of the recently published doses obtained by medical staff working in pulsed radiation fields, and performing interventional radiology (IR) or interventional cardiology (IC) procedures, as well as applications of radionuclides in nuclear medicine (NM), have shown significantly high levels of exposure, mainly to the hands and other parts of their bodies uncovered by protective equipment. The coordinated project ORAMED (Optimization of Radiation Protection of Medical Staff) was set-up by participation of 12 European countries and 34 IR/IC and NM departments, with the 5 main tasks: (i) optimization of radiation protection in IR and IC,with the aim to standardize a unified method of extremities and eye lens doses estimation, for 3 cardiac and 5 interventional diagnostic and therapeutic examinations; (ii) verification of the possibilities to use active personal dosemeters for typical pulsed radiation fields used in IR and IC; (iii) contribution to the extremities and eye lens dose reduction in nuclear medicine; (iv) development and application of a suitable eye lens dosemeter; and (v) elaboration of training materials and guidelines for radiation protection issues at IR, IC and NM workplaces. The present study presents some important results and recommendations for dose reduction and avoidance of some typical failures during work near ionizing radiation sources. (P.A.)

  16. 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.

  17. 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

  18. 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.)

  19. 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.

  20. Development of a Real-time Hand Dose Monitor for Personnel in Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Ban, N.; Nakaoka, H.; Haruta, R.; Murakami, Y.; Kubo, T.; Maeda, T.; Kusama, T

    2001-07-01

    Medical procedures denoted as interventional radiology require operation near an X ray beam, which brings high dose exposures to the operators' hands. For the effectual control of their extremity doses, a prototype of a real-time wrist dosemeter has been developed, hand dose monitor (HDM), based on a single silicon detector. Experiments were performed to test its response to diagnostic X rays. The HDM was highly sensitive and showed a linear response down to doses of a few tens of microsieverts. Though dose rate, energy and angular dependence of the response were observed in some extreme conditions, the HDM was proved to be of practical use if it was appropriately calibrated. Since an HDM enables personnel to check their hand doses on a real-time basis, it would enable medical staff to control the exposure themselves. (author)

  1. 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

  2. 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)

  3. Measurements of eye lens doses in interventional radiology and cardiology: Final results of the ORAMED project

    International Nuclear Information System (INIS)

    Vanhavere, F.; Carinou, E.; Domienik, J.; Donadille, L.; Ginjaume, M.; Gualdrini, G.; Koukorava, C.; Krim, S.; Nikodemova, D.; Ruiz-Lopez, N.; Sans-Merce, M.; Struelens, L.

    2011-01-01

    Within the ORAMED project (Optimization of Radiation Protection of Medical Staff) a coordinated measurement program for occupationally exposed medical staff was performed in different hospitals in Europe ( (www.oramed-fp7.eu)). The main objective was to obtain a set of standardized data on extremity and eye lens doses for staff involved in interventional radiology and cardiology and to optimize radiation protection. Special attention was given to the measurement of the doses to the eye lenses. In this paper an overview will be given of the measured eye lens doses and the main influence factors for these doses. The measured eye lens doses are extrapolated to annual doses. The extrapolations showed that monitoring of the eye lens should be performed on routine basis.

  4. 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

  5. Interventional radiology in the provision and maintenance of long-term central venous access

    International Nuclear Information System (INIS)

    Lyon, S.M.; Given, M.; Marshall, N.L.

    2008-01-01

    Establishing and maintaining venous access forms an increasing proportion of the workload in interventional radiology. Several patient groups require medium-term to long-term venous catheters for a variety of purposes, including chemotherapy, long-term antimicrobials, parenteral nutrition, short-term access for haemodialysis or exhausted haemodialysis. Often, these catheters are required for treatment and frequent blood testing, which can quickly exhaust the peripheral veins. Venous access devices include implantable catheters (ports), tunnelled catheters and peripherally inserted central catheters, which have different functions, advantages and limitations. Imaging-guided placement is the preferred method of insertion in many institutions because of higher success rates and radiologists are well suited to address catheter complications.

  6. 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

  7. Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Safari, M. J.; Wong, J. H. D.; Ng, K. H., E-mail: ngkh@um.edu.my [Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603 (Malaysia); Jong, W. L. [Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603 (Malaysia); Cutajar, D. L.; Rosenfeld, A. B. [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia)

    2015-05-15

    Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

  8. 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)

  9. The novel application of Benford's second order analysis for monitoring radiation output in interventional radiology.

    Science.gov (United States)

    Cournane, S; Sheehy, N; Cooke, J

    2014-06-01

    Benford's law is an empirical observation which predicts the expected frequency of digits in naturally occurring datasets spanning multiple orders of magnitude, with the law having been most successfully applied as an audit tool in accountancy. This study investigated the sensitivity of the technique in identifying system output changes using simulated changes in interventional radiology Dose-Area-Product (DAP) data, with any deviations from Benford's distribution identified using z-statistics. The radiation output for interventional radiology X-ray equipment is monitored annually during quality control testing; however, for a considerable portion of the year an increased output of the system, potentially caused by engineering adjustments or spontaneous system faults may go unnoticed, leading to a potential increase in the radiation dose to patients. In normal operation recorded examination radiation outputs vary over multiple orders of magnitude rendering the application of normal statistics ineffective for detecting systematic changes in the output. In this work, the annual DAP datasets complied with Benford's first order law for first, second and combinations of the first and second digits. Further, a continuous 'rolling' second order technique was devised for trending simulated changes over shorter timescales. This distribution analysis, the first employment of the method for radiation output trending, detected significant changes simulated on the original data, proving the technique useful in this case. The potential is demonstrated for implementation of this novel analysis for monitoring and identifying change in suitable datasets for the purpose of system process control. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  10. The role of interventional radiology in management of patients with end-stage renal disease

    International Nuclear Information System (INIS)

    Surlan, M.; Popovic, P.

    2003-01-01

    The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The technical success rates are over 90% for dilatation. One-year primary patency rate in forearm fistula is 51%, versus graft 40%. Stents are placed only in selected cases; routinely in central vein after dilatation, in ruptured vein and elastic recoil. Thrombosed fistula and grafts can be declotted by purely mechanical methods or in combination with a lytic drug. The success rate of the technique is 89-90%. Primary patency rate is 8-26% per year and secondary 75% per year. The most frequently radiologically evaluated and treated complications in renal transplantation are perirenal and renal fluid collection and abnormalities of the vasculature and collecting system. US is often the method of choice for the diagnostic evaluation and management of the percutaneous therapeutic procedures in early and late transplantation complications. Computed tomography and magnetic resonance are valuable alternatives when US is inconclusive. Renal and perirenal fluid collection are usually treated successfully with

  11. 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)

  12. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

    Energy Technology Data Exchange (ETDEWEB)

    Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology (United States); Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)

    2016-03-15

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures.

  13. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

    International Nuclear Information System (INIS)

    Taslakian, Bedros; Sebaaly, Mikhael Georges; Al-Kutoubi, Aghiad

    2016-01-01

    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures

  14. 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).

  15. Improving patient follow-up in interventional radiology and radiation-based acts. To reduce the risk of deterministic effects

    International Nuclear Information System (INIS)

    Etard, Cecile; Aubert, Bernard; Lafont, Marielle; Mougniot, Sandrine; Rousse, Carole; Bey, Eric; Cassagnes, Lucie; Guersen, Joel; Ducou Le Pointe, Hubert; Elhadad, Simon; Georges, Jean-Louis; Nonent, Michel; Paisant-Thouveny, Francine; Salvat, Cecile; Vidal, Vincent; Chauvet, Bruno; Riu, Jean-Luc; Voix, Fabien; Bar, Olivier; Le Du, Dominique; Maccia, Carlo; Lacombe, Pascal; Mertz, Luc; Valery, Charles

    2014-04-01

    After having presented an example of adverse reaction to interventional radiology (a case of a iatrogenic radiodermatitis), this report first presents the context which creates a risk situation. It describes risks related to the use of ionizing radiations, identifies risk factors and how to make procedures safer, and indicates actions aimed at reducing risks (in a preventive way, in recovery, by attenuation)

  16. 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.

  17. The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Frederic, E-mail: fredericbaumann@hotmail.com; Katzen, Barry T. [Baptist Hospital of Miami, Miami Cardiac & Vascular Institute (MCVI) (United States); Carelsen, Bart [Philips HealthCare, Clinical Science Interventional X-ray (Netherlands); Diehm, Nicolas [Kantonsspital Aarau, Clinical and Interventional Angiology (Switzerland); Benenati, James F.; Peña, Constantino S. [Baptist Hospital of Miami, Miami Cardiac & Vascular Institute (MCVI) (United States)

    2015-10-15

    PurposeThe purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.Materials and MethodsIn one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.ResultsA total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).ConclusionA real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter.

  18. The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting

    International Nuclear Information System (INIS)

    Baumann, Frederic; Katzen, Barry T.; Carelsen, Bart; Diehm, Nicolas; Benenati, James F.; Peña, Constantino S.

    2015-01-01

    PurposeThe purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.Materials and MethodsIn one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.ResultsA total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).ConclusionA real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter

  19. Innovation is the permanent motivation to make continuous development of interventional radiology: comments about esophageal internal irradiation stent for the treatment of esophageal cancer

    International Nuclear Information System (INIS)

    Teng Gaojun

    2011-01-01

    Treatment of esophageal carcinoma is still a tough issue. Although metallic esophageal stent implantation is an important technique, as it can safety and quickly relieve the dysphagia caused by esophageal cancer, is has no effect on the malignant tumor itself. As a carrier of radioactive seeds, the novel esophageal stent plays functions of relieving dysphagia and conducting brachytherapy of the tumor, which creates a new therapy for esophageal carcinoma and expands the clinical significance of the stent implantation treatment. The history of interventional radiology indicates that it is the innovation that is the permanent motivation to make continuous development of interventional radiology. Innovations include new technology, new practical devices and new theories. Today, even if the interventional radiology has highly developed, innovation is till an 'unbreakable truth' for the development of interventional radiology and it makes the interventional radiology full of vitality. (author)

  20. 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

  1. 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.

  2. 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.

  3. Role of Interventional Radiology in the Treatment of Biliary Strictures Following Orthotopic Liver Transplantation

    International Nuclear Information System (INIS)

    Righi, Dorico; Cesarani, Federico; Muraro, Emanuele; Gazzera, Carlo; Salizzoni, Mauro; Gandini, Giovanni

    2002-01-01

    Purpose: To evaluate the efficacy and safety of percutaneous treatment of biliary strictures complicating orthotopic liver transplantation (OLT). Methods: Between October 1990 and May 2000, 619 patients underwent 678 liver transplants. Seventy of the 619 (11%) patients were found to be affected by biliary strictures by July 2000. Bilioplasty was performed in 51 of these 70 (73%) patients. A cohort of 33 of 51 (65%) patients were clinically followed for more than 12 months after the last percutaneous treatment and included in the survey results. Results: After one to three treatments 24 of 33 (73%)patients were stricture-free on ultrasound and MR cholangiography follow-up. A delayed stricture recurrence required a fourth percutaneous bilioplasty in two of 33 (6%) patients. A surgical bilioenteric anastomosis was performed in six of 33 (18%) patients.Retransplantation was performed due to ischemic damage in one of 33(3%) patients. Conclusion: Interventional radiology is an effective therapeutic alternative for the treatment of most biliary strictures complicating OLT. It has a high success rate and should be considered before surgical interventions. Elective surgery may be necessary in a few failed cases or those with more severe and extensive biliary strictures

  4. 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

  5. Evaluation of the efficiency of different methods of personal dosimetry in vascular interventional radiology

    International Nuclear Information System (INIS)

    Bacchim Neto, F.A.; Alves, A.F.F.; Rosa, M.E.D.; Pina, D.R.

    2017-01-01

    Interventional Radiology - IR is the area of medicine that provides the largest occupational exposures. The dose values to which interventionists are exposed are difficult to standardize. The objective of the study is to perform a complete evaluation of occupational exposures and to determine the efficiency of different personal dosimetry methods used in IR. We evaluated the efficiencies of 6 different personal dosimetry methodologies used internationally to estimate the effective dose received by interventional professionals. And, based on this analysis, determine the characteristics of each methodology. One of the methods of personal dosimetry recommended by Brazilian legislation was the most conservative, overestimating, on average, the effective dose of professionals by up to 200%, reaching maximum values close to 400%. The most accurate method was that used in North America. This method did not overestimate the effective dose of the professionals more than a few percent and their standard deviation relative to the effective reference dose were the lowest. Based on these results, the choice of methodologies employing at least two dosimeters, one under and above protective aprons is recommended. In addition, in some situations where the dose in the hands may be high, additional dosimeters for this region are also recommended

  6. 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.

  7. 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.

  8. 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)

  9. Preliminary study of using imaging plates to map skin dose of patients in interventional radiology procedures

    International Nuclear Information System (INIS)

    Ohuchi, H.; Satoh, T.; Eguchi, Y.; Mori, K.

    2005-01-01

    A method using europium-doped BaFBr imaging plates (IPs) has been studied for mapping entrance skin doses during interventional radiology (IR); the mapping is useful for detecting overlap between irradiation fields and determining the most exposed skin areas. IPs, which are two-dimensional radiation sensors made of photostimulated luminescence materials, have a linear dose response up to ∼100 Gy, can accurately measure doses from 1 μGy to 10 Gy and can be used repeatedly. Because the energy dependence of IPs is rather high, the IPs were characterised in this study and a sensitivity variation of ∼13% was observed for effective energies of 32.7 to 44.7 keV, which are used in IR procedures. Simulation of actual interventional cardiology procedures showed that the variation of sensitivity was within 5%, meaning that IPs are practical for measuring skin doses during IR. Moreover, the patient data can be stored online and easily called up when IR procedures must be repeated, helping to prevent radiation injuries. (authors)

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Ban, Nobuhiko; Kusama, Tomoko [Oita University of Nursing and Health Sciences, Oita (Japan); Adachi, Akiko [Oita Medical University, Oita (JP)] [and others

    2000-05-01

    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

  12. 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)

  13. 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

  14. Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

    Science.gov (United States)

    Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

    2018-01-01

    We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

  15. 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)

  16. 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)

  17. 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.

  18. 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)

  19. Recommendations to reduce extremity and eye lens doses in interventional radiology and cardiology

    International Nuclear Information System (INIS)

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

    2011-01-01

    The main aim of the Work Package 1 (WP1) of the ORAMED project, Collaborative Project (2008–2011), supported by the European Commission within its 7th Framework Programme, was to obtain a set of standardized data on extremity and eye lens doses for staff in interventional radiology and cardiology (IR/IC) workplaces and to recommend a series of guidelines on radiation protection in order to both guarantee and optimize staff protection. Within the project, coordinated measurements were performed in 34 hospitals in 6 European countries. Furthermore, simulations of the most representative workplaces in IR and IC were performed to determine the main parameters that influence the extremity and eye lens doses. The work presented in this paper shows the recommendations that were formulated by the results obtained from both measurements and simulations. The presented guidelines are directed to operators, assistant personnel, radiation protection officers and medical physics experts. They concern radiation protection issues, such as the use of room protective equipment, as well as the positioning of the extremity and eye lens dosemeters for routine monitoring.

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

    Science.gov (United States)

    Ojha, Utkarsh; Mohammed, Raihan; Vivekanantham, Sayinthen

    2017-01-01

    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.

  1. 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)

  2. 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

  3. British Society of Interventional Radiology: Biliary Drainage and Stenting Registry (BDSR)

    International Nuclear Information System (INIS)

    Uberoi, R.; Das, N.; Moss, J.; Robertson, I.

    2012-01-01

    Objectives: This study was designed to audit current practice in percutaneous biliary drainage and stenting in the United Kingdom. Methods: In 2006, the British Society of Interventional Radiology set up the first web-based Biliary Drainage and Stenting Registry (BDSR). This consisted of a series of tick sheets, which were completed online. Data collection included technical and clinical success of the procedures and outcomes at discharge with a separate form for any follow-up visits. Two months before data analysis, all contributors were asked via email to complete any outstanding data. This paper reports on data collected between November 1, 2006 and August 18, 2009. Results: A total of 833 procedures were recorded and were entered by 62 operators from 44 institutions within the United Kingdom. There were 455 men and 378 women with a median age of 69 (range 20–101) years.The majority of procedures were performed by a consultant. Successful drainage of the biliary tree was achieved in 98.7%. Partial or complete relief of symptoms was seen in 65% of patients. Minor complications, predominantly pain (14.3%), were seen in 26% and major complications, predominantly sepsis (3.5%), were seen in 7.9% of patients. Conclusions: These figures provide an essential benchmark for both audit and patient information. Identifying areas of good practice and those that require improvement will ultimately result in better patient care.

  4. Monte Carlo calculations on extremity and eye lens dosimetry for medical staff at interventional radiology procedures

    International Nuclear Information System (INIS)

    Carinou, E.; Ferrari, P.; Koukorava, C.; Krim, S.; Struelens, L.

    2011-01-01

    There are many factors that can influence the extremity and eye lens doses of the medical staff during interventional radiology and cardiology procedures. Numerical simulations can play an important role in evaluating extremity and eye lens doses in correlation with many different parameters. In the present study, the first results of the ORAMED (Optimisation of Radiation protection of Medical staff) simulation campaign are presented. The parameters investigated for their influence on eye lens, hand, wrist and leg doses are: tube voltage, filtration, beam projection, field size and irradiated part of the patient's body. The tube voltage ranged from 60 to 110 kVp, filtration from 3 to 6 mm Al and from 0 to 0.9 mm Cu. For all projections, the results showed that doses received by the operator decreased with increasing tube voltage and filtration. The magnitude of the influence of the tube voltage and the filtration on the doses depends on the beam projection and the irradiated part of the patient's body. Finally, the influence of the field size is significant in decreasing the doses. (authors)

  5. 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.

  6. 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)

  7. 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)

  8. 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

  9. 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)

  10. 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

  11. 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)

  12. 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 far.

  13. High potential for weathering and climate effects of non-vascular vegetation in the Late Ordovician

    Science.gov (United States)

    Porada, Philipp; Lenton, Tim; Pohl, Alexandre; Weber, Bettina; Mander, Luke; Donnadieu, Yannick; Beer, Christian; Pöschl, Ulrich; Kleidon, Axel

    2017-04-01

    Early non-vascular vegetation in the Late Ordovician may have strongly increased chemical weathering rates of surface rocks at the global scale. This could have led to a drawdown of atmospheric CO2 and, consequently, a decrease in global temperature and an interval of glaciations. Under current climatic conditions, usually field or laboratory experiments are used to quantify enhancement of chemical weathering rates by non-vascular vegetation. However, these experiments are constrained to a small spatial scale and a limited number of species. This complicates the extrapolation to the global scale, even more so for the geological past, where physiological properties of non-vascular vegetation may have differed from current species. Here we present a spatially explicit modelling approach to simulate large-scale chemical weathering by non-vascular vegetation in the Late Ordovician. For this purpose, we use a process-based model of lichens and bryophytes, since these organisms are probably the closest living analogue to Late Ordovician vegetation. The model explicitly represents multiple physiological strategies, which enables the simulated vegetation to adapt to Ordovician climatic conditions. We estimate productivity of Ordovician vegetation with the model, and relate it to chemical weathering by assuming that the organisms dissolve rocks to extract phosphorus for the production of new biomass. Thereby we account for limits on weathering due to reduced supply of unweathered rock material in shallow regions, as well as decreased transport capacity of runoff for dissolved weathered material in dry areas. We simulate a potential global weathering flux of 2.8 km3 (rock) per year, which we define as volume of primary minerals affected by chemical transformation. Our estimate is around 3 times larger than today's global chemical weathering flux. Furthermore, chemical weathering rates simulated by our model are highly sensitive to atmospheric CO2 concentration, which implies

  14. 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)

  15. 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.

  16. Overview of double dosimetry procedures for the determination of the effective dose to the interventional radiology staff

    International Nuclear Information System (INIS)

    Jaervinen, H.; Buls, N.; Clerinx, P.; Jansen, J.; Miljanic, S.; Nikodemova, D.; Ranogajec-Komor, M.; D'Errico, F.

    2008-01-01

    In interventional radiology, for an accurate determination of effective dose to the staff, measurements with two dosemeters have been recommended, one located above and one under the protective apron. Such 'double dosimetry' practices and the algorithms used for the determination of effective dose were reviewed in this study by circulating a questionnaire and by an extensive literature search. The results indicated that regulations for double dosimetry almost do not exist and there is no firm consensus on the most suitable calculation algorithms. The calculation of effective dose is mainly based on the single dosemeter measurements, in which either personal dose equivalent, directly, (dosemeter below the apron) or a fraction of personal dose equivalent (dosemeter above the apron) is taken as an assessment of effective dose. The most recent studies suggest that there might not be just one double dosimetry algorithm that would be optimum for all interventional radiology procedures. Further investigations in several critical configurations of interventional radiology procedures are needed to assess the suitability of the proposed algorithms. (authors)

  17. 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.

  18. 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

  19. Joint WHO/ISH workshop on efficacy and radiation safety in interventional radiology

    International Nuclear Information System (INIS)

    Baeuml, A.; Bauer, B.; Bernhardt, J.H.; Stieve, F.E.; Veit, R.; Zeitlberger, I.

    1997-02-01

    With the constantly developing technology and the opening of new fields of application, the implementation of Interventional Radiology (IR) is increasing considerably. These sophisticated procedures can frequently replace open surgery, and this is of enormous benefit for the patient. On the other hand, IR involves prolonged application of fluoroscopy and - due to the need for excellent image quality - partly very high dose-rate levels. Additionally, cine-series, and alsogreat numbers of single radiographs are necessary. Accordingly, the levels of exposure to patients and staff are very high. In order to consider possible reduction of the radiation risks of IR procedures interdiciplinary talks between representatives of manufacturers of X-ray equipment, hospital physicists and the clinical community would seem necessary in order to find ways of avoiding unproductive radiation exposure to the patient and to clinical staff. This was the aim of a workshop on IR, which was jointly organized by the World Health Organization and the Institute of Radiation Hygiene of the Federal Office for Radiation Protection in Germany in October 1995. It was intended as a forum for the discussion of issues related to IR, and to forster improved application, that is to say as an opportunity: To present the state of the art; to work out proposals for more efficient clinical protocols; to discuss on schemes of education and training and on equipment-related developments. Improvement of radiation safety for both patients and staff, was the general aim of the workshop. This volume contains the presentations given on the first day of the workshop. (orig./DG) [de

  20. 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)

  1. 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.

  2. Percutaneous transgluteal drainage of pelvic abscesses in interventional radiology: A safe alternative to surgery.

    Science.gov (United States)

    Robert, B; Chivot, C; Rebibo, L; Sabbagh, C; Regimbeau, J-M; Yzet, T

    2016-02-01

    Interventional radiology plays an important role in the management of deep pelvic abscesses. Percutaneous drainage is currently considered as the first-line alternative to surgery. A transgluteal computed tomography (CT)-guided approach allows to access to deep infected collections avoiding many anatomical obstacles (vessels, nerves, bowel, bladder). The objective of this study was to assess the safety and efficacy of a transgluteal approach by reviewing our clinical experience. We reviewed medical records of patients having undergone percutaneous CT-guided transgluteal drainage for deep pelvic abscesses. We focused on the duration of catheter drainage, the complications related to the procedures and the rate of complete resolution. Between 2005 and 2013, 39patients (27women and 12men; mean age: 52.5) underwent transgluteal approach CT-guided percutaneous drainage of pelvis abscesses in our department. The origins of abscesses were postoperative complications in 34patients (87.2%) and infectious intra-abdominal disease in 5patients (12.8%). The mean duration of drainage was 8.3days (range: 3-33). Laboratory cultures were positive in 35patients (89.7%) and Escherichia coli was present in 71.4% of the positive samples. No major complication was observed. Drainage was successful in 38patients (97.4%). A transpiriformis approach was more significantly associated with intra-procedural pain (P=0.003). Percutaneous CT-guided drainage with a transgluteal approach is a safe, well-tolerated and effective alternative to surgery for deep pelvic abscesses. This approach should be considered as the first-line intention for the treatment of deep pelvic abscesses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. 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

  4. 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)

  5. Study of the parameters affecting operator doses in interventional radiology using Monte Carlo simulations

    International Nuclear Information System (INIS)

    Koukorava, C.; Carinou, E.; Ferrari, P.; Krim, S.; Struelens, L.

    2011-01-01

    Measurements performed within the ORAMED project helped to evaluate the dose levels to the operators’ hands, wrists, legs and eye lenses, during several types of interventional radiology (IR) and cardiology (IC) procedures, and also to determine the parameters that affect the doses. However, the study of the effect of each parameter separately, was possible only through Monte Carlo (MC) simulations, as in clinical practice many of those parameters change simultaneously. The influence of the protective equipment, the beam projections, the beam quality, the field size and the position of the operator according to the position of access of the catheter was investigated, using anthropomorphic phantoms in setups that represent realistic IR/IC procedures. The proper use of protective shields was found to be the most important way of reducing extremity and eye lens exposure during such examinations. Ceiling suspended shields can reduce the doses to the eye lenses up to 97%, but they can also reduce hand doses about 70% when placed correctly. The highest exposure to the operator is observed for left anterior oblique (LAO) and cranial projections. Additionally, for overcouch irradiations the eyes and the hands are about 6 times more exposed compared to the cases where the tube is below the operating table. For the lateral LAO projection, placing the ceiling suspended shield at the left side of the operator is twice more effective for the protection of the eyes compared to the cases where it is placed above the patient. Finally, beam collimation was found to play an important role in the reduction of the hands and wrists doses, especially when the operator is close to the irradiation field.

  6. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Reekers, J. A., E-mail: j.a.reekers@amc.uva.nl [AMC, University of Amsterdam, Department of Radiology (Netherlands); Lee, M J [Beaumont Hospital, Department of Academic Radiology (Ireland); Belli, A M [St. George' s Hospital, Department of Radiology (United Kingdom); Barkhof, F [MS Center Amsterdam, VU University Medical Center, Department of Radiology (Netherlands)

    2011-02-15

    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.

  8. 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.

  9. 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.

  10. 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

  11. The role of interventional radiology in the management of intra-and extra-Peritoneal leakage in patients who have undergone continent urinary diversion

    International Nuclear Information System (INIS)

    Bodner, Leonard; Nosher, John L.; Siegel, Randall; Russer, Tadeus; Cummings, Kenneth; Kraus, Stephen

    1997-01-01

    Purpose. To assess how radiologic intervention altered the hospital course of patients undergoing continent urinary diversion. Methods. Thirty-seven consecutive patients with bladder cancer invading the muscular layer were treated with total cystectomy and construction of a continent urinary reservoir. Eleven of 37 patients suffered early and late anastomotic leakage; six had prolonged extraperitoneal leakage at the urethroenteric anastomosis, three had prolonged intraperitoneal pouch leaks, and two had delayed ureteroenteric leaks. Seven of these patients required radiologic intervention.Results. Intervention in the form of drainage catheter manipulation (n=4), percutaneous nephrostomy (n=4), or ureteral stent placement (n=2) resulted in cessation of leakage without surgical intervention in all seven patients. Intraperitoneal pouch leaks were more difficult to control than extraperitoneal leakage and required longer drainage intervals.Conclusion. Interventional radiologic procedures played a key role in the management of continent urinary diversion complications obviating the need for repeat surgical intervention in all instances

  12. 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

  13. 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

  14. 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

  15. Radioisotope treatment for benign strictures of non-vascular luminal organs

    International Nuclear Information System (INIS)

    Shin, Ji Hoon

    2006-01-01

    Tissue hyperplasia in one of the most frequently encountered complications when self-expanding stents are placed in benign non-vascular luminal organ strictures, thus causing of the lumen. The investigators postulated that ionizing irradiation could be applied to prevent restenosis caused by tissue hyperplasia in non-vascular luminal organs as it reduced coronary or peripheral arterial narrowing successfully. The authors combined β-irradiation using 188 Re-MAG 3 solution with balloon for animal and clinical studies because this new treatment approach had the advantages such as low penetration depth of β-ray, self-centering irradiation, and mechanical effect of balloon dilation over using γ-irradiation with afterloading devices. In this article, the concept and mechanism of radioisotope balloon dilation, and animal and clinical studies using radioisotope balloon dilation are reviewed

  16. Angiography and interventional radiology of the kidneys; Angiographie und interventionelle Radiologie der Nieren

    Energy Technology Data Exchange (ETDEWEB)

    Hansmann, J.; Richter, G.M.; Hallscheidt, P.; Duex, M.; Noeldge, G.; Kaufmann, G.W. [Heidelberg Univ. (Germany). Abt. Radiodiagnostik

    1999-05-01

    For imaging of renal pathology a broad spectrum of radiologic diagnostic procedures are available which are, sometimes and particularly more recently, competing among each other in their diagnostic yield and relevance. For tumorous lesions ultrasound, computed tomography and magnetic resonance imaging are performed predominantly. Angiography is no longer required with the exception of highly selected cases and in some specific preoperative workup requirements. Until recently, catheter based digital subtraction angiography has been considered as gold standard. However, non-invasive techniques such as CT-angiography and MR-angiography are evolving parallel to their quantum leap of resolutions and readiness to use. Nevertheless, well accepted criteria for quality assessement of these new modalities are still lacking. More comparison studies are urgently warranted. Despite the availability of ultrashort pulse sequences applying the T1 relaxation reduction effect of gadolinium enhanced MR techniques overestimation of renal artery stenosis still poses a substantial problem. Renal intervention implies a variety of procedures such as plain angioplasty, stent placement, embolization of traumatic and both benign and malignant tumors. These methods have emerged over the last two decades from a more experimental nature to a fully accepted treatment option. When renal artery angioplasty is embedded in an aggressive approach including stenting as an adjunct for more complex cases, renal ostial lesions and a well organized follow-up regimen its therapeutic potential for treatment of renal insufficiency, malignant hypertension, for organ preservation bears a very high potential. Provided adequate periinterventional drug regimen restenosis rates may be as low as 10%. In highly selected cases capillary embolization might be used as an alternative to nephrectomy with a similar clinical outcome. Particularly the development of superselective small caliber embolization catheters

  17. Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England.

    Science.gov (United States)

    Hughes, Jane; Scrimshire, Ashley; Steinberg, Laura; Yiannoullou, Petros; Newton, Katherine; Hall, Claire; Pearce, Lyndsay; Macdonald, Andrew

    2017-05-01

    The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012. A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI. 116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were received. 79% provide a single dedicated IR service but over 50% cover more than one hospital within the network. All offer arterial embolisation for BSI. Only 25% follow guidelines. In haemodynamically stable patients, an increasing trend for embolisation was seen as grade of splenic injury increased from 1 to 4 (12.5%-82.14%, pSplenic embolisation is offered for a variety of injury grades, providing the patient remains stable. Variation in interventional radiology services remain despite the introduction of regional trauma networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Characterization of MOSFET detectors for in vivo dosimetry in interventional radiology and for dose reconstruction in case of overexposure.

    Science.gov (United States)

    Bassinet, Céline; Huet, Christelle; Baumann, Marion; Etard, Cécile; Réhel, Jean-Luc; Boisserie, Gilbert; Debroas, Jacques; Aubert, Bernard; Clairand, Isabelle

    2013-04-01

    As MOSFET (Metal Oxide Semiconductor Field Effect Transistor) detectors allow dose measurements in real time, the interest in these dosimeters is growing. The aim of this study was to investigate the dosimetric properties of commercially available TN-502RD-H MOSFET silicon detectors (Best Medical Canada, Ottawa, Canada) in order to use them for in vivo dosimetry in interventional radiology and for dose reconstruction in case of overexposure. Reproducibility of the measurements, dose rate dependence, and dose response of the MOSFET detectors have been studied with a Co source. Influence of the dose rate, frequency, and pulse duration on MOSFET responses has also been studied in pulsed x-ray fields. Finally, in order to validate the integrated dose given by MOSFET detectors, MOSFETs and TLDs (LiF:Mg,Cu,P) were fixed on an Alderson-Rando phantom in the conditions of an interventional neuroradiology procedure, and their responses have been compared. The results of this study show the suitability of MOSFET detectors for in vivo dosimetry in interventional radiology and for dose reconstruction in case of accident, provided a well-corrected energy dependence, a pulse duration equal to or higher than 10 ms, and an optimized contact between the detector and the skin of the patient are achieved.

  19. On intervention levels for nuclear or radiological emergency and decision-making on protective measures

    International Nuclear Information System (INIS)

    Wang Hengde; Nakashima, Y.

    1999-01-01

    The intervention principles and intervention levels newly recommended by ICRP and IAEA are introduced, the necessarily of determining site specific intervention levels is discussed, the method of estimating intervention levels with human capital approach by an example of Japan case is described, and finally decision-making issues are discussed and a decision-making chain is given

  20. Current radiology. Volume 5

    International Nuclear Information System (INIS)

    Wilson, G.H.; Hanafee, W.N.

    1984-01-01

    This book contains 10 selections. They are: Nuclear Magnetic Resonance Imaging, Interventional Vascular Radiology, Genitourinary Radiology, Skeletal Radiology, Digital Subtraction Angiography, Neuroradiology, Computed Tomographic Evaluation of Degenerative Diseases of the Lumbar Spine, The Lung, Otolaringology and Opthalmology, and Pediatric Radiology: Cranial, Facial, Cervical, Vertebral, and Appendicular

  1. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)

    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.)

  2. 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)

  3. Developing low-dose C-arm CT imaging for temporomandibular joint (TMJ) disorder in interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaowei; Cahill, Anne Marie [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Felice, Marc [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States); Johnson, Laura [Computed Tomography Division, Siemens Healthcare Sector, Shanghai (China); Sarmiento, Marily [Siemens Medical Solutions, Angiography and X-ray Division, Hoffman Estates, IL (United States)

    2011-04-15

    Manufacturers have provided C-arm CT imaging technologies for applications in interventional radiology in recent years. However, clinical imaging protocols and radiation doses have not been well studied or reported. The purpose of this study is to develop low-dose settings for clinically acceptable CT imaging of temporomandibular joint in interventional radiology suites, using a C-arm imaging angiography system. CT scans were performed with a flat-panel digital C-arm angiographic system on a 5-year-old anthropomorphic phantom. The CTDI was determined for various rotation times, dose settings and Cu filter selections. The CTDI values were compared with those of conventional low-dose CT for the same phantom. The effectiveness of using Cu filters to reduce dose was also investigated. Images were reviewed by a senior radiologist for clinical acceptance. The manufacturer's default setting gave an equivalent CTDI of 4.8 mGy. Optimizing the dose settings and adding copper filtration reduced the radiation dose by 94%. This represents a 50% reduction from conventional CT. Use of Cu filters and low-dose settings significantly reduced radiation dose from that of standard settings. This phantom study process successfully guided the clinical implementation of low-dose studies for all ages at our institution. (orig.)

  4. The role of interventional radiology in biliary complications after orthotopic liver transplantation: a single-center experience

    International Nuclear Information System (INIS)

    Civelli, Enrico Maria; Cozzi, Guido; Milella, Marco; Suman, Laura; Severini, Aldo; Meroni, Roberta; Vercelli, Ruggero

    2004-01-01

    This study evaluated interventional radiological experience in the management of biliary complications of OLT at the National Cancer Institute of Milan. Seventeen patients who had undergone orthotopic liver transplantation in various hospital were referred to our unit with biliary complications. Group I consisted of 8 patients with anastomotic biliary fistula who came to our attention a short time after transplantation. Group II consisted of 9 patients with anastomotic strictures who came to our attention in a longer period. Two different interventional radiological approaches were used: (a) percutaneous transhepatic biliary drainage (PTBD) in the presence of fistulas in patients of group I; and (b) percutaneous transhepatic biliary drainage combined with dilatation of the strictures with a balloon catheter in patients of group II. On the whole resolution of the biliary complications was achieved in 13 of the 17 cases treated (76.5%), 5 of 8 in group I and 8 of 9 in group II. No secondary stenosis after PTBD were observed in group I, whereas two patients of group II needed a second dilatation. Percutaneous biliary drainage is indicated as a valid treatment in the management of biliary complications, either to allow closure of the fistula either to perform balloon dilatation of stenosis. (orig.)

  5. 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.

  6. Life-threatening bleeding and radiologic intervention after aesthetic surgeries with minimal invasive approaches: report of two cases.

    Science.gov (United States)

    Kim, Youn-Hwan; Kim, Jong-Do; Visconti, Giuseppe; Kim, Jeong-Tae

    2010-10-01

    In this article, the authors report two cases of life-threatening bleeding after cosmetic surgeries that have been successfully treated with radiologic intervention. A 25-year-old female and a 35-year-old female presented at their institutions because of postoperative bleeding after intraoral mandibular angle ostectomy and endoscopic-guided trans-axillary breast augmentation, respectively. A ruptured traumatic pseudo-aneurysm of the right superficial temporal artery was diagnosed in the first case and a haematoma posterior to the right pectoralis major, due to active bleeding from a perforator of internal mammary artery, in the second case. Attempts were made to stop the haemorrhage using standard methods, but failed. Therefore, superselective microcatheter angioembolisation has been successfully performed in both the cases. At 22-month follow-up for the first case and at 12-month follow-up for the second case, the patients are asymptomatic and the cosmetic outcomes are being preserved. With radiologic intervention, the authors gained satisfactory results in the above-mentioned situations. Using this, with only local anaesthesia and the absence of incisions, a precise approach with immediate treatment to the haemorrhaging site is possible. This can be an excellent solution for arterial bleeding that is difficult to access anatomically after aesthetic surgeries, and in selected cases. Furthermore, this procedure is less disfiguring and preserves the aesthetic surgery outcomes. Copyright 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology

    International Nuclear Information System (INIS)

    Kamran, Mudassar; Nagaraja, Sanjoy; Byrne, James V.

    2010-01-01

    Flat detector computed tomography (FDCT) is an imaging tool that generates three-dimensional (3-D) volumes from data obtained during C-arm rotation using CT-like reconstruction algorithms. The technique is relatively new and, at current levels of performance, lags behind conventional CT in terms of image quality. However, the advantage of its availability in the interventional room has prompted neuro-radiologists to identify clinical settings where its role is uniquely beneficial. We performed a search of the online literature databases to identify studies reporting experience with FDCT in interventional neuro-radiology. The studies were systematically reviewed and their findings grouped according to specific clinical situation addressed. FDCT images allow detection of procedural complications, evaluation of low-radiopacity stents and assessment of endosaccular coil packing in intra-cranial aneurysms. Additional roles are 3-D angiography that provides an accurate depiction of vessel morphology with low concentrations of radiographic contrast media and a potential for perfusion imaging due to its dynamic scanning capability. A single scan combining soft tissue and angiographic examinations reduces radiation dose and examination time. Ongoing developments in flat detector technology and reconstruction algorithms are expected to further enhance its performance and increase this range of applications. FDCT images provide useful information in neuro-interventional setting. If current research confirms its potential for assessing cerebral haemodynamics by perfusion scanning, the combination would redefine it as an invaluable tool for interventional neuro-radiology procedures. This facility and its existing capabilities of parenchymal and angiographic imaging would also extend its use to the triage of acute stroke patients. (orig.)

  8. 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.)

  9. 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

  10. 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.

  11. Steadily promoting the technical research and the clinical application of interventional radiology for cervical spine

    International Nuclear Information System (INIS)

    Wu Chungen; Zhou Bing

    2009-01-01

    Many interventional procedures have been practiced in the treatment of cervical spine diseases for recent years. There are percutaneous biopsy, periradicular therapy for cervical never pain, percutaneous vertebroplasty and many kinds of intervertebral disc decompression. However, because of the manipulation difficulties and high risks of these procedures the popularization of interventional techniques in treating cervical spine disorders has actually been beset with difficulties. The main risks caused by interventional operation are puncture injuries and side-effect of therapeutic design. Therefore, how to reduce the procedure's risk is a great challenge to interventional radiologists as well as an urgent research task. (authors)

  12. 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.

  13. 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

  14. Digitised and intervention radiology in cardiovascular disorders. Digitale und interventionelle Radiologie bei Herz- und Gefaesskrankheiten

    Energy Technology Data Exchange (ETDEWEB)

    Richter, K. (Herz-Kreislaufklinik, Berlin-Buch (Germany)) (ed.)

    1992-01-01

    This volume offers a selection of scientific assessments and data contributed by numerous experts that were based on recent experience in various fields, which include in particular: contrast echocardiography, quantitative characterisation of myocardial tissue, filmless cardangiography, quantitative DSA, digitised luminescence radiology of the thorax, on-line computer-aided cardiac evaluations, automatic recognition of image characteristics, ROC analysis, trends in PACS development, contrast media including their influences on microcirculation, recent developments and trends of non-surgical angioplasty, newly devised stents, atherectomy, the use of excimer lasers in coronaries and other vessels and of microcoils in neuroradiology. (MG).

  15. 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)

  16. 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)

  17. 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)

  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. 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)

  20. 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)

  1. Estimation of absorbed dose and its biological effects in subjects undergoing neuro interventional radiological procedures

    International Nuclear Information System (INIS)

    Basheerudeen, Safa Abdul Syed; Subramanian, Vinodhini; Venkatachalam, Perumal; Joseph, Santosh; Selvam, Paneer; Jose, M.T.; Annalakshmi, O.

    2016-01-01

    Radiological imaging has many applications due to its non-invasiveness, rapid diagnosis of life threatening diseases, and shorter hospital stay which benefit patients of all age groups. However, these procedures are complicated and time consuming, which use repeated imaging views and radiation, thereby increasing patient dose, and collective effective dose to the background at low doses. The effects of high dose radiation are well established. However, the effects of low dose exposure remain to be determined. Therefore, investigating the effect on medically exposed individuals is an alternative source to understand the low dose effects of radiation. The ESD (Entrance Surface Dose) was recorded using Lithium borate based TL dosimeters to measure the doses received by the head, neck and shoulder of the study subjects (n = 70) who underwent procedures like cerebral angiography, coiling, stenting and embolization

  2. Sox17 drives functional engraftment of endothelium converted from non-vascular cells.

    Science.gov (United States)

    Schachterle, William; Badwe, Chaitanya R; Palikuqi, Brisa; Kunar, Balvir; Ginsberg, Michael; Lis, Raphael; Yokoyama, Masataka; Elemento, Olivier; Scandura, Joseph M; Rafii, Shahin

    2017-01-16

    Transplanting vascular endothelial cells (ECs) to support metabolism and express regenerative paracrine factors is a strategy to treat vasculopathies and to promote tissue regeneration. However, transplantation strategies have been challenging to develop, because ECs are difficult to culture and little is known about how to direct them to stably integrate into vasculature. Here we show that only amniotic cells could convert to cells that maintain EC gene expression. Even so, these converted cells perform sub-optimally in transplantation studies. Constitutive Akt signalling increases expression of EC morphogenesis genes, including Sox17, shifts the genomic targeting of Fli1 to favour nearby Sox consensus sites and enhances the vascular function of converted cells. Enforced expression of Sox17 increases expression of morphogenesis genes and promotes integration of transplanted converted cells into injured vessels. Thus, Ets transcription factors specify non-vascular, amniotic cells to EC-like cells, whereas Sox17 expression is required to confer EC function.

  3. 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

  4. 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.

  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. 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)

  7. 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)

  8. 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.

  9. 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

  10. 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.

  11. The Role of Interventional Radiology in the Management of Deep Venous Thrombosis: Advanced Therapy

    International Nuclear Information System (INIS)

    O’Sullivan, Gerard J.

    2011-01-01

    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.

  12. Fast and Efficient Radiological Interventions via a Graphical User Interface Commanded Magnetic Resonance Compatible Robotic Device

    Science.gov (United States)

    Özcan, Alpay; Christoforou, Eftychios; Brown, Daniel; Tsekos, Nikolaos

    2011-01-01

    The graphical user interface for an MR compatible robotic device has the capability of displaying oblique MR slices in 2D and a 3D virtual environment along with the representation of the robotic arm in order to swiftly complete the intervention. Using the advantages of the MR modality the device saves time and effort, is safer for the medical staff and is more comfortable for the patient. PMID:17946067

  13. Interventional radiology emergency service provision for a large UK urban population: Initial 3.5 years of experience

    International Nuclear Information System (INIS)

    Christie, A.; Robertson, I.; Moss, J.

    2013-01-01

    Aim: To review the activity and impact of an out-of-hours (OOH) interventional radiology service introduced in Glasgow in 2007. Material and methods: A retrospective review of the first 42 months formal OOH activity across 11 hospital sites covering a population of 1.2 million was undertaken. The 30 day mortality and cause of death was logged for each procedural subtype [nephrostomy, biliary and abscess drainage, enteric stenting, transjugular intrahepatic porto-systemic shunt (TIPS), thoracic endovascular aortic aneurysm repair (TEVAR), endovascular, and embolization]. Results: From October 2007 to March 2011, 502 cases were identified. The mean number of procedures performed per month was 12 (range 5–21). This represents an event rate of 12/100,000 population/year. A minority (11%) of cases were undertaken after midnight. The activity levels were stable over the 42 month study period. The most frequent procedures were percutaneous nephrostomy (32%) and embolization for haemorrhage (30%). Thirty-day mortality was 17% for the entire group but varied from 53% (biliary intervention) to 0% (TEVAR). There was no death following embolization for obstetric haemorrhage. Approximately half of the deaths were due to a failure of the procedure to control the underlying clinical problem. Conclusion: The demand for OOH services is important but not unduly onerous. There is no evidence of expansion of demand after launching such a service. Mortality rates probably reflect the underlying clinical status of this emergency patient group. Certain procedures carry a high mortality rate, raising issues of clinical judgement, appropriateness of intervention, and/or timing

  14. A method to reduce patient's eye lens dose in neuro-interventional radiology procedures

    International Nuclear Information System (INIS)

    Safari, M.J.; Wong, J.H.D.; Kadir, K.A.A.; Sani, F.M.; Ng, K.H.

    2016-01-01

    Complex and prolonged neuro-interventional radiology procedures using the biplane angiography system increase the patient's risk of radiation-induced cataract. Physical collimation is the most effective way of reducing the radiation dose to the patient's eye lens, but in instances where collimation is not possible, an attenuator may be useful in protecting the eyes. In this study, an eye lens protector was designed and fabricated to reduce the radiation dose to the patients’ eye lens during neuro-interventional procedures. The eye protector was characterised before being tested on its effectiveness in a simulated aneurysm procedure on an anthropomorphic phantom. Effects on the automatic dose rate control (ADRC) and image quality are also evaluated. The eye protector reduced the radiation dose by up to 62.1% at the eye lens. The eye protector is faintly visible in the fluoroscopy images and increased the tube current by a maximum of 3.7%. It is completely invisible in the acquisition mode and does not interfere with the clinical procedure. The eye protector placed within the radiation field of view was able to reduce the radiation dose to the eye lens by direct radiation beam of the lateral x-ray tube with minimal effect on the ADRC system. - Highlights: • The eye protector can considerably reduce the patient's eye lens dose during neuro-interventional procedures. • This protector does not significantly perturb the fluoroscopy image and was completely invisible on the acquisition image due to image subtraction. • The eye protector does not significantly change the exposure parameters (kV and mAs).

  15. 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

  16. Diagnostic imaging and interventional radiology of hepatocellular carcinoma: A multicenter study on 290 cases

    International Nuclear Information System (INIS)

    Dalla Palma, Ludovico; Puzzi Mucelli, Roberto; Sponza, Massimo; De Santis, Mario; Gandini, Giovanni; Matricardi, Luigi; Rossi, Cristina

    1997-01-01

    The authors report of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC).The first aim -diagnostic - was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in hepatocellular carcinoma detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning.The second aim - treatment - consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced hepatocellular carcinoma and of intraarterial chemoembolization versus no treatment (NT) in advanced hepatocellular carcinoma. Treatment efficacy was evaluated with the following randomized protocols

  17. Pictorial essay: Interventional radiology in the management of hemodialysis vascular access - A single-center experience

    International Nuclear Information System (INIS)

    Mammen, Suraj; Keshava, Shyamkumar N; Moses, Vinu; Babu, Surendra; Varughese, Santhosh

    2012-01-01

    Chronic kidney disease (CKD) is a worldwide public health problem and is associated with high morbidity and mortality. The majority of patients with CKD stage 5 (CKD-5), who cannot undergo renal transplant, depend on maintenance hemodialysis by surgically created access sites. Native fistulae are preferred over grafts due to their longevity. More than half of these vital portals for dialysis access will fail over time. Screening procedures to select high-risk patients before thrombosis or stenosis appears have resulted in aggressive management. These patients are referred for angiographic evaluation and/or therapy. We present the patterns of dialysis-related interventions done in our institution

  18. 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

  19. Postoperative radiology

    International Nuclear Information System (INIS)

    Burhenne, H.J.

    1989-01-01

    This paper reports on the importance of postoperative radiology. Most surgical procedures on the alimentary tract are successful, but postoperative complications remain a common occurrence. The radiologist must be familiar with a large variety of possible surgical complications, because it is this specialty that is most commonly called on to render a definitive diagnosis. The decision for reoperation, for instance, is usually based on results from radiologic imaging techniques. These now include ultrasonography, CT scanning, needle biopsy, and interventional techniques in addition to contrast studies and nuclear medicine investigation

  20. 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.

  1. 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

  2. Dosimetry using Gafchromic XR-RV2 radiochromic films in interventional radiology

    International Nuclear Information System (INIS)

    Neocleous, A.; Yakoumakis, E.; Gialousis, G.; Dimitriadis, A.; Yakoumakis, N.; Georgiou, E.

    2011-01-01

    Patient dose measurements of local entrance dose to the skin have been carried out using radiochromic film (Gafchromic XR-RV2) in a sample of interventional procedures. The major aim of the work was to measure patient entrance dose from such examinations using Gafchromic XR-RV2. Forty-five various interventional procedures (including nephrostomies and urinary stenting, biliary stenting and percutaneous transhepatic biliary drainage (PTBD) and aorta stent grafting) were evaluated. Maximum entrance doses were 537±119 mGy in nephrostomies, 943±631 mGy in biliary stenting and PTBD and 2425±569 mGy in aorta stent grafting. Results indicate that all patients undergoing aorta stent grafting received skin dose above 1500 mGy, which means that there is an increasing potential to suffer radiation-induced skin injuries. The film provides dose mapping, the position of the skin area with highest dose and can be used for immediate qualitative and as well as for quantitative assessment of patient skin dose. (authors)

  3. 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)

  4. 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.

  5. Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

    Science.gov (United States)

    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

    2009-03-01

    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 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 1,009,095.35 euros. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Physician-received scatter radiation with angiography systems used for interventional radiology: Comparison among many x-ray systems

    International Nuclear Information System (INIS)

    Chida, K.; Morishima, Y.; Inaba, Y.; Taura, M.; Ebata, A.; Takeda, K.; Shimura, H.; Zuguchi, M.

    2012-01-01

    Radiation protection for interventional radiology (IR) physicians is very important. Current IR X-ray systems tend to use flat-panel detectors (FPDs) rather than image intensifiers (IIs). The purpose of this study is to test the hypothesis that there is no difference in physician-received scatter radiation (PRSR) between FPD systems and II systems. This study examined 20 X-ray systems in 15 cardiac catheterisation laboratories (11 used a FPD and 9 used an II). The PRSR with digital cine-angiography and fluoroscopy were compared among the 20 X-ray systems using a phantom and a solid-state-detector electronic pocket dosemeter. The maximum PRSR exceeded the minimum PRSR by ∼12-fold for cine-angiography and ∼9-fold for fluoroscopy. For both fluoroscopy and digital cine-angiography, the PRSR had a statistically significant positive correlation with the entrance surface dose (fluoroscopy, r = 0.87; cine-angiography, r = 0.86). There was no statistically significant difference between the average PRSR of FPDs and IIs during either digital cine-angiography or fluoroscopy. There is a wide range of PRSR among the radiography systems evaluated. The PRSR correlated well with the entrance surface dose of the phantom in 20 X-ray units used for IR. Hence, decreasing the dose to the patient will also decrease the dose to staff. (authors)

  10. 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

  11. 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 travel time when more than one location providing IR procedures is available within the same hospital system.

  12. A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study.

    Science.gov (United States)

    Salajegheh, Ali; Jahangiri, Alborz; Dolan-Evans, Elliot; Pakneshan, Sahar

    2016-02-03

    The ability to interpret an X-Ray is a vital skill for graduating medical students which guides clinicians towards accurate diagnosis and treatment of the patient. However, research has suggested that radiological interpretation skills are less than satisfactory in not only medical students, but also in residents and consultants. This study investigated the effectiveness of e-learning for the development of X-ray interpretation skills in pre-clinical medical students. Competencies in clinical X-Ray interpretation were assessed by comparison of pre- and post-intervention scores and one year follow up assessment, where the e-learning course was the 'intervention'. Our results demonstrate improved knowledge and skills in X-ray interpretation in students. Assessment of the post training students showed significantly higher scores than the scores of control group of students undertaking the same assessment at the same time. The development of the Internet and advances in multimedia technologies has paved the way for computer-assisted education. As more rural clinical schools are established the electronic delivery of radiology teaching through websites will become a necessity. The use of e-learning to deliver radiology tuition to medical students represents an exciting alternative and is an effective method of developing competency in radiological interpretation for medical students.

  13. How to Interpret Thyroid Biopsy Results: A Three-Year Retrospective Interventional Radiology Experience

    International Nuclear Information System (INIS)

    Oppenheimer, Jason D.; Kasuganti, Deepa; Nayar, Ritu; Chrisman, Howard B.; Lewandowski, Robert J.; Nemcek, Albert A.; Ryu, Robert K.

    2010-01-01

    Results of thyroid biopsy determine whether thyroid nodule resection is appropriate and the extent of thyroid surgery. At our institution we use 20/22-gauge core biopsy (CBx) in conjunction with fine-needle aspiration (FNA) to decrease the number of passes and improve adequacy. Occasionally, both ultrasound (US)-guided FNA and CBx yield unsatisfactory specimens. To justify clinical recommendations for these unsatisfactory thyroid biopsies, we compare rates of malignancy at surgical resection for unsatisfactory biopsy results against definitive biopsy results. We retrospectively reviewed a database of 1979 patients who had a total of 2677 FNA and 663 CBx performed by experienced interventional radiologists under US guidance from 2003 to 2006 at a tertiary-care academic center. In 451 patients who had surgery following biopsy, Fisher's exact test was used to compare surgical malignancy rates between unsatisfactory and malignant biopsy cohorts as well as between unsatisfactory and benign biopsy cohorts. We defined statistical significance at P = 0.05. We reported an overall unsatisfactory thyroid biopsy rate of 3.7% (100/2677). A statistically significant higher rate of surgically proven malignancies was found in malignant biopsy patients compared to unsatisfactory biopsy patients (P = 0.0001). The incidence of surgically proven malignancy in unsatisfactory biopsy patients was not significantly different from that in benign biopsy patients (P = 0.8625). In conclusion, an extremely low incidence of malignancy was associated with both benign and unsatisfactory thyroid biopsy results. The difference in incidence between these two groups was not statistically significant. Therefore, patients with unsatisfactory biopsy specimens can be reassured and counseled accordingly.

  14. 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

  15. 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

  16. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Thénint, Marie-Aude, E-mail: marie-aude.thenint@chru-strasbourg.fr; Rao, Pramod, E-mail: pramodrao@me.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

    2016-07-15

    ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  17. Occurrence of undesirable tissue reaction in interventional vascular radiology; La radiologie interventionnelle et les risques associes: etude d'un cas clinique

    Energy Technology Data Exchange (ETDEWEB)

    Thouveny, Francine [Service de radiologie, Centre Hospitalier Universitaire d' Angers, 4, rue Larrey, 49933 Angers Cedex 9 (France)

    2011-07-15

    After lengthy technological development, the constantly evolving diagnostic and therapeutic interventional radiology procedures have become vital factors in patient care. X-rays remain the key tool for these techniques in a large number of cases, including certain complex vascular pathologies for which endovascular treatment is associated with prolonged irradiation. The risk they represent are however outweighed by the underlying therapeutic stakes and remains of secondary medical concern. In these difficult cases, which require maximum concentration on the intervention, the practitioner will need to be aided by tools that strictly limit and monitor the dose. The manufacturers and radiological physicists must be involved in configuring the facilities used and the health professionals in determining reference levels and professional recommendations that take account of the dose optimisation tools. (authors)

  18. 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

  19. Percutaneous BioOrganic Sealing of Duodenal Fistulas: Case Report and Review of Biological Sealants with Potential Use in Interventional Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Wadhwa, Vibhor, E-mail: vwadhwa1@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Leeper, William R., E-mail: rob.leeper@jhmi.edu [Johns Hopkins University School of Medicine, Department of Surgery (United States); Tamrazi, Anobel, E-mail: atamraz1@jhmi.edu [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States)

    2015-08-15

    Biological sealants are being increasingly used in a variety of surgical specialties for their hemostatic and sealing capabilities. However, their use in interventional radiology has not been widely reported. The authors describe a case of duodenal perforation occurring after 15 years of gastric bypass surgery, in whom surgical diversion was unsuccessfully attempted and the leakage was successfully controlled using percutaneous administration of a combination of biological and organic sealants.

  20. 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.

  1. 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

  2. Hydraulic efficiency and safety of vascular and non-vascular components in Pinus pinaster leaves.

    Science.gov (United States)

    Charra-Vaskou, Katline; Badel, Eric; Burlett, Régis; Cochard, Hervé; Delzon, Sylvain; Mayr, Stefan

    2012-09-01

    Leaves, the distal section of the soil-plant-atmosphere continuum, exhibit the lowest water potentials in a plant. In contrast to angiosperm leaves, knowledge of the hydraulic architecture of conifer needles is scant. We investigated the hydraulic efficiency and safety of Pinus pinaster needles, comparing different techniques. The xylem hydraulic conductivity (k(s)) and embolism vulnerability (P(50)) of both needle and stem were measured using the cavitron technique. The conductance and vulnerability of whole needles were measured via rehydration kinetics, and Cryo-SEM and 3D X-ray microtomographic observations were used as reference tools to validate physical measurements. The needle xylem of P. pinaster had lower hydraulic efficiency (k(s) = 2.0 × 10(-4) m(2) MPa(-1) s(-1)) and safety (P(50) = - 1.5 MPa) than stem xylem (k(s) = 7.7 × 10(-4) m(2) MPa(-1) s(-1); P(50) = - 3.6 to - 3.2 MPa). P(50) of whole needles (both extra-vascular and vascular pathways) was - 0.5 MPa, suggesting that non-vascular tissues were more vulnerable than the xylem. During dehydration to - 3.5 MPa, collapse and embolism in xylem tracheids, and gap formation in surrounding tissues were observed. However, a discrepancy in hydraulic and acoustic results appeared compared with visualizations, arguing for greater caution with these techniques when applied to needles. Our results indicate that the most distal parts of the water transport pathway are limiting for hydraulics of P. pinaster. Needle tissues exhibit a low hydraulic efficiency and low hydraulic safety, but may also act to buffer short-term water deficits, thus preventing xylem embolism.

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

    International Nuclear Information System (INIS)

    Shaikh, M.; Shaygi, B.; Asadi, H.; Thanaratnam, P.; Pennycooke, K.; Mirza, M.; Lee, M.

    2016-01-01

    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.

  4. 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.

  5. Usefulness and Limitation of Manual Aspiration Immediately After Pneumothorax Complicating Interventional Radiological Procedures with the Transthoracic Approach

    International Nuclear Information System (INIS)

    Yamagami, Takuji; Kato, Takeharu; Hirota, Tatsuya; Yoshimatsu, Rika; Matsumoto, Tomohiro; Nishimura, Tsunehiko

    2006-01-01

    The goal of this study was to evaluate the efficacy of simple aspiration of air from the pleural space to prevent increased pneumothorax and avoid chest tube placement in cases of pneumothorax following interventional radiological procedures performed under computed tomography fluoroscopic guidance with the transthoracic percutaneous approach. While still on the scanner table, 102 cases underwent percutaneous manual aspiration of a moderate or large pneumothorax that had developed during mediastinal, lung, and transthoracic liver biopsies and ablations of lung and hepatic tumors (independent of symptoms). Air was aspirated from the pleural space by an 18- or 20-gauge intravenous catheter attached to a three-way stopcock and 20- or 50-mL syringe. We evaluated the management of each such case during and after manual aspiration. In 87 of the 102 patients (85.3%), the pneumothorax had resolved completely on follow-up chest radiographs without chest tube placement, but chest tube placement was required in 15 patients. Requirement of chest tube insertion significantly increased in parallel with the increased volume of aspirated air. When receiver-operating characteristic curves were applied retrospectively, the optimal cutoff level of aspirated air on which to base a decision to abandon manual aspiration alone and resort to chest tube placement was 670 mL. Percutaneous manual aspiration of the pneumothorax performed immediately after the procedure might prevent progressive pneumothorax and eliminate the need for chest tube placement. However, when the amount of aspirated air is large (such as more than 670 mL), chest tube placement should be considered

  6. Eye lens monitoring for interventional radiology personnel: dosemeters, calibration and practical aspects of Hp(3) monitoring. A 2015 review

    International Nuclear Information System (INIS)

    Carinou, Eleftheria; Ferrari, Paolo; Bjelac, Olivera Ciraj; Gingaume, Merce; Merce, Marta Sans; O’Connor, Una

    2015-01-01

    A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3). At present, several dosemeters are available for eye lens monitoring and calibration procedures are being developed. However, in practice, very often, alternative methods are used to assess the dose to the eye lens. A summary of correction factors found in the literature for the assessment of the eye lens dose is provided. These factors can give an estimation of the eye lens dose when alternative methods, such as the use of a whole body dosemeter, are used. A wide range of values is found, thus indicating the large uncertainty associated with these simplified methods. Reduction factors from most common protective devices obtained experimentally and using Monte Carlo calculations are presented. The paper concludes that the use of a dosemeter placed at collar level outside the lead apron can provide a useful first estimate of the eye lens exposure. However, for workplaces with estimated annual equivalent dose to the eye lens close to the dose limit, specific eye lens monitoring should be performed. Finally, training of the involved medical staff on the risks of ionising radiation for the eye lens and on the correct use of protective systems is strongly recommended. (review)

  7. 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.

  8. 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)

  9. 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

  10. 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

  11. Paediatric interventional radiology

    African Journals Online (AJOL)

    2016-06-29

    Jun 29, 2016 ... Non-operative management is the standard of care in children with blunt solid ... treatment of choice in children with extensive deep venous ... thrombosis. An IVC .... children, a paediatric nurse comfortable with administering.

  12. 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.)

  13. Eye lens dose estimation during interventional radiology and its impact on the existing radiation protection and safety program: in the context with new International Commission on Radiological Protection guidelines

    International Nuclear Information System (INIS)

    Chaudhari, Suresh

    2014-01-01

    Interventional radiology procedures are used for diagnosing certain medical conditions. The radiologists and medical professionals are exposed to ionizing radiation from X-rays of the equipments and also from scattered radiation during these procedures. The radiation exposure to the eye is more important to be assessed while performing such procedures. ICRP has revised the annual dose limit to the lens of the eye from 150 mSv to 20 mSv. In view of this revision, a study was carried out to evaluate the dose to the lens of the eye during interventional radiology. The paper gives the details of calibration of TLDs using a head phantom, predict annual equivalent dose and also highlight the dependence of dose on the position of TLD on the head. It is observed the predicted annual equivalent doses to the lens of eye are in the range of 25 mGy to 37 mGy. The selection of dosimeter placement may also result in an uncertainty of -14% to 20%. (author)

  14. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management.

    Science.gov (United States)

    Sadick, Maliha; Dally, Franz Josef; Schönberg, Stefan O; Stroszczynski, Christian; Wohlgemuth, Walter A

    2017-10-01

    Background  Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts. Method  Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies. Results  Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care. Conclusion  This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points   · Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat.. · There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies - there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients.. · Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management.. Citation Format · Sadick M, Dally FJ, Schönberg SO et al. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management. Fortschr Röntgenstr 2017; 189: 957 - 966. © Georg Thieme Verlag KG Stuttgart · New

  15. Extremity doses of medical staff involved in interventional radiology and cardiology: Correlations and annual doses (hands and legs)

    International Nuclear Information System (INIS)

    Krim, S.; Brodecki, M.; Carinou, E.; Donadille, L.; Jankowski, J.; Koukorava, C.; Dominiek, J.; Nikodemova, D.; Ruiz-Lopez, N.; Sans-Merce, M.; Struelens, L.; Vanhavere, F.

    2011-01-01

    An intensive measurement campaign was launched in different hospitals in Europe within work package 1 of the ORAMED project (Optimization of RAdiation protection for MEDical staff). Its main objective was to obtain a set of standardized data on extremity and eye lens doses for staff in interventional radiology (IR) and cardiology (IC) and to optimize staff protection. The monitored procedures were divided in three main categories: cardiac, general angiography and endoscopic retrograde cholangio-pancreatography(ERCP) procedures. Using a common measurement protocol, information such as the protective equipment used (lead table curtain, transparent lead glass ceiling screen, patient shielding, whole body shielding or special cabin etc.) as well as Kerma Area Product (KAP) values and access of the catheter were recorded. This study was performed with a final database of more than 1300 procedures performed in 34 European hospitals. Its objectives were firstly to determine if the measured extremity doses could be correlated to the KAP values; secondly to check if the doses to the eyes could be linked to the doses to the hands (finger or wrist positions) and finally if the doses to the fingers could be estimated based on the doses to the wrists. General correlations were very difficult to find and their strength was mostly influenced by three main parameters: the X-ray tube configuration, the room collective radioprotective equipment and the access of the catheter. The KAP value can provide a simple mean to estimate the extremity doses of the operator given that it is assessed correctly for the operator when he is actually using the X-ray tube. Moreover, this study showed that the doses to the left finger are strongly correlated to the doses to the left wrist when no ceiling shield is used. It is also possible to estimate the doses to the eyes given the doses to the left finger or left wrist but the X-ray tube configuration and the access have to be considered. The annual

  16. 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

  17. 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)

  18. 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

  19. Radiology today

    International Nuclear Information System (INIS)

    Donner, M.W.; Heuck, F.H.W.

    1981-01-01

    The book encompasses the proceedings of a postgraduate course held in Salzburg in June 1980. 230 radiologists from 17 countries discussed here the important and practical advances of diagnostic radiology, nuclear medicine and ultrasound as they contribute to gastrointestinal, urologic, skeletal, cardiovascular, pediatric, and neuroradiology. The book contains 55 single contributions of different authors to the following main themes: Cardiovascular, Radiology, pulmonary radiology, gastrointestinal radiology, urinary tract radiology, skeletal radiology, mammography, lymphography, ultrasound, ENT radiology, and neuroradiology. (orig./MG)

  20. Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study.

    Science.gov (United States)

    Napierala, Christoph; Boes, Stefan

    2017-02-28

    In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital. This is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods. Radiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (pDRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows.

  1. 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.)

  2. 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

  3. 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

  4. 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.)

  5. Materials management system in interventional radiology - initial experience with a computer-supported program; Materialverwaltung in der interventionellen Radiologie - erste Erfahrungen mit einem computergestuetzten Programm

    Energy Technology Data Exchange (ETDEWEB)

    Clevert, D.-A.; Reiser, M. [Universitaetsklinikum Muenchen (Germany). Institut fuer klinische Radiologie; Jung, E.M.; Rupp, N. [Institut fuer diagnostische Radiologie, Passau (Germany)

    2004-10-01

    Purpose: To perform a cost analysis for assessing options of reorganizing material supplies and reducing costs of the radiology division through the introduction of a materials management system. Materials and Methods: A materials management system (Piranha, Boston Scientific) was installed on an existing computer system. All consumables were inventoried and entered into the system. An ABC analysis determined further action. On the basis of order frequencies and availability requirements for emergencies, safety levels were agreed with physicians and other medical staff. Inventory costs were computed using these data. The interest rate for the capital tied up in the inventory was 8% per year. Results: The inventory showed that the capital tied up in stocks was Euro 260,000 and 2001 and Euro 190,000 in 2002. A change in supply strategy reduced inventory cost in 2001 and 2002. Annual interest expense was lowered by Euro 18,420. Another saving of Euro 2,700 was achieved by a reduction in storage cost. Annual inventory turnover totaled Euro 298,000. The total cost cut through improved inventory management was Euro 21,120 per year, which is equivalent to 7% of the annual expenses. Adding the decline in the cost of shelf time overruns equal to 5% of the annual expenses, the saving was approximately 12% of total interventional radiology cost in 2001 and some 11% in 2002. Conclusion: Flexible supply strategies and the introduction of a materials management program can help to reduce inventory costs in interventional radiology divisions without any impact on service levels. (orig.)

  6. A feasibility inquiry on the radiodermatitis secondary to an interventional radiology act;Une enquete de faisabilite sur les radiodermites secondaires a un geste de radiologie interventionnelle

    Energy Technology Data Exchange (ETDEWEB)

    Roudier, C.; Pirard, Ph.; Donadieu, J. [Institut de veille sanitaire, Saint-Maurice (France)

    2006-04-15

    The radiodermatitis is a burning of skin tissue and subcutaneous tissue in relation with ionizing radiation. In the medical practice, outside radiotherapy excluded of our study, it is observed only with acts of interventional radiology. The consequences of a radiodermatitis can be aesthetic, with appearance of a scar or a definitive alopecia, functional with loss of substance needing sometimes a remedial surgical act and finally oncologic with a risk of localised skin cancer. A radiodermatitis can appear with a radiation dose of 2 grays and its intensity worsens with the dose. Since the late 1970's about 200 cases of radiodermatitis have been reported. the most of cases have been reported between 1993 and 2000 and less than ten cases have been reported since 2000, suggesting a possible reduction of incidence explainable by a concomitant improvement of technological quality of the equipment. In order to confirm this eventual trend az feasibility study has been organised and is reported in this article. Given the results, this complication is still existing. In spite of the small number of observed cases, it is to notice that every procedures of interventional radiology are concerned. The preliminary character of this study encourages the institute of Health surveillance to work on the elaboration of a program of radiodermatitis surveillance. It could be associated to actions of improvement of the prevention and follow-up of patients, of feedback, and making easy an optimization of the practices. (N.C.)

  7. 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

  8. Dosimetric studies of the lens of the eye using a new dosimeter - polls in two departments of Interventional Radiology of the autonomous city of Buenos Aires

    International Nuclear Information System (INIS)

    Pirchio, R.; Sánchez, H.; Domazet, W

    2013-01-01

    During interventional radiology (IR) and cardiology (IC) procedures, medical staff can receive high doses to their eye lenses. The Retrospective Evaluation of Lens Injuries and Dose (RELID) study organized in Argentina in 2010 found incipient opacity in 50% of IC physicians and 41% of IC technicians/nurses. These results, added to the recommendations of the International Commission on Radiological Protection (ICRP), which lowered their former occupational equivalent dose limit for the lens, led us to assess the eye lens dose, Hp(3), during interventional procedures. To this end, a new dosemeter was designed and calibrated at the National Atomic Energy Commission (CNEA) of Argentina to evaluate Hp(3). Personal dose equivalent (Hp(10)), and Hp(3) were assessed for 3 months in two IC and IR departments of Buenos Aires City using thermoluminescent dosimeters (TLD) and electronic personal dosimeter (EPD). An Rando Alderson phantom was used to simulate monthly exposures of five occupational staff members. Hp(3) and Hp(10) were obtained monthly for 14 occupational staff members exposed to 121 IR and IC procedures. We concluded that the annual effective dose and Hp(3) were lower than 0.3 and 10 mSv, respectively. An occupational annual dose constraint of 0.3 mSv was calculated. Average cumulative Hp(3) for working life of 40 years should be lower than 400 and 200 mSv for physicians and technicians/scrub nurse, respectively. Also we concluded that a calibrated EPD worn on a pocket in the lead apron and a TLD dosemeter worn on the collar thyroid (both at the maximal radiation side) could be used as guidance to the lens dose. Finally, To reduce doses of medical staff, actions should be promoted to maximize radiation protection in interventional procedures with appropriate training, using personal dosimetry and protection instruments as lead glasses, ceiling-suspended shields and others. (author)

  9. Utilization of a modified Clavien Classification System in reporting complications after ultrasound-guided percutaneous nephrostomy tube placement: comparison to standard Society of Interventional Radiology practice guidelines.

    Science.gov (United States)

    Degirmenci, Tansu; Gunlusoy, Bulent; Kozacioglu, Zafer; Arslan, Murat; Ceylan, Yasin; Ors, Bumin; Minareci, Suleyman

    2013-06-01

    To report our results on percutaneous nephrostomy (PCN) and classify our complications with the Standard of Practice Committee of the Society of Interventional Radiology guidelines and the modified Clavien Classification System (CCS). Three hundred eighty-nine PCN insertions were performed in 322 patients (224 men and 98 women) at our institution. PCN insertion was performed under ultrasound for dilated pelvicalyceal system and ultrasound/fluoroscopy for nondilated system. PCN was considered successful if the catheter was drained urine spontaneously. Number of complications was registered. Primary successful PCN insertion was achieved in 368 of the 389 procedures (94.6%). The success rates for nondilated and dilated systems were 82.7% and 96.4%, respectively. Major complications occurred in 9.6% and minor complications in 9.9% according to the Society of Interventional Radiology. According to the modified CCS grades I, II, III, IV, and V was 9.9%, 1.2%, 6.8%, 1.2%, and 0.3%, respectively. Age, grade of the hydronephrosis, serum creatinine levels, and mean hemoglobin levels were statistically significant parameters for the occurrence of complications on univariate analysis. The nondilated system has statistically significant parameters affecting the complication rates on multivariate analysis (P = .001, odds ratio [OR] = 6.1, 95% confidence interval [CI] = 2-18.4). Percutaneous nephrostomy is a well-known procedure in the treatment of temporary or permanent drainage of an obstructed system. It is very important to define the complications related to interventions for interpretation of clinical comparisons more accurately. Modified CCS is a reproducible system to evaluate the complications. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

    Energy Technology Data Exchange (ETDEWEB)

    Kohlbrenner, R; Kolli, KP; Taylor, A; Kohi, M; Fidelman, N; LaBerge, J; Kerlan, R; Gould, R [University of California, San Francisco, San Francisco, CA (United States)

    2014-06-01

    Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treat HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav

  11. SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

    International Nuclear Information System (INIS)

    Kohlbrenner, R; Kolli, KP; Taylor, A; Kohi, M; Fidelman, N; LaBerge, J; Kerlan, R; Gould, R

    2014-01-01

    Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treat HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav

  12. Proposed method to calculate FRMAC intervention levels for the assessment of radiologically contaminated food and comparison of the proposed method to the U.S. FDA's method to calculate derived intervention levels

    Energy Technology Data Exchange (ETDEWEB)

    Kraus, Terrence D.; Hunt, Brian D.

    2014-02-01

    This report reviews the method recommended by the U.S. Food and Drug Administration for calculating Derived Intervention Levels (DILs) and identifies potential improvements to the DIL calculation method to support more accurate ingestion pathway analyses and protective action decisions. Further, this report proposes an alternate method for use by the Federal Emergency Radiological Assessment Center (FRMAC) to calculate FRMAC Intervention Levels (FILs). The default approach of the FRMAC during an emergency response is to use the FDA recommended methods. However, FRMAC recommends implementing the FIL method because we believe it to be more technically accurate. FRMAC will only implement the FIL method when approved by the FDA representative on the Federal Advisory Team for Environment, Food, and Health.

  13. Qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins; Qualifizierungsleitlinie der Deutschen Roentgengesellschaft (DRG) und der Deutschen Gesellschaft fuer Interventionelle Radiologie und minimalinvasive Therapie (DeGIR) zur Durchfuehrung interventionell-radiologischer minimalinvasiver Verfahren an Arterien und Venen

    Energy Technology Data Exchange (ETDEWEB)

    Buecker, A. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany); Gross-Fengels, W. [Asklepiosklinik, Hamburg-Harburg (Germany); Haage, P. [Helios-Kliniken, Wuppertal (Germany); Huppert, P. [Klinikum Darmstadt (Germany); Landwehr, P. [Henriettenstiftung, Hannover (Germany); Loose, R. [Klinikum Nuernberg-Nord (Germany); Reimer, P. [Klinikum Karlsruhe (Germany); Tacke, J. [Klinikum Passau (Germany); Vorwerk, D. [Klinikum Ingolstadt (Germany); Fischer, J.

    2012-06-15

    The topics covered in the qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins are the following: Practical qualification: aorta iliac vessels and vessels in the upper and lower extremities, kidney and visceral arteries, head and neck arteries, dialysis shunts, veins and pulmonary arteries, aorta aneurysms and peripheral artery aneurysms. Knowledge acquisition concerning radiation protection: legal fundamentals, education and training, knowledge actualization and quality control, definition of the user and the procedure, competence preservation.

  14. Effect of gamma rays on electrically evoked contractions of non-vascular smooth muscles (rat vas deferens)

    International Nuclear Information System (INIS)

    Azroony, R.; Ksies, F.; Alya, G.

    2002-10-01

    We have tried, in this experiment, to study the modifications of non-vascular smooth muscles contraction induced via gamma rays. Smooth muscular fibers were isolated from the vas deferens of an adult rat and contractions were electrically evoked. Our results show that irradiation activates the VOC (Voltage Operated Channel) type of ionic channels which causes an increasing in the inward flux of Ca 2+ and then causes an increasing in the inner calcium concentration [Ca 2] i, the matter which means an increasing in the force of muscular contraction. Concerning to the response of vas deferens smooth muscles to the activation of membrane receptors, we have tried to study the effects of gamma rays on activating adrenergic and cholinergic receptors, also, we have tried to show the effects of different doses of gamma rays (1, 3, 5, 7 Gy) on regulating the contractile response of this type of smooth muscles. And results show that: - Irradiation increases contraction force, mediated by adrenergic and cholinergic receptors, in a dose dependent manner, with E m ax 1 Gy m axc 3 Gy m ax 5 Gy m ax 7 Gy. There is an important shift on irradiated rats (3, 5, 7 Gy) where the maximum effect of Acetylcholine (E m ax) can be obtained in lower concentrations of Acetylcholine. These results mean that irradiation activates the inward flux of Ca 2+ through the ROC (Receptors Operated Channels) type of ionic channels, which rely, in their activation, on activating the membrane receptors. By comparing these results with the effects of gamma rays on activating vascular adrenergic and cholinergic receptors, we concluded that: Non-vascular smooth muscles (vas deferens) are less sensitive to irradiation in comparing with vascular smooth muscles (venae portal hepatica), and irradiation increases the sensitivity of cholinergic receptors to acetylcholine in the smooth muscular fibers of vas deferens while; if decreases this sensitivity in the smooth muscular fibers of venae portal hepatica

  15. Effective dose estimation from the Hp(10) value measured by film OR TL dosemeter located above the lead apron in medical diagnostic and intervention radiology

    International Nuclear Information System (INIS)

    Trousil, J.; Plichta, J.; Petrova, K.

    2001-01-01

    In medical institutions where the diagnostic and intervention radiology is examined the staff personnel doses reach for a long time the annual limit. State Office for Radiation Safety ordered the research task with a view to: (a) the influence of the dosemeter location on different parts of the body on the reliability of E value estimation by means of the value which is measured on the standard body location - left part of the chest above the lead apron. (b) the influence of the protective lead apron (neck, spectacles) with known lead equivalent on the E and H T value determination. In this contribution we present the results of this experimental study including the recommendation for the number and location on the body of dosemeters which are needed for the reliable estimation of E value. (authors)

  16. 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.)

  17. Proposals for the type tests criteria and calibration conditions of passive eye lens dosemeters to be used in interventional cardiology and radiology workplaces

    International Nuclear Information System (INIS)

    Bordy, J.M.; Daures, J.; Denozière, M.; Gualdrini, G.; Ginjaume, M.; Carinou, E.; Vanhavere, F.

    2011-01-01

    The paper is aimed at making a proposal for the type test and calibration of eye lens passive dosemeters especially used in the interventional cardiology/radiology (IC/IR). Starting from the only existing standard dealing with eye lens dosimetry using TLDs (), parameters such as, detection threshold, energy and angle dependence of response criteria have been reviewed and it has been tried to harmonise them as much as possible with the IEC 62387 requirements, taking into account the particular use at IC/IR workplaces. Conversion coefficients from air kerma to dose equivalent at 3 mm depth for RQR and ISO radiation qualities, employed for type test and calibration purposes, have been calculated in a new phantom introduced within the ORAMED (Optimization of RAdiation protection for MEDical staff) project. This phantom is more representative of the head so that the estimation of H lens by H p (3) is more accurate.

  18. More attention on the application of interventional radiology in patients with severe symptoms of advanced malignant tumor

    International Nuclear Information System (INIS)

    Mao Aiwu; Cheng Yongde

    2007-01-01

    Along with the development of medical science and the improvement of interventional medical products, the clinical experience and operational skills of relevant interventional physicans, the interventional techniques have broken through the traditional limitation and being used more and more often and widely in the patients of advanced malignant tumor and played an important role; including intraarterial chemotherapy, perfusion, nerve block and percutaneous vertebroplasty for suppressing pain; stent placement for esophageal, tracheal, intestinal strictures and fistula; percutaneous centesis for hydrocele, etc. Taking this profit, for further extension of interventional diagnosis and treatment in late-stage cancer patients outcomes with a positive role in prolonging life span and improving the life qualities while they are alive. (authors)

  19. [Controlling instruments in radiology].

    Science.gov (United States)

    Maurer, M

    2013-10-01

    Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

  20. Radiology. 3. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Reiser, Maximilian; Kuhn, Fritz-Peter; Debus, Juergen

    2011-01-01

    The text book on radiology covers the following issues: Part A: General radiology: Fundamental physics: radiation biology; radiation protection fundamentals: radiologic methods; radiotherapy; nuclear medicine. Part B: Special radiology: Thorax; heart; urogenital tract and retroperitoneum; vascular system and interventional radiology; esophagus, stomach, small and large intestines; liver, biliary system, pancreas and spleen; mammary glands; central nervous system; spinal cord and spinal canal; basis of the skull, facial bones and eye socket; neck; pediatric imaging diagnostics.

  1. Radiology. 3. rev. and enl. ed.; Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Reiser, Maximilian [Klinikum der Universitaet Muenchen (Germany). Inst. fuer Klinische Radiologie; Kuhn, Fritz-Peter [Klinikum Kassel (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Debus, Juergen [Radiologische Universitaetsklinik, Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie

    2011-07-01

    The text book on radiology covers the following issues: Part A: General radiology: Fundamental physics: radiation biology; radiation protection fundamentals: radiologic methods; radiotherapy; nuclear medicine. Part B: Special radiology: Thorax; heart; urogenital tract and retroperitoneum; vascular system and interventional radiology; esophagus, stomach, small and large intestines; liver, biliary system, pancreas and spleen; mammary glands; central nervous system; spinal cord and spinal canal; basis of the skull, facial bones and eye socket; neck; pediatric imaging diagnostics.

  2. Generic intervention levels for protecting the public in the event of a nuclear accident or radiological emergency

    International Nuclear Information System (INIS)

    1993-04-01

    Many international organizations are in the process of developing common safety standards for protection against ionizing radiation and for the safety of radiation sources. This document is intended to provide input to the final specification of intervention levels, at which actions of various kinds to protect members oft the public after an accident are advised. It provides the radiation protection principles underlying such intervention levels and proposes numerical values for these levels based on an analysis of some of the more directly quantifiable factors involved. Factors such as social disruption, psychological factors and political considerations are discussed, but are explicitly excluded from the derivation. Refs, figs and tabs

  3. 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