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

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.)

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.

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

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.

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.

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.

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

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

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

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)

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.

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

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.

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.)

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.)

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.

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.

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.

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

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.

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

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.

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 ...

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.

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...

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.

[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.

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)

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.

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

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)

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)

Imaging and interventions in hilar cholangiocarcinoma: A review

Science.gov (United States)

Madhusudhan, Kumble Seetharama; Gamanagatti, Shivanand; Gupta, Arun Kumar

2015-01-01

Hilar cholangiocarcinoma is a common malignant tumor of the biliary tree. It has poor prognosis with very low 5-year survival rates. Various imaging modalities are available for detection and staging of the hilar cholangiocarcinoma. Although ultrasonography is the initial investigation of choice, imaging with contrast enhanced computed tomography scan or magnetic resonance imaging is needed prior to management. Surgery is curative wherever possible. Radiological interventions play a role in operable patients in the form of biliary drainage and/or portal vein embolization. In inoperable cases, palliative interventions include biliary drainage, biliary stenting and intra-biliary palliative treatment techniques. Complete knowledge of application of various imaging modalities available and about the possible radiological interventions is important for a radiologist to play a critical role in appropriate management of such patients.We review the various imaging techniques and appearances of hilar cholangiocarcinoma and the possible radiological interventions. PMID:25729485

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

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.

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

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

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.

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

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.

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.

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

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.

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

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

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)

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

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

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.

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)

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

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.

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).

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

Evaluation of use of e-Learning in undergraduate radiology education: a review.

Science.gov (United States)

Zafar, Saad; Safdar, Saima; Zafar, Aasma N

2014-12-01

The aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level. Four databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies. The results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of customized tools according to learner needs assessment in radiology education at undergraduate level. All these initiatives are leading toward highly interactive self directed learning environments to support the idea of life-long independent learners. Moreover, majority of the studies in literature regarding e-Learning in radiology at undergraduate level are based on participant satisfaction followed by participant results or outcomes either before or after an intervention or both. There was no research particularly demonstrating performance change in clinical practice or patient outcome as they may be difficult to measure in medical education. Thus clinical competences and performances are

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.

FDH radiological design review guidelines

International Nuclear Information System (INIS)

Millsap, W.J.

1998-01-01

These guidelines discuss in more detail the radiological design review process used by the Project Hanford Management Contractors as described in HNF-PRO-1622, Radiological Design Review Process. They are intended to supplement the procedure by providing background information on the design review process and providing a ready source of information to design reviewers. The guidelines are not intended to contain all the information in the procedure, but at points, in order to maintain continuity, they contain some of the same information

FDH radiological design review guidelines

Energy Technology Data Exchange (ETDEWEB)

Millsap, W.J.

1998-09-29

These guidelines discuss in more detail the radiological design review process used by the Project Hanford Management Contractors as described in HNF-PRO-1622, Radiological Design Review Process. They are intended to supplement the procedure by providing background information on the design review process and providing a ready source of information to design reviewers. The guidelines are not intended to contain all the information in the procedure, but at points, in order to maintain continuity, they contain some of the same information.

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.

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

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)

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)

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

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.

Radiological review of accident and emergency radiographs: A 1-year audit

International Nuclear Information System (INIS)

Williams, Stuart M.; Connelly, Daniel J.; Wadsworth, Susan; Wilson, David

2000-01-01

AIM: To assess the impact and cost effectiveness of a system of radiological review of accident and emergency (A and E) plain films. MATERIALS AND METHODS: Review documentation was studied retrospectively over a 1-year period. Six hundred and eighty-four actual or suspected errors in the initial radiological interpretation by A and E staff were highlighted by radiologists in training. These selected 'red reports' were then further reviewed by a musculoskeletal radiologist and a more senior member of the A and E team. RESULTS: Three hundred and fifty-one missed or strongly suspected fractures were detected, with ankle, finger and elbow lesions predominating. Other errors included 11 missed chest radiograph abnormalities and 24 A and E false-positives. Radiologists in training tended to over-report abnormalities with an 18% false-positive rate when compared to the subsequent musculoskeletal radiology opinion. Following review, further action was taken by A and E staff in 286 (42.6%) of cases. No operative intervention was required in those patients with a delayed or missed A and E diagnosis. Consideration is given to the cost of providing this form of review and the impact of medico-legal factors. CONCLUSION: Compared with the large numbers of patients seen and radiographed in a busy A and E department, the number of radiological errors was small. There were even fewer changes in management. Despite this, concern over litigation, clinical governance and future work patterns in A and E make this form of review a useful means of risk reduction in a teaching hospital. Williams, S.M. (2000). Clinical Radiology 55, 861-865

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

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)

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.)

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)

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.

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.

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.

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

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.

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

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.)

Evaluation of use of e-Learning in undergraduate radiology education: A review

Energy Technology Data Exchange (ETDEWEB)

Zafar, Saad, E-mail: saad.zafar@riphah.edu.pk [Riphah International University, Islamabad (Pakistan); Safdar, Saima, E-mail: saima.safdar@riphah.edu.pk [Riphah International University, Islamabad (Pakistan); Zafar, Aasma N., E-mail: aasmarad@gmail.com [Radiology Department, Senior Registrar Shifa College of Medicine and Assistant Consultant Shifa International Hospital, Islamabad (Pakistan)

2014-12-15

Highlights: • We have systematically reviewed the literature on use of e-Learning in Radiology at the undergraduate level. • Kirkpatrick's Learning Model is used to evaluate the learning outcomes of the reported studies. • There is an increase in positive response for learning management systems used in blended learning environments. • There are wide range of technologies being used for e-Learning including use of audio response system and customized PAC solutions. • There is a clear trend toward highly interactive, self directed learning environment to support the concept of life long independent learners. - Abstract: Purpose: The aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level. Materials and methods: Four databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies. Results: The results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of

Evaluation of use of e-Learning in undergraduate radiology education: A review

International Nuclear Information System (INIS)

Zafar, Saad; Safdar, Saima; Zafar, Aasma N.

2014-01-01

Highlights: • We have systematically reviewed the literature on use of e-Learning in Radiology at the undergraduate level. • Kirkpatrick's Learning Model is used to evaluate the learning outcomes of the reported studies. • There is an increase in positive response for learning management systems used in blended learning environments. • There are wide range of technologies being used for e-Learning including use of audio response system and customized PAC solutions. • There is a clear trend toward highly interactive, self directed learning environment to support the concept of life long independent learners. - Abstract: Purpose: The aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level. Materials and methods: Four databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies. Results: The results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of

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

Radiology research in mainland China in the past 10 years: a survey of original articles published in Radiology and European Radiology.

Science.gov (United States)

Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Schoepf, U Joseph; Xu, Jiaqian; Lu, Guang Ming; Li, Enzhong

2017-10-01

To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. • Radiology research in Mainland China saw a substantial increase. • Neuroradiology, vascular/interventional Radiology, and abdominal Radiology are the most productive fields. • MRI is the most used modality in Mainland China's Radiology research. • Guangdong, Shanghai, and Beijing are the most productive provinces.

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)

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...

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

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)

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

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)

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

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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.

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

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)

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)

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

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.

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.

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

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.)

Radiology research in mainland China in the past 10 years: a survey of original articles published in Radiology and European Radiology

International Nuclear Information System (INIS)

Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Lu, Guang Ming; Schoepf, U.J.; Xu, Jiaqian; Li, Enzhong

2017-01-01

To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P < 0.001). Within Mainland China's Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. (orig.)

Radiology research in mainland China in the past 10 years: a survey of original articles published in Radiology and European Radiology

Energy Technology Data Exchange (ETDEWEB)

Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Lu, Guang Ming [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Schoepf, U.J. [Medical School of Nanjing University, Department of Medical Imaging, Jinling Hospital, Nanjing, Jiangsu (China); Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Xu, Jiaqian [Medical University of South Carolina, Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Charleston, SC (United States); Li, Enzhong [National Natural Science Foundation of China, Department of Medical Science, Beijing (China)

2017-10-15

To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P < 0.001). Within Mainland China's Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. (orig.)

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

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

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.

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.

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

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.

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

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)

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)

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.

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.

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)

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

[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.

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

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

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)

Radiologic image compression -- A review

International Nuclear Information System (INIS)

Wong, S.; Huang, H.K.; Zaremba, L.; Gooden, D.

1995-01-01

The objective of radiologic image compression is to reduce the data volume of and to achieve a lot bit rate in the digital representation of radiologic images without perceived loss of image quality. However, the demand for transmission bandwidth and storage space in the digital radiology environment, especially picture archiving and communication systems (PACS) and teleradiology, and the proliferating use of various imaging modalities, such as magnetic resonance imaging, computed tomography, ultrasonography, nuclear medicine, computed radiography, and digital subtraction angiography, continue to outstrip the capabilities of existing technologies. The availability of lossy coding techniques for clinical diagnoses further implicates many complex legal and regulatory issues. This paper reviews the recent progress of lossless and lossy radiologic image compression and presents the legal challenges of using lossy compression of medical records. To do so, the authors first describe the fundamental concepts of radiologic imaging and digitization. Then, the authors examine current compression technology in the field of medical imaging and discuss important regulatory policies and legal questions facing the use of compression in this field. The authors conclude with a summary of future challenges and research directions. 170 refs

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.)

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.)

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

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

Solutions in radiology services management: a literature review.

Science.gov (United States)

Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

2015-01-01

The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. In the databases, 565 papers - 120 out of them, pdf free - were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

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)

Criteria and actions facing a radiological environmental contamination

International Nuclear Information System (INIS)

Gutierrez, Jose; Montero, Milagros

2008-01-01

An approach to improve the management of the radiological risk due to an environmental contamination is presented. The experience gained in emergency response has clearly demonstrated the importance to have an efficient emergency system including planning, procedures and operational internally consistent criteria. The lack of these components in the emergency system could lead to important radiological and non radiological consequences. The setting of internationally agreed criteria and guides is very important in the anticipated emergency response plan. The paper firstly reviews the approaches proposed by international recommendations and norms. From this review, a substantial coincidence on the basic principles is stated, in spite of small differences in its formulation. Also, a need for harmonization is endorsed. So, generic levels, in terms of imparted dose or avoided dose due to intervention, and, in some cases, derived levels, in terms of activity concentration, are proposed. Numerical values for emergency actions are also identified. The second part deals with the adaptation of the existing prediction and decision systems to the above radiological criteria. Relations among deposition, activity concentrations and annual doses for different scenarios, exposure pathways and age groups are established. Also, the sensibility of the radiological impact against different characteristics of the intervention scenarios is stated. This makes easy to assess the radiological significance of different contamination situations by comparison to the existing action generic levels. Furthermore, the radiological impact can be numerically incorporated in a decision system which includes non radiological aspects of the applicable intervention options. Agricultural, urban and mixed scenarios are presented and solved for a 137 Cs contamination. The results can be further used to develop a methodology guide for setting action generic levels in post-accidental interventions and

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)

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.

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

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.)

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

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.

Natural Language Processing in Radiology: A Systematic Review.

Science.gov (United States)

Pons, Ewoud; Braun, Loes M M; Hunink, M G Myriam; Kors, Jan A

2016-05-01

Radiological reporting has generated large quantities of digital content within the electronic health record, which is potentially a valuable source of information for improving clinical care and supporting research. Although radiology reports are stored for communication and documentation of diagnostic imaging, harnessing their potential requires efficient and automated information extraction: they exist mainly as free-text clinical narrative, from which it is a major challenge to obtain structured data. Natural language processing (NLP) provides techniques that aid the conversion of text into a structured representation, and thus enables computers to derive meaning from human (ie, natural language) input. Used on radiology reports, NLP techniques enable automatic identification and extraction of information. By exploring the various purposes for their use, this review examines how radiology benefits from NLP. A systematic literature search identified 67 relevant publications describing NLP methods that support practical applications in radiology. This review takes a close look at the individual studies in terms of tasks (ie, the extracted information), the NLP methodology and tools used, and their application purpose and performance results. Additionally, limitations, future challenges, and requirements for advancing NLP in radiology will be discussed. (©) RSNA, 2016 Online supplemental material is available for this article.

Solutions in radiology services management: a literature review

Directory of Open Access Journals (Sweden)

Aline Garcia Pereira

2015-10-01

Full Text Available AbstractObjective:The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services.Materials and Methods:Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares.Results:In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others.Conclusion:Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

Solutions in radiology services management: a literature review*

Science.gov (United States)

Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

2015-01-01

Objective The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Materials and Methods Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. Results In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Conclusion Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies. PMID:26543281

Ethical Issues in Radiology Journalism, Peer Review, and Research.

Science.gov (United States)

Katz, Douglas S; Gardner, James B; Hoffmann, Jason C; Patlas, Michael N; Bhargava, Puneet; Moshiri, Mariam; Remer, Erick M; Gould, Elaine S; Smith, Stacy

2016-08-17

Although some research and publication practices are clearly unethical, including fraud and plagiarism, other areas of research and publication, such as informed consent and conflicts of interest, fall into grayer areas. The purposes of this article are, therefore, to review a variety of relevant ethical issues in radiology-related journalism, peer review, and research; to review the radiology literature to date that has addressed these issues; and to present position statements and potential solutions to these problems.

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

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.

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.

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.

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

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.)

Concierge and Second-Opinion Radiology: Review of Current Practices.

Science.gov (United States)

Shaikh, Shehbaz; Bafana, Rounak; Halabi, Safwan S

2016-01-01

Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices. Copyright © 2015 Mosby, Inc. All rights reserved.

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

Microcephaly: a radiological review

Energy Technology Data Exchange (ETDEWEB)

Tarrant, Ailbhe; Garel, Catherine; Germanaud, David; Lenoir, Marion; Pointe, Hubert Ducou le [Universite Paris VI Pierre et Marie Curie, Radiology Department, Hopital d' Enfants Armand-Trousseau, Paris (France); Villemeur, Thierry Billette de; Mignot, Cyril [Universite Paris V Rene Descartes, CNRS (UMR 8104), Inserm, U567, Institut Cochin, Paris (France); Universite Paris VI Pierre et Marie Curie, Paediatric Neurology Department, Hopital d' Enfants Armand-Trousseau, Paris (France)

2009-08-15

Microcephaly results from inadequate brain growth during development. It may develop in utero, and therefore be present at birth, or may develop later as a result of perinatal events or postnatal conditions. The aetiology of microcephaly may be congenital (secondary to cerebral malformations or metabolic abnormalities) or acquired, most frequently following an ischaemic insult. This distinct radiological and pathological entity is reviewed with a specific focus on aetiology. (orig.)

Non-accidental injury: a review of the radiology

International Nuclear Information System (INIS)

Carty, H.

1997-01-01

There have been many descriptions of the radiological features of non-accidental injury since John Caffey introduced the concept of inflicted injury and initially described some of the patterns of injury. Since then, our understanding of the radiologically detectable injuries has increased. This article provides a review of our current understanding of the lesions. (orig.)

Review at Bikini Atoll. Assessing radiological conditions at Bikini Atoll and the prospects for resettlement

International Nuclear Information System (INIS)

Stegnar, P.

1998-01-01

Some testing during the development of the atomic bomb was done in countries that do not have the infrastructure and expertise for evaluating any associated radiation risks. In such cases, outside expertise is needed to obtain independent advice about the radiological situation caused by residual radioactive material from nuclear testing. The IAEA has been requested by the governments of a number of its Member States to provide assistance in this context. Among the former nuclear test sites which the IAEA has reviewed is the Bikini Atoll of the Marshall Islands. Based on its review, the IAEA Advisory Group determined that no further corroboration of the measurements and assessments of the radiological conditions at Bikini Atoll is necessary. The data that have been collected are of sufficient quality to allow an appropriate evaluation to be performed. The limited IAEA monitoring of the area provided a good quality assurance verification of the previously collected data. It was recommended that Bikini Island should not be permanently resettled under the present radiological conditions. This recommendation was based on the assumption that persons resettling on the island would consume a diet of entirely locally produced food. The radiological data support that if a diet of this type were permitted, it could lead to an annual effective dose of about 15 mSv. This level was judged to require intervention of some type for radiation protection purposes

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)

A review of selected derived intervention levels for Hong Kong

International Nuclear Information System (INIS)

Tang, S.L.; Tso, M.Y.W.; Leung, J.K.C.

1993-01-01

A review on the computation of derived intervention levels (DILs) for the internal pathways of exposure namely inhalation of plume and of resuspended radionuclides and ingestion of contaminated food and water is provided. The main parameters which depend on individual metabolism and habit (i.e., inhalation rate and food consumption pattern) of local population are revised. The DILs so calculated are very different from those based on parameters adopted by the Radiological Protection Advisory Group (RPAG) of the Hong Kong Government. Thus it is worthwhile to have an intensive review on the DILs based on more realistic local parameters. (6 tabs.)

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.)

Review of IAEA documentation on Nuclear and radiological emergency

International Nuclear Information System (INIS)

Mukhono, P. M.

2014-10-01

The project focuses on the review of IAEA documentation on nuclear or radiological emergencies with main focus on methodology for developing and arrangement for nuclear and radiological emergencies. The main objective of this work is to identify limitations in IAEA documentation on emergency preparedness and response (EPR) and provide recommendation on the main actions needed to fill the gaps identified thus aiding in improvement of emergency preparedness and response to nuclear and radiological accidents. The review of IAEA documentation on nuclear and radiological emergency has been carried out by evaluating various emergency response elements. Several elements for EPR were highlighted covering the safety fundamentals, general safety requirements and EPR methods for development of an effective emergence response capability for nuclear or radiological emergencies. From these issues, the limitations of IAEA documentation on EPR were drawn and recommendations suggested as a means of improving EPR methods. Among them was the need for IAEA consider establishment of follow up and inspection programmes to facilitate implementation of EPR requirements in most developing countries, establishment of programmes that provide platforms for the countries to be motivated to update their system in line with the current status of emergency preparedness, review of the international information exchange aspects of nuclear emergencies in order to improve capabilities to communicate reliable data, information and decisions quickly and effectively among national authorities and their emergency and emergency response centres. (au)

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.

A Systematic Review of Fatigue in Radiology: Is It a Problem?

Science.gov (United States)

Stec, Nadia; Arje, Danielle; Moody, Alan R; Krupinski, Elizabeth A; Tyrrell, Pascal N

2018-04-01

The purpose of this study was to review current literature regarding radiologist fatigue. A literature search was performed using PubMed. Key words and Medical Subject Heading terms were used to generate refined queries with inclusion and exclusion criteria, focusing on fatigue and error. Results were selected according to these criteria: examined radiologist fatigue and radiologic error stemming from fatigue; experimental results measured as accuracy, error, or performance; and peer-reviewed publication. The risk of bias was addressed by including both quantitative and qualitative studies. Twenty-seven articles were included, mainly primary research articles. Common outcome measures included subjective self-reports and tests to measure eyestrain. Reaction time was also recorded, accounting for variables such as age and experience. One group recommended that guidelines should be implemented regarding number of hours worked. Most recommended ergonomic interventions, proposing the implementation of tools to measure and standardize fatigue and optimize workflow, in conjunction with considering radiologists individually. Education in appropriate viewing habits and breaks were also suggested. Only one study with seven participants recommended that radiologists should sleep well to improve their performance and overall well-being, despite the undeniable evidence that radiologists are fatigued. Fatigue is present in radiology and affects diagnostic accuracy.

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)

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.)

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.

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

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

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.

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

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

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

Peer Review in Radiology: A Resident and Fellow Perspective.

Science.gov (United States)

Grenville, Jeffrey; Doucette-Preville, David; Vlachou, Paraskevi A; Mnatzakanian, Gevork N; Raikhlin, Antony; Colak, Errol

2016-02-01

The purpose of this study was to explore Canadian radiology residents' and fellows' understanding, attitudes, opinions, and preferences toward peer review. An Internet-based anonymous questionnaire designed to understand one's familiarity, attitudes, opinions, and preferences toward peer review was distributed to radiology residents and fellows across Canada. Data were analyzed using descriptive statistics, and answers were stratified by level of training. A total of 136 trainees responded to the survey with 92 completed survey responses available for descriptive statistics. Approximately half of respondents are familiar with peer review (49%), and 39% of trainees are involved in peer review. Most respondents (92%) expressed an interest in learning more about peer review; believe that it should be incorporated into the residency training curriculum (86%), be mandatory (72%), and that current participation will increase odds of future participation (91%). Most trainees (80%) are comfortable advising one another about errors, but less comfortable advising staff (21%). Residents and fellows welcome the opportunity to learn more about peer review and believe it should be incorporated into the residency training curriculum. Understanding the attitudes and perceptions held by trainees regarding peer review is important, as a means to optimize education and maximize current and future participation in peer review. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

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.

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.

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.

Endovascular interventional magnetic resonance imaging

International Nuclear Information System (INIS)

Bartels, L W; Bakker, C J G

2003-01-01

Minimally invasive interventional radiological procedures, such as balloon angioplasty, stent placement or coiling of aneurysms, play an increasingly important role in the treatment of patients suffering from vascular disease. The non-destructive nature of magnetic resonance imaging (MRI), its ability to combine the acquisition of high quality anatomical images and functional information, such as blood flow velocities, perfusion and diffusion, together with its inherent three dimensionality and tomographic imaging capacities, have been advocated as advantages of using the MRI technique for guidance of endovascular radiological interventions. Within this light, endovascular interventional MRI has emerged as an interesting and promising new branch of interventional radiology. In this review article, the authors will give an overview of the most important issues related to this field. In this context, we will focus on the prerequisites for endovascular interventional MRI to come to maturity. In particular, the various approaches for device tracking that were proposed will be discussed and categorized. Furthermore, dedicated MRI systems, safety and compatibility issues and promising applications that could become clinical practice in the future will be discussed. (topical review)

Radiology responsibilities post NPSA guidelines for nasogastric tube insertion: A single centre review

International Nuclear Information System (INIS)

Snaith, Beverly; Flintham, Kevin

2015-01-01

Background: There are well-recognised complications associated with malposition of nasogastric (NG) tubes. In 2011 the UK National Patient Safety Agency (NPSA) published an alert regarding their insertion and position confirmation. This alert also identified the expected radiology standards for both image acquisition and reporting. Method: This was a retrospective review of referrals over a six-month period within a multi-site NHS Trust. A consecutive sampling approach was used and radiology reports where the text included the terms “NG tube”, “nasogastric” or “feeding” were included. Data were collected from the radiology information system and NG tube visibility and image quality were confirmed by two independent reviewers. Results: 1137 examinations demonstrated an NG tube, of which 68.3% were performed to check tube position. There was statistically significant correlation between lower radiation exposure and non-visualisation (Fishers exact test, p < 0.001). The number of examinations with higher exposure index (EI) in the NG check cohort suggests that the radiographer increased the exposure to improve visualization (x 2  = 2.846; 95% CI; p = 0.046), although the utility of this is unproven. Malplaced tubes were demonstrated either in the respiratory tract (1.8%) or proximal gastrointestinal tract (8.6%) as a result of insufficient length introduced. Conclusion: The prompt acquisition and reporting of radiographs is essential to reduce the risk of NG tube complications. Respiratory tract misplacement rates were in line with the published literature, but this study does raise concern regarding the number of tubes located in the proximal GI tract. Radiology's responsibility in accurate and effective reporting of medical interventions is significant

Rapidly Progressive Osteoarthritis: a Review of the Clinical and Radiologic Presentation.

Science.gov (United States)

Flemming, Donald J; Gustas-French, Cristy N

2017-07-01

The purpose of this paper is to review the distinct clinical and radiographic features that may lead to prompt diagnosis of rapidly progressive osteoarthritis (RPOA) and thus obviate unnecessary and costly diagnostic workup. RPOA is uncommon but is more frequently seen in practice because of the aging population. RPOA is a destructive arthropathy that occurs most commonly in elderly women but can also be seen in patients that have sustained trauma. The dramatic radiologic manifestations of RPOA can lead to diagnostic confusion with other arthropathies, infection, and osteonecrosis. RPOA was originally described in the hip but may also involve the shoulder. The etiology of RPOA is not well understood, but subchondral fracture probably plays a role in the development of dramatic destruction of the joint that is seen in affected patients. Early diagnosis may reduce the complexity of surgical management. RPOA is an uncommon condition that occurs most frequently in elderly woman or in patients who have sustained trauma. Prompt recognition of the clinical and radiologic features of this arthropathy can reduce unnecessary diagnostic workup and complexity of surgical intervention.

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)

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 ...

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)

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

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)

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.

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.

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.

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

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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.

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.

Paediatric Interventional Uroradiology

International Nuclear Information System (INIS)

Barnacle, Alex M.; Wilkinson, A. Graham; Roebuck, Derek J.

2011-01-01

Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

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.

Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

Science.gov (United States)

Sanders, Vicki L; Flanagan, Jennifer

2015-01-01

The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

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

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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.

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)

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.

Biological effects and radiation protection in veterinary radiology: a literature review

International Nuclear Information System (INIS)

Rosa, P.C.; Siqueira, D.; Barros, F.S.

2017-01-01

Veterinary radiology is a tool of excellent diagnostic support. Besides X--ray, it counts on technological advances such as computed tomography, nuclear medicine and interventional radiology . It is common during X-ray practice to use exposure parameters with short times to avoid blurring by the movement of the animal, but the fact that the animals need to be immobilized during the exposures contribute significantly with the increase of the dose received by the professionals, whose biological risks are not yet well established as a result of exposure to other factors harmful to health, such as anesthetic gases, insecticides, zoonoses and others. For this reason, we sought to verify the main radiological risks to which veterinarians are exposed and the best means to guarantee radiological protection

Data analysis and review of radiology services at Glasgow 2014 Commonwealth Games

International Nuclear Information System (INIS)

Bethapudi, Sarath; Ritchie, David; Bongale, Santosh; Gordon, Jonny; MacLean, John; Mendl, Liz

2015-01-01

Medical services at the Glasgow 2014 Commonwealth Games (CWG) were provided though a purpose-built medical polyclinic, which had a fully equipped radiology department along with other services, set up within the main Games Village. Data analysis of radiology services offered at CWG has not been published before. Imaging services within the polyclinic, Athletes Village, Glasgow 2014 CWG. The aim of the paper is to analyse data on radiological investigations and assess the demand and distribution of workload on imaging services at CWG 2014. Data on radiology investigations at the CWG 2014 was retrieved from the Carestream picture archiving and communication system (PACS) and Pharmasys (CWG official centralised electronic database system) and analysed. Six hundred ninety-seven diagnostic and interventional procedures were performed. Of these 37.9 % were magnetic resonance imaging (MRI) scans, 22 % were diagnostic ultrasound (US) examinations, 33.1 % were radiographs, 4.3 % were computed tomography (CT) scans and 2.7 % were imaging-guided interventional procedures. 88 % of imaging was performed on athletes and the remainder were performed on team officials and workforce. Demand on radiology services gradually picked up through the pre-competition period and peaked half way through the CWG. Radiology played a vital role in the successful provision of medical services at the Glasgow 2014 CWG. High demand on imaging services can be expected at major international sporting events and therefore pre-event planning is vital. Having back-up facilities in case of technical failure should be given due importance when planning radiology services at future CWG events. (orig.)

Data analysis and review of radiology services at Glasgow 2014 Commonwealth Games.

Science.gov (United States)

Bethapudi, Sarath; Ritchie, David; Bongale, Santosh; Gordon, Jonny; MacLean, John; Mendl, Liz

2015-10-01

Medical services at the Glasgow 2014 Commonwealth Games (CWG) were provided though a purpose-built medical polyclinic, which had a fully equipped radiology department along with other services, set up within the main Games Village. Data analysis of radiology services offered at CWG has not been published before. Imaging services within the polyclinic, Athletes Village, Glasgow 2014 CWG. The aim of the paper is to analyse data on radiological investigations and assess the demand and distribution of workload on imaging services at CWG 2014. Data on radiology investigations at the CWG 2014 was retrieved from the Carestream picture archiving and communication system (PACS) and Pharmasys (CWG official centralised electronic database system) and analysed. Six hundred ninety-seven diagnostic and interventional procedures were performed. Of these 37.9% were magnetic resonance imaging (MRI) scans, 22% were diagnostic ultrasound (US) examinations, 33.1% were radiographs, 4.3% were computed tomography (CT) scans and 2.7% were imaging-guided interventional procedures. 88% of imaging was performed on athletes and the remainder were performed on team officials and workforce. Demand on radiology services gradually picked up through the pre-competition period and peaked half way through the CWG. Radiology played a vital role in the successful provision of medical services at the Glasgow 2014 CWG. High demand on imaging services can be expected at major international sporting events and therefore pre-event planning is vital. Having back-up facilities in case of technical failure should be given due importance when planning radiology services at future CWG events.

Data analysis and review of radiology services at Glasgow 2014 Commonwealth Games

Energy Technology Data Exchange (ETDEWEB)

Bethapudi, Sarath [County Durham Darlington Foundation NHS Trust, Durham (United Kingdom); Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); Ritchie, David [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); Greater Glasgow and Clyde Hospitals NHS Trust, Western Infirmary, Glasgow (United Kingdom); Bongale, Santosh [Glasgow 2014 Commonwealth Games, Immediate Care Department, Glasgow (United Kingdom); NHS Greater Glasgow and Clyde, Royal Alexandra Hospital, Paisley (United Kingdom); Gordon, Jonny [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); NHS Greater Glasgow and Clyde, Glasgow (United Kingdom); MacLean, John [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); National Stadium Sports Medicine Centre, Glasgow (United Kingdom); Mendl, Liz [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom)

2015-10-15

Medical services at the Glasgow 2014 Commonwealth Games (CWG) were provided though a purpose-built medical polyclinic, which had a fully equipped radiology department along with other services, set up within the main Games Village. Data analysis of radiology services offered at CWG has not been published before. Imaging services within the polyclinic, Athletes Village, Glasgow 2014 CWG. The aim of the paper is to analyse data on radiological investigations and assess the demand and distribution of workload on imaging services at CWG 2014. Data on radiology investigations at the CWG 2014 was retrieved from the Carestream picture archiving and communication system (PACS) and Pharmasys (CWG official centralised electronic database system) and analysed. Six hundred ninety-seven diagnostic and interventional procedures were performed. Of these 37.9 % were magnetic resonance imaging (MRI) scans, 22 % were diagnostic ultrasound (US) examinations, 33.1 % were radiographs, 4.3 % were computed tomography (CT) scans and 2.7 % were imaging-guided interventional procedures. 88 % of imaging was performed on athletes and the remainder were performed on team officials and workforce. Demand on radiology services gradually picked up through the pre-competition period and peaked half way through the CWG. Radiology played a vital role in the successful provision of medical services at the Glasgow 2014 CWG. High demand on imaging services can be expected at major international sporting events and therefore pre-event planning is vital. Having back-up facilities in case of technical failure should be given due importance when planning radiology services at future CWG events. (orig.)

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)

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)

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

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)

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

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

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

Radiation protection in the intervenmtional radiology

International Nuclear Information System (INIS)

Becker, Benjamin V.; Lissek, Friedrich; Waldeck, Stephan

2017-01-01

Interventional radiology and neuroradiology covers a variety of diagnostic and therapeutic methods. A minimal invasive percutaneous access under imaging guidance is common for all these methods. The legal regulations for quality assurance are reviewed, technical possibilities for dose reduction and the importance of modern radiation protection procedures are discussed.

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)

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)

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.)

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.)

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.

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.

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

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.

Role of radiology in occupational medicine

International Nuclear Information System (INIS)

Vehmas, T.

2004-01-01

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

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

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.)

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

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

New recommendations from the International Commission on Radiological Protection-a review

International Nuclear Information System (INIS)

Wrixon, A D

2008-01-01

For almost half a century, the International Commission on Radiological Protection (ICRP) has revised its recommendations on radiological protection with an average frequency of about 10 years, building on the experience gained in their implementation. This has ensured that the recommendations remain up to date and fit for purpose and it is this that has led in turn to their wide acceptance internationally. Indeed, the 1990 version of the recommendations forms the basis of the international radiological protection standards and the systems of control of exposure to ionizing radiation in many countries throughout the world. This version introduced new concepts and a more holistic approach to radiological protection but marrying the different exposure situations into one coherent framework has proved not to be straightforward and further reflection seemed necessary in order to satisfy both those who are responsible for the development of the control systems as well as a broader audience. Review of the 1990 recommendations started around 1998 and, since then, many ideas have been explored and avenues followed. Eventually, new recommendations were agreed by the Commission at its meeting in Essen in March 2007. This paper provides a review of these new recommendations and their possible implications. (topical review)

Review of radiological problems of floating nuclear power plants

International Nuclear Information System (INIS)

Rodd, T.

1982-01-01

Radiological problems associated with floating nuclear power plants under both normal operation and accident conditions are discussed. In the latter case, aspects of both the airborne and liquid pathways are reviewed

Online Radiology Reporting with Peer Review as a Learning and Feedback Tool in Radiology; Implementation, Validity, and Student Impressions

DEFF Research Database (Denmark)

McEvoy, Fintan; Shen, Nicholas W; Nielsen, Dorte Hald

2017-01-01

for student-generated radiological reports were compared to scores obtained in the summative multiple choice (MCQ) examination for the course. Student satisfaction was measured using a bespoke questionnaire. There was a weak positive correlation (Pearson correlation coefficient = 0.32, p ... scores awarded by the students and the scores they obtained in the MCQ examination (Pearson correlation coefficient = 0.17, p = 0.14). In conclusion, we have created a realistic radiology imaging exercise with readily available software. The peer review scores are valid in that to a limited degree...... review scores students received and the student scores obtained in the MCQ examination. The difference in peer review scores received by students grouped according to their level of course performance (high vs. low) was statistically significant (p correlation was found between peer review...

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

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)

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

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)

1987 year book of diagnostic radiology

International Nuclear Information System (INIS)

Bragg, D.G.; Keats, T.E.; Kieffer, S.A.; Kirkpatrick, J.A. Jr.; Koehler, P.R.

1987-01-01

The book is divided into seven sections, which cover neuroradiology, the thorax, the abdomen, the musculoskeletal system, pediatric radiology, radiation physics, and cardiovascular and interventional radiology. Each of the seven editors was responsible for one section. These editors gleaned what they thought were the most important articles from 78 medical journals worldwide, wrote abstracts, and then commented on their relevance. For each journal article, the heading lists the title of the paper, the authors, the authors' affiliations, and the journal name. If an article contained an important table or figure, it was reproduced for the review

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)

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.

Lessons learned in radiology

International Nuclear Information System (INIS)

Goodenough, D.J.

2001-01-01

The paper reviews aspects of the history of radiology with the goal of identifying lessons learned, particularly in the area of radiological protection of the patient in diagnostic and interventional radiology, nuclear medicine and radiotherapy. It is pointed out that since the days of Roentgen there has been a need not only to control and quantify the amount of radiation reaching the patient but also to optimize the imaging process to offer the greatest diagnostic benefit within allowable levels of patient dose. To this end, in diagnostic radiology, one finds the development of better films, X rays tubes, grids, screens and processing techniques, while in fluoroscopy, one sees the increased luminance of calcium tungstate. In interventional radiology, one finds an improvement in catheterization techniques and contrast agents. In nuclear medicine, the development of tracer techniques into modern cameras and isotopes such as technetium can be followed. In radiotherapy, one sees the early superficial X rays and radium sources gradually replaced with radon seeds, supervoltage, 60 Co and today's linear accelerators. Along with the incredible advances in imaging and therapeutic technologies comes the growing realization of the potential danger of radiation and the need to protect the patient (as well as physicians, ancillary personnel and the general population) from unnecessary radiation. The important lesson learned is that we must walk a tightrope, balancing the benefits and risks of any technology utilizing radiation to produce the greatest benefits at the lowest acceptable risk. The alternative techniques using non-ionizing radiation will have to be considered as part of the general armamentarium for medical imaging whenever radiation consequences are unacceptable. (author)

Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department

Science.gov (United States)

White, Benjamin A.; Yun, Brian J.; Lev, Michael H.; Raja, Ali S.

2017-01-01

Introduction Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. Methods This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013–3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Results Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5–7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7–8.2]; to 23.3 ± 3

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)

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

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

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

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)

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.

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

RSVP radiology

International Nuclear Information System (INIS)

Kirks, D.R.; Chaffee, D.J.

1990-01-01

This paper develops a relative scale of value for pediatric radiology (RSVPR). Neither the HCFA/ACA Relative Value Scale nor the Workload Measurement System developed by Health and Welfare Canada specifically addressed pediatric radiologic examinations. Technical and professional charges for examinations at Children's Hospital Medical Center were reviewed and compared with time and cost analysis. A scale was developed with chest radiography (PA and lateral views) assigned a value of 1. After review by pediatric radiologic technologists, radiologic administrators, pediatric radiologists, and chairs of departments of children's hospitals, this proposed scale was modified to reflect more accurately relative value components of pediatric radiologic and imaging examinations

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

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.

Telemedicine-based system for quality management and peer review in radiology.

Science.gov (United States)

Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

2018-06-01

Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

Adnexal masses literature review, detection, characterization and radiological staging

International Nuclear Information System (INIS)

Quesada Gonzalez, Diana

2011-01-01

A literature review was conducted on radiological detection and characterization of major adnexal masses identified in ultrasound, computerized axial tomography and magnetic resonance. The characteristics, and incidence findings have been identified in imaging methods of benign adnexal masses and most common ovarian neoplasms. The proposed new classification of adnexal masses GI-RADS has been released. The report of adnexal ultrasound images were classified into 5 categories. They have relied on morphological findings and the likelihood of benignity or malignancy, in addition to the radiological staging submit. The purpose has been simplifying the diagnosis and better therapeutic for the patient behavior [es

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.)

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

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)

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)

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

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

Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

International Nuclear Information System (INIS)

Bandaralage, Sahan P.S.; Farnaghi, Soheil; Dulhunty, Joel M.; Kothari, Alka

2016-01-01

Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

Energy Technology Data Exchange (ETDEWEB)

Bandaralage, Sahan P.S. [Gold Coast Hospital and Health Service, Southport, Queensland (Australia); Griffith University, School of Medicine, Southport, Queensland (Australia); Farnaghi, Soheil [Caboolture Hospital, Caboolture, Queensland (Australia); Dulhunty, Joel M.; Kothari, Alka [Redcliffe Hospital, Redcliffe, Queensland (Australia); The University of Queensland, School of Medicine, Herston, Queensland (Australia)

2016-03-15

Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)

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)

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.

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.

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

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)

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.

SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

International Nuclear Information System (INIS)

Pollock, S; Keall, P; Keall, R

2015-01-01

Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

Energy Technology Data Exchange (ETDEWEB)

Pollock, S; Keall, P [University of Sydney, Sydney (Australia); Keall, R [Hammond Care Palliative and Supportive Care Service, Sydney, NSW (Australia)

2015-06-15

Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

New international ways in radiology continuing education: www.eurorad.org - an EAR project for online publication of radiological data

International Nuclear Information System (INIS)

Vorwerk, D.

2002-01-01

Eurorad (www.eurorad.org) is a joint project of EAR and has support of 27 national and 8 subspeciality radiology societies. Eurorad is the first noncommercial radiologicial publication that is exclusively based on the internet as a communication line with all steps of submission, reviewing and publication being performed online. Eurorad wants to build up a huge and exhaustive case file of diagnostic and interventional radiology. Like all scientific publications, Eurorad bases on an editor in chief and 13 section editors who are responsible for organizing each section of Eurorad. Each section has a number of peer reviewer with an overall total of more than 100. For submission and publication, all cases are structured in the same manner with case report, method and discussion. For the time being, Eurorad hosts 779 cases, of whom 346 are free available on the net. The actual rejection rate is 4.5%, other cases are under review. (orig.) [de

Radiology today. Volume 4

International Nuclear Information System (INIS)

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

1987-01-01

The book discusses the following contents: Advances in Cardiovascular Imaging: Digital Arteriography: Ongoing Developments. Magnetic Resonance Imaging of the Cardiovascular System. Comparison of Vascular CT and MRI. Characterization of Vascular Lesions by Ultrasound - Progress in Vascular Interventions: Laser Angioplasty: A Review. Fibrinolytic Therapy Combined with Clot Extraction. Drugs Useful in Angioplasty. Developments in Cardiovascular Imaging: Blood Flow Measurements with Digital Arteriography. Selection of Imaging Techniques for Venous Thromboembolic Disease. Clinical Usefulness of High-Verus Low-Osmolality Contrast Agents. Developments in Angiographic and Interventional Instrumentation. Progress in Cardiovascular Interventions. Inferior Vena Cava Filters: Types, Placement, and Efficiency. Transluminal Vascular Stenting and Grafting. Venography and Sclerotherapy of Varioceles in Children and Adolescents. A New Catheter System - Important Hip Problems: Radiologic and Pathologic Correlation and Hip Disease. Comparison of Imaging Modalities in Femoral Head Necrosis. Osteoartrosis and Arthritis (Synovitis) of the Hip. Hip Anthrography

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

The effectiveness of service delivery initiatives at improving patients' waiting times in clinical radiology departments: a systematic review.

Science.gov (United States)

Olisemeke, B; Chen, Y F; Hemming, K; Girling, A

2014-12-01

We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre- and post-intervention and the post-intervention designs were used in 54 (95%) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore meta-analysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivity-enhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

Review of specific radiological accident considerations

International Nuclear Information System (INIS)

Elder, J.

1984-01-01

Specific points of guidance provided in the forthcoming document A Guide to Radiological Accident Considerations for Siting and Design of Nonreactor Nuclear Facilities are discussed. Of these, the following are considered of particular interest to analysts of hypothetical accidents: onsite dose limits; population dose, public health effects, and environmental contamination as accident consequences which should be addressed; risk analysis; natural phenomena as accident initiators; recommended dose models; multiple organ equivalent dose; and recommended methods and parameters for source terms and release amount calculations. Comments are being invited on this document, which is undergoing rewrite after the first stage of peer review

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.)

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)

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

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)

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

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.

Comparison of fluoroscopy-guided pull-type percutaneous radiological gastrostomy (pull-type-PRG) with conventional percutaneous radiological gastrostomy (push-type-PRG): clinical results in 253 patients

Energy Technology Data Exchange (ETDEWEB)

Yang, Yang; Schneider, J.; Dueber, C.; Pitton, M.B. [University Medical Center of the Johannes Gutenberg University Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany)

2011-11-15

To analyze the clinical results and complications of fluoroscopy guided internal-external pull-type percutaneous radiological gastrostomy (pull-type-PRG) and conventional external-internal percutaneous radiological gastrostomy (push-type-PRG). A total of 253 patients underwent radiological gastrostomy between January 2002 and January 2010. Data were collected retrospectively from radiology reports, Chart review of clinical notes, procedure reports, discharge summaries and subsequent hospital visits. Statistical analysis was performed to compare the two methods for gastrostomy with respect to peri-interventional aspects and clinical results. 128 patients received the Pull-type-PRG whereas the other 125 patients were served with the Push-type-PRG. Indications for gastrostomy were similar in these two groups. The most frequent indications for the both methods were stenotic oesophageal tumors or head/neck tumors (54.7% in pull-type-PRG, 68% in push-type-PRG). Gastrostomy procedures were successful in 98.3% in pull-type-PRG compared to 92% in push-type-PRG. There was no procedure-related mortality. Compared to Push-type-PRG, the peri-interventional complication rate was significantly reduced in pull-type-PRG (14.8% versus 34.4%, P = 0.002). Compared to the external-internal push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications. (orig.)

Comparison of fluoroscopy-guided pull-type percutaneous radiological gastrostomy (pull-type-PRG) with conventional percutaneous radiological gastrostomy (push-type-PRG): clinical results in 253 patients

International Nuclear Information System (INIS)

Yang, Yang; Schneider, J.; Dueber, C.; Pitton, M.B.

2011-01-01

To analyze the clinical results and complications of fluoroscopy guided internal-external pull-type percutaneous radiological gastrostomy (pull-type-PRG) and conventional external-internal percutaneous radiological gastrostomy (push-type-PRG). A total of 253 patients underwent radiological gastrostomy between January 2002 and January 2010. Data were collected retrospectively from radiology reports, Chart review of clinical notes, procedure reports, discharge summaries and subsequent hospital visits. Statistical analysis was performed to compare the two methods for gastrostomy with respect to peri-interventional aspects and clinical results. 128 patients received the Pull-type-PRG whereas the other 125 patients were served with the Push-type-PRG. Indications for gastrostomy were similar in these two groups. The most frequent indications for the both methods were stenotic oesophageal tumors or head/neck tumors (54.7% in pull-type-PRG, 68% in push-type-PRG). Gastrostomy procedures were successful in 98.3% in pull-type-PRG compared to 92% in push-type-PRG. There was no procedure-related mortality. Compared to Push-type-PRG, the peri-interventional complication rate was significantly reduced in pull-type-PRG (14.8% versus 34.4%, P = 0.002). Compared to the external-internal push-type-PRG, the internal-external Pull-type-PRG showed a high primary success rate and a decreased incidence of peri-interventional complications. (orig.)

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.

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.)

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)

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.)

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.)

Radiation protection in the intervenmtional radiology; Strahlenschutz in der interventionellen Radiologie

Energy Technology Data Exchange (ETDEWEB)

Becker, Benjamin V. [Institut fuer Radiobiologie der Bundeswehr, Muenchen (Germany); Ulm Univ. (Germany); Lissek, Friedrich; Waldeck, Stephan [Bundeswehrzentralkrankenhaus Koblenz (Germany). Klinik fuer Radiologie und Neuroradiologie

2017-07-01

Interventional radiology and neuroradiology covers a variety of diagnostic and therapeutic methods. A minimal invasive percutaneous access under imaging guidance is common for all these methods. The legal regulations for quality assurance are reviewed, technical possibilities for dose reduction and the importance of modern radiation protection procedures are discussed.

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.)

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.

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.

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.

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.

Systematic review of reviews of intervention components associated with increased effectiveness in dietary and physical activity interventions

Directory of Open Access Journals (Sweden)

Evans Philip H

2011-02-01

Full Text Available Abstract Background To develop more efficient programmes for promoting dietary and/or physical activity change (in order to prevent type 2 diabetes it is critical to ensure that the intervention components and characteristics most strongly associated with effectiveness are included. The aim of this systematic review of reviews was to identify intervention components that are associated with increased change in diet and/or physical activity in individuals at risk of type 2 diabetes. Methods MEDLINE, EMBASE, CINAHL, PsycInfo, and the Cochrane Library were searched for systematic reviews of interventions targeting diet and/or physical activity in adults at risk of developing type 2 diabetes from 1998 to 2008. Two reviewers independently selected reviews and rated methodological quality. Individual analyses from reviews relating effectiveness to intervention components were extracted, graded for evidence quality and summarised. Results Of 3856 identified articles, 30 met the inclusion criteria and 129 analyses related intervention components to effectiveness. These included causal analyses (based on randomisation of participants to different intervention conditions and associative analyses (e.g. meta-regression. Overall, interventions produced clinically meaningful weight loss (3-5 kg at 12 months; 2-3 kg at 36 months and increased physical activity (30-60 mins/week of moderate activity at 12-18 months. Based on causal analyses, intervention effectiveness was increased by engaging social support, targeting both diet and physical activity, and using well-defined/established behaviour change techniques. Increased effectiveness was also associated with increased contact frequency and using a specific cluster of "self-regulatory" behaviour change techniques (e.g. goal-setting, self-monitoring. No clear relationships were found between effectiveness and intervention setting, delivery mode, study population or delivery provider. Evidence on long

The role of radiology in diagnostic error: a medical malpractice claims review.

Science.gov (United States)

Siegal, Dana; Stratchko, Lindsay M; DeRoo, Courtney

2017-09-26

Just as radiologic studies allow us to see past the surface to the vulnerable and broken parts of the human body, medical malpractice claims help us see past the surface of medical errors to the deeper vulnerabilities and potentially broken aspects of our healthcare delivery system. And just as the insights we gain through radiologic studies provide focus for a treatment plan for healing, so too can the analysis of malpractice claims provide insights to improve the delivery of safe patient care. We review 1325 coded claims where Radiology was the primary service provider to better understand the problems leading to patient harm, and the opportunities most likely to improve diagnostic care in the future.

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

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)

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)

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

Effectiveness of E-Learning in Oral Radiology Education: A Systematic Review.

Science.gov (United States)

Santos, Glaucia Nize M; Leite, André F; Figueiredo, Paulo T de S; Pimentel, Nara M; Flores-Mir, Carlos; de Melo, Nilce S; Guerra, Eliete N S; De Luca Canto, Graziela

2016-09-01

E-learning has been used recently in dental curricula to support traditional learning methods. However, the published literature concerning e-learning in oral radiology has shown mixed conclusions. The aim of this systematic review was to provide a synthesis of the effectiveness of e-learning in oral radiology education when compared with traditional classroom learning methods. A search of the literature was conducted on the LILACS, PubMed, Science Direct, Scopus, and Web of Science databases. Trials registries were also consulted for ongoing trials, and a partial grey literature search was conducted. Controlled trials about oral radiology education that compared any e-learning method with a control group using any traditional classroom instruction method were included. E-learning effectiveness was measured using three outcomes from Kirkpatrick's model of evaluation: attitudes about e-learning, knowledge gain, and performance on clinical procedures. Data were analyzed descriptively. Qualitative appraisal was performed according to the Cochrane risk of bias tool for randomized trials and MINORS tool for non-randomized trials. Eleven studies met the inclusion criteria. Risk of bias was identified related to the selection procedures, blinding, lack of sample size calculation, and incomplete analyses. Ten studies reported that students had positive attitude when using e-learning. Results from the knowledge gain outcome were mixed. Only two studies examined performance on clinical procedures, showing contrasting results. The evidence reviewed in this study suggests that e-learning in oral radiology is at least as effective as traditional learning methods and that students have positive attitudes about e-learning.

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

A review of scientific topics and literature in abdominal radiology in Germany. Pt. 1. Gastrointestinal tract

International Nuclear Information System (INIS)

Schreyer, A.G.

2016-01-01

The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society (DRG) focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract with all parenchymatous abdominal organs. In addition to the clinical and scientific further development of abdominal radiology, the education of radiologists within this core discipline of radiology is one of the major aims. In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. This manuscript focuses on the most recent literature on the diagnosis of the stomach, small bowel, colon and rectum. The review with a focus on the most recent studies published by German radiologists concludes with a synopsis of mesenterial bleeding and ischemia followed by a critical appraisal of the current literature on conventional abdominal radiography.

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)

Quality Measurements in Radiology: A Systematic Review of the Literature and Survey of Radiology Benefit Management Groups.

Science.gov (United States)

Narayan, Anand; Cinelli, Christina; Carrino, John A; Nagy, Paul; Coresh, Josef; Riese, Victoria G; Durand, Daniel J

2015-11-01

As the US health care system transitions toward value-based reimbursement, there is an increasing need for metrics to quantify health care quality. Within radiology, many quality metrics are in use, and still more have been proposed, but there have been limited attempts to systematically inventory these measures and classify them using a standard framework. The purpose of this study was to develop an exhaustive inventory of public and private sector imaging quality metrics classified according to the classic Donabedian framework (structure, process, and outcome). A systematic review was performed in which eligibility criteria included published articles (from 2000 onward) from multiple databases. Studies were double-read, with discrepancies resolved by consensus. For the radiology benefit management group (RBM) survey, the six known companies nationally were surveyed. Outcome measures were organized on the basis of standard categories (structure, process, and outcome) and reported using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search strategy yielded 1,816 citations; review yielded 110 reports (29 included for final analysis). Three of six RBMs (50%) responded to the survey; the websites of the other RBMs were searched for additional metrics. Seventy-five unique metrics were reported: 35 structure (46%), 20 outcome (27%), and 20 process (27%) metrics. For RBMs, 35 metrics were reported: 27 structure (77%), 4 process (11%), and 4 outcome (11%) metrics. The most commonly cited structure, process, and outcome metrics included ACR accreditation (37%), ACR Appropriateness Criteria (85%), and peer review (95%), respectively. Imaging quality metrics are more likely to be structural (46%) than process (27%) or outcome (27%) based (P < .05). As national value-based reimbursement programs increasingly emphasize outcome-based metrics, radiologists must keep pace by developing the data infrastructure required to collect outcome

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.

Radiology of the spleen

International Nuclear Information System (INIS)

Robertson, F.; Leander, P.; Ekberg, O.

2001-01-01

The spleen is generally not considered a challenge to the radiologist. Most often it poses a problem by anomalies or an irregular but normal contrast enhancement; however, a variety of inflammatory, infectious and neoplastic diseases may involve the spleen. CT and ultrasonography are screening modalities for the spleen. For problem solving, MR imaging can be helpful, especially due to its free choice of the imaging plane and because of the high resolution in contrast MR imaging. Splenic angiography as a diagnostic tool has generally been replaced by CT, ultrasound, or MR and is now used as an interventional method, e.g., in non-surgical management of patients with chronic idiopathic thrombocytopenia or in patients with splenic trauma. This article reviews the radiology of the spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction, cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of different imaging modalities and underlying gross and microscopic pathologic features leads to a better understanding of the radiologic findings. (orig.)

Nuclear emergency planning in Spain. The PLABEN review project

International Nuclear Information System (INIS)

Lentijo Lentijo, J. C.; Vila Pena, M.

2002-01-01

The international rules and recommendations for nuclear emergency planning and the Spanish experience gained in the management of event with radiological risk have noticed that is necessary to review the planning radiological bases for emergencies in nuclear power plants and to define the planning radiological bases for radiological emergencies that could happen in radioactive facilities or in activities out of the regulatory framework. The paper focuses on CSN actions concerning the Plaben review project related to define the new radiological principles taking into account the current international recommendations for interventions, make a proposal about the organisation and operation of the provincial radiological action group and the national support level for radiological emergency response. (Author) 7 refs

A review of radiology staff doses and dose monitoring requirements

International Nuclear Information System (INIS)

Martin, C. J.

2009-01-01

Studies of radiation doses received during X-ray procedures by radiology, cardiology and other clinical staff have been reviewed. Data for effective dose (E), and doses to the eyes, thyroid, hands and legs have been analysed. These data have been supplemented with local measurements to determine the most exposed part of the hand for monitoring purposes. There are ranges of 60-100 in doses to individual tissues reported in the literature for similar procedures at different centres. While ranges in the doses per unit dose-area product (DAP) are between 10 and 25, large variations in dose result from differences in the sensitivity of the X-ray equipment, the type of procedure and the operator technique, but protection factors are important in maintaining dose levels as low as possible. The influence of shielding devices is significant for determining the dose to the eyes and thyroid, and the position of the operator, which depends on the procedure, is the most significant factor determining doses to the hands. A second body dosemeter worn at the level of the collar is recommended for operators with high workloads for use in assessment of effective dose and the dose to the eye. It is proposed that the third quartile values from the distributions of dose per unit DAP identified in the review might be employed in predicting the orders of magnitude of doses to the eye, thyroid and hands, based on interventional operator workloads. Such dose estimates could be employed in risk assessments when reviewing protection and monitoring requirements. A dosemeter worn on the little finger of the hand nearest to the X-ray tube is recommended for monitoring the hand. (authors)

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

Generic procedures for assessment and response during a radiological emergency

International Nuclear Information System (INIS)

2000-08-01

One of the most important aspects of managing a radiological emergency is the ability to promptly and adequately determine and take actions to protect members of the public and emergency workers. Radiological accident assessment must take account of all critical information available at any time and must be an iterative and dynamic process aimed at reviewing the response as more detailed and complete information becomes available. This manual provides the tools, generic procedures and data needed for an initial response to a non-reactor radiological accident. This manual is one out of a set of IAEA publications on emergency preparedness and response, including Method for the Development of Emergency Response Preparedness for Nuclear or Radiological Accidents (IAEA-TECDOC-953), Generic Assessment Procedures for Determining Protective Actions During a Reactor Accident (IAEA-TECDOC-955) and Intervention Criteria in a Nuclear or Radiation Emergency (Safety Series No. 109)

[Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews].

Science.gov (United States)

Rütten, Alfred; Abu-Omar, Karim; Burlacu, Ionut; Schätzlein, Valentin; Suhrcke, Marc

2017-03-01

On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and

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.

Quality assurance in radiology: peer review and peer feedback

International Nuclear Information System (INIS)

Strickland, N.H.

2015-01-01

Peer review in radiology means an assessment of the accuracy of a report issued by another radiologist. Inevitably, this involves a judgement opinion from the reviewing radiologist. Peer feedback is the means by which any form of peer review is communicated back to the original author of the report. This article defines terms, discusses the current status, identifies problems, and provides some recommendations as to the way forward, concentrating upon the software requirements for efficient peer review and peer feedback of reported imaging studies. Radiologists undertake routine peer review in their everyday clinical practice, particularly when reporting and preparing for multidisciplinary team meetings. More formal peer review of reported imaging studies has been advocated as a quality assurance measure to promote good clinical practice. It is also a way of assessing the competency of reporting radiologists referred for investigation to bodies such as the General Medical Council (GMC). The literature shows, firstly, that there is a very wide reported range of discrepancy rates in many studies, which have used a variety of non-comparable methodologies; and secondly, that applying scoring systems in formal peer review is often meaningless, unhelpful, and can even be detrimental. There is currently a lack of electronic peer feedback system software on the market to inform radiologists of any review of their work that has occurred or to provide them with clinical outcome information on cases they have previously reported. Learning opportunities are therefore missed. Radiologists should actively engage with the medical informatics industry to design optimal peer review and feedback software with features to meet their needs. Such a system should be easy to use, be fully integrated with the radiological information and picture archiving systems used clinically, and contain a free-text comment box, without a numerical scoring system. It should form a temporary record

Intervention quality is not routinely assessed in Cochrane systematic reviews of radiation therapy interventions.

Science.gov (United States)

Abdul Rahim, Mohamad R; James, Melissa L; Hickey, Brigid E

2017-10-01

The aim of this study was to maximise the benefits from clinical trials involving technological interventions such as radiation therapy. High compliance to the quality assurance protocols is crucial. We assessed whether the quality of radiation therapy intervention was evaluated in Cochrane systematic reviews. We searched 416 published Cochrane systematic reviews and identified 67 Cochrane systematic reviews that investigated radiation therapy or radiotherapy as an intervention. For each systematic review, either quality assurance or quality control for the intervention was identified by a description of such processes in the published systematic reviews. Of the 67 Cochrane systematic reviews studied, only two mentioned quality assurance or quality control. Our findings revealed that 65 of 67 (97%) Cochrane systematic reviews of radiation therapy interventions failed to consider the quality of the intervention. We suggest that advice about the evaluation of intervention quality be added to author support materials. © 2017 The Royal Australian and New Zealand College of Radiologists.

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.

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)

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)

Surgical interventions for gastric cancer: a review of systematic reviews.

Science.gov (United States)

He, Weiling; Tu, Jian; Huo, Zijun; Li, Yuhuang; Peng, Jintao; Qiu, Zhenwen; Luo, Dandong; Ke, Zunfu; Chen, Xinlin

2015-01-01

To evaluate methodological quality and the extent of concordance among meta-analysis and/or systematic reviews on surgical interventions for gastric cancer (GC). A comprehensive search of PubMed, Medline, EMBASE, the Cochrane library and the DARE database was conducted to identify the reviews comparing different surgical interventions for GC prior to April 2014. After applying included criteria, available data were summarized and appraised by the Oxman and Guyatt scale. Fifty six reviews were included. Forty five reviews (80.4%) were well conducted, with scores of adapted Oxman and Guyatt scale ≥ 14. The reviews differed in criteria for avoiding bias and assessing the validity of the primary studies. Many primary studies displayed major methodological flaws, such as randomization, allocation concealment, and dropouts and withdrawals. According to the concordance assessment, laparoscopy-assisted gastrectomy (LAG) was superior to open gastrectomy, and laparoscopy-assisted distal gastrectomy was superior to open distal gastrectomy in short-term outcomes. However, the concordance regarding other surgical interventions, such as D1 vs. D2 lymphadenectomy, and robotic gastrectomy vs. LAG were absent. Systematic reviews on surgical interventions for GC displayed relatively high methodological quality. The improvement of methodological quality and reporting was necessary for primary studies. The superiority of laparoscopic over open surgery was demonstrated. But concordance on other surgical interventions was rare, which needed more well-designed RCTs and systematic reviews.

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.

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.

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.

Progress in diagnosis of breast cancer: Advances in radiology technology

Directory of Open Access Journals (Sweden)

J Mari Beth Linder

2015-01-01

Full Text Available Breast cancer is the leading cause of cancer in females between the ages of 15 and 54, and the second leading cause of cancer death in women in the United States. Diagnosis begins with detection by breast examination (clinical breast exam or breast self-exam or by radiologic studies, like mammography. Many advances in the diagnosis of breast cancer have taken place in recent years. This article will review the history of radiologic advances in the diagnosis of breast cancer. Use of technological advancements in digital breast tomosynthesis, magnetic resonance imaging, and ultrasound in breast cancer diagnosis will be presented. Advantages and disadvantages of these diagnostic interventions when compared to older, traditional X-ray films will be discussed. It is important for all nurses, including radiology and oncology nurses, to be well informed about these varied diagnostic modalities, and appreciate the fact that advances in radiologic imaging technologies can yield improved outcomes for breast cancer patients.

Radiology Resident Supply and Demand: A Regional Perspective.

Science.gov (United States)

Pfeifer, Cory M

2017-09-01

Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future. The number of per capita radiology trainees in each region was derived from data published by the National Resident Matching Program, as were annual match statistics over the years 2012 through 2016. Data regarding new interventional radiology and diagnostic radiology enrollees were also obtained from the National Resident Matching Program. The seven states with the most per capita radiology residents were in the Mid-Atlantic and Northeastern United States in both 2006 and 2016, and three of these seven also showed the greatest per capita growth over the course of the 10 years studied. New radiology programs were accredited during the peak of the job shortage. Integrated interventional radiology training created 24 de novo radiology residents in the 2017 match. Fill rates are weakly positively correlated with program size. Unregulated radiology program growth persisted during the decade leading up to 2016. The region with the fewest jobs available since 2012 is also home to the greatest number of per capita radiology residents. Numerous published opinions during the crisis did not result in enforced policy change. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

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

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.)

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)

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)

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.

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)

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.

Transition From Peer Review to Peer Learning: Experience in a Radiology Department.

Science.gov (United States)

Donnelly, Lane F; Dorfman, Scott R; Jones, Jeremy; Bisset, George S

2017-10-18

To describe the process by which a radiology department moved from peer review to peer collaborative improvement (PCI) and review data from the first 16 months of the PCI process. Data from the first 16 months after PCI were reviewed: number of case reviews performed, number of learning opportunities identified, percentage yield of learning opportunities identified, type of learning opportunities identified, and comparison of the previous parameters between case randomly reviewed versus actively pushed (issues actively identified and entered). Changes in actively pushed cases were also assessed as volume per month over the 16 months (run chart). Faculty members were surveyed about their perception of the conversion to PCI. In all, 12,197 cases were peer reviewed, yielding 1,140 learning opportunities (9.34%). The most common types of learning opportunities for all reviewed cases included perception (5.1%) and reporting (1.9%). The yield of learning opportunities from actively pushed cases was 96.3% compared with 3.88% for randomly reviewed cases. The number of actively pushed cases per month increased over the course of the period and established two new confidence intervals. The faculty survey revealed that the faculty perceived the new PCI process as positive, nonpunitive, and focused on improvement. The study demonstrates that a switch to PCI is perceived as nonpunitive and associated with increased radiologist submission of learning opportunities. Active entering of identified learning opportunities had a greater yield and perceived value, compared with random review of cases. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

Science.gov (United States)

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post

Quality assurance in radiology: peer review and peer feedback.

Science.gov (United States)

Strickland, N H

2015-11-01

Peer review in radiology means an assessment of the accuracy of a report issued by another radiologist. Inevitably, this involves a judgement opinion from the reviewing radiologist. Peer feedback is the means by which any form of peer review is communicated back to the original author of the report. This article defines terms, discusses the current status, identifies problems, and provides some recommendations as to the way forward, concentrating upon the software requirements for efficient peer review and peer feedback of reported imaging studies. Radiologists undertake routine peer review in their everyday clinical practice, particularly when reporting and preparing for multidisciplinary team meetings. More formal peer review of reported imaging studies has been advocated as a quality assurance measure to promote good clinical practice. It is also a way of assessing the competency of reporting radiologists referred for investigation to bodies such as the General Medical Council (GMC). The literature shows, firstly, that there is a very wide reported range of discrepancy rates in many studies, which have used a variety of non-comparable methodologies; and secondly, that applying scoring systems in formal peer review is often meaningless, unhelpful, and can even be detrimental. There is currently a lack of electronic peer feedback system software on the market to inform radiologists of any review of their work that has occurred or to provide them with clinical outcome information on cases they have previously reported. Learning opportunities are therefore missed. Radiologists should actively engage with the medical informatics industry to design optimal peer review and feedback software with features to meet their needs. Such a system should be easy to use, be fully integrated with the radiological information and picture archiving systems used clinically, and contain a free-text comment box, without a numerical scoring system. It should form a temporary record

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

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.

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

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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.

Efforts towards enhancing the quality of radiological services in Malaysia: review of patient dose surveys 1993-2007

International Nuclear Information System (INIS)

Hairuman, H.; Sapiin, B.; Muthuvelu, P.; Hatta, N.; Hambali, A.S.

2008-01-01

Full text: The Ministry of Health (MoH) Malaysia is continuously taking steps to improve the quality of radiological services provided by the public and private medical institutions. This is to ensure that optimum diagnostic information is obtained with the least exposure to patients as well as staff. Over the years, MOH has taken both administrative and legislative measures to enforce the various requirements under the Atomic Energy Licensing Act 1984. In order to further upgrade and enhance the quality, safety and efficacy of radiological services, implementation of the Quality Assurance Programme (QAP) has been made mandatory. Implementation of the QAP comprises certification of irradiating equipment, training of personnel (continuous professional education), film reject rate analysis and film auditing and assessment. All these particulars must be documented and submitted annually to the MoH in order to comply with licensing requirements. It is envisaged that with the implementation of QAP, the medical institutions will be able to institutionalise and internalise the culture of quality and safety in the applications of radiation in medicine. This implementation will indirectly result in reduction of dose to the patient and importantly in optimization the use of ionizing radiation in medicine. With the QAP in place a survey of doses to patient in 7 routine X-ray examinations was initiated in 1993 to provide a reference dose baseline in Malaysia. This was then followed by further dose surveys involving other modalities namely interventional radiology, mammography, adult chest and abdominal X-rays and computer tomography dose index (CTDI) for head and body phantom in CT scanner. The results of these dose surveys will be reviewed in this paper. The results of the mean entrance surface dose (ESD) (mGy) to patients in 7 routine X-ray examination done (1993 - 1995), the mean values of dose area product (DAP) (Gycm 2 ) for patient undergoing interventional radiology

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)

Diagnostic radiology of pet and wild birds: a review I. Radiographic techniques and radiographs of healthy birds

International Nuclear Information System (INIS)

Beregi, A.; Molnar, V.; Felkai, F.; Biro, F.; Szentgali, Zs.

1999-01-01

The first part of the present review summaries the basic technical conditions of radiological examinations, analyses the radiographic features of healthy birds, and describes the procedure and radiological indications of contrast radiography. (This paper can be seen on the Internet at: http://www.akkrt.hu)

Interventional techniques in medicine and radioprotection

International Nuclear Information System (INIS)

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

2009-01-01

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

Radiology and the mobile device: Radiology in motion

Directory of Open Access Journals (Sweden)

Sridhar G Panughpath

2012-01-01

Full Text Available The use of mobile devices is revolutionizing the way we communicate, interact, are entertained, and organize our lives. With healthcare in general and radiology in particular becoming increasingly digital, the use of such devices in radiologic practice is inevitable. This article reviews the current status of the use of mobile devices in the clinical practice of radiology, namely in emergency teleradiology. Technical parameters such as luminance and resolution are discussed. The article also discusses the benefits of such mobility vis-à-vis the current limitations of the technologies available.

Radiology and the mobile device: Radiology in motion

International Nuclear Information System (INIS)

Panughpath, Sridhar G; Kalyanpur, Arjun

2012-01-01

The use of mobile devices is revolutionizing the way we communicate, interact, are entertained, and organize our lives. With healthcare in general and radiology in particular becoming increasingly digital, the use of such devices in radiologic practice is inevitable. This article reviews the current status of the use of mobile devices in the clinical practice of radiology, namely in emergency teleradiology. Technical parameters such as luminance and resolution are discussed. The article also discusses the benefits of such mobility vis-à-vis the current limitations of the technologies available

Craniopagus twins: a comparative study of radiological findings and surgery (with a review of literatures)

International Nuclear Information System (INIS)

Yang Zhiyun; Luo Baining; Wu Xinjian

2005-01-01

Objective: To improve the understanding of craniopagus twins through a case report and literature review. Method: A pair of female craniopagus twins was examined with CT and MRI and angiography. The radiological findings were compared with operation. Results: The operation result was in consistent with imaging findings. Conclusion: Modern radiological modalities can evaluate complex deformity, which play an important role in the orthopedic procedures. (authors)

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

Qualitative review of usability problems in health information systems for radiology.

Science.gov (United States)

Dias, Camila Rodrigues; Pereira, Marluce Rodrigues; Freire, André Pimenta

2017-12-01

Radiology processes are commonly supported by Radiology Information System (RIS), Picture Archiving and Communication System (PACS) and other software for radiology. However, these information technologies can present usability problems that affect the performance of radiologists and physicians, especially considering the complexity of the tasks involved. The purpose of this study was to extract, classify and analyze qualitatively the usability problems in PACS, RIS and other software for radiology. A systematic review was performed to extract usability problems reported in empirical usability studies in the literature. The usability problems were categorized as violations of Nielsen and Molich's usability heuristics. The qualitative analysis indicated the causes and the effects of the identified usability problems. From the 431 papers initially identified, 10 met the study criteria. The analysis of the papers identified 90 instances of usability problems, classified into categories corresponding to established usability heuristics. The five heuristics with the highest number of instances of usability problems were "Flexibility and efficiency of use", "Consistency and standards", "Match between system and the real world", "Recognition rather than recall" and "Help and documentation", respectively. These problems can make the interaction time consuming, causing delays in tasks, dissatisfaction, frustration, preventing users from enjoying all the benefits and functionalities of the system, as well as leading to more errors and difficulties in carrying out clinical analyses. Furthermore, the present paper showed a lack of studies performed on systems for radiology, especially usability evaluations using formal methods of evaluation involving the final users. Copyright © 2017 Elsevier Inc. All rights reserved.

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

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.

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

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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)

Renal trauma imaging: Diagnosis and management. A pictorial review

International Nuclear Information System (INIS)

Szmigielski, Wojciech; Kumar, Rajendra; Al Hilli, Shatha; Ismail, Mostafa

2013-01-01

The purpose of this review is to illustrate and discuss the spectrum of imaging findings, particularly computed tomography (CT), of blunt and penetrating renal trauma, based on our own materials, according to the American Association for Surgery of Trauma (AAST) renal injury grading scale. The article also indicates the conditions in which interventional radiology procedures can be applied for the management of renal trauma. Cases for this pictorial review were selected from the imaging material collected at the Radiology Department of Hamad Medical Corporation during a 14-year period from 1999 to 2012. The material includes 176 cases (164 males and 12 females) with confirmed blunt or penetrating renal trauma. Following abdominal trauma, all patients had a CT examination performed on admission to the hospital and/or during hospitalization. The most representative and illustrative cases of renal trauma were reviewed according to CT findings and were categorized according to the AAST grading system. The review describes a spectrum of imaging presentations with special emphasis on the 5 grades of renal injury on a CT according to the AAST scale. The most representative cases were illustrated and discussed with indications of possible interventional radiology treatment. Two groups of patients not included in the AAST grading system were presented separately: those with preexisting renal abnormalities and those with sustained iatrogenic renal injury. Proper application of renal trauma grading scale is essential for selecting the patients for conservative treatment, surgery or interventional radiology procedure

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

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

Evaluation of Stress and a Stress-Reduction Program Among Radiologic Technologists.

Science.gov (United States)

Reingold, Lynn

2015-01-01

To investigate stress levels and causes of stress among radiologic technologists and determine whether an intervention could reduce stress in a selected radiologic technologist population. Demographic characteristics and data on preintervention stress sources and levels were collected through Internet-based questionnaires. A 6-week, self-administered, mindfulness-based stress-reduction program was conducted as a pilot intervention with 42 radiologic technologists from the Veterans Administration Medical Center. Data also were collected postintervention. Identified sources of stress were compared with findings from previous studies. Some radiologic technologists experienced improvement in their perceptions of stress after the intervention. Sources of stress for radiologic technologists were similar to those shown in earlier research, including inconsistent management, poor management communication, conflicting demands, long work hours, excessive workloads, lack of work breaks, and time pressures. The mindfulness-based stress-reduction program is an example of an inexpensive method that could improve personal well-being, reduce work errors, improve relationships in the workplace, and increase job satisfaction. More research is needed to determine the best type of intervention for stress reduction in a larger radiologic technologist population.

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.

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

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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)

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)

Radiological findings of Currarino's triad - a case report and review of the literature

International Nuclear Information System (INIS)

Machado Junior, Marcos Alberto; Barbosa, Veronica Aline de Oliveira; Rocha, Josilton Antonio; Ferreira, Eliane Fiuza; Maximo, Marcia Andrade; Castro, Luiz Eduardo; Vieira, Lauro Conceicao

1998-01-01

The authors report a child case with congenital malformation Currarino triad characterized by a rare complex of a congenital sacral bony abnormality, anorectal malformation and a presacral mass. A bibliographic review was done, focusing the radiological and tomographic findings. (author)

AAC Modeling Intervention Research Review

Science.gov (United States)

Sennott, Samuel C.; Light, Janice C.; McNaughton, David

2016-01-01

A systematic review of research on the effects of interventions that include communication partner modeling of aided augmentative and alternative communication (AAC) on the language acquisition of individuals with complex communication needs was conducted. Included studies incorporated AAC modeling as a primary component of the intervention,…

Psychosocial Benefits of Cooking Interventions: A Systematic Review

Science.gov (United States)

Farmer, Nicole; Touchton-Leonard, Katherine; Ross, Alyson

2018-01-01

Objectives: Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods: A systematic review of the…

Monitoring activities review of the Radiological Environmental Surveillance Program

International Nuclear Information System (INIS)

Ritter, P.D.

1992-03-01

The 1992 Monitoring Activities Review (MAR) is directed at the Radiological Environment Surveillance Program (RESP) activities at the Radioactive Waste Management Complex (RWMC) of Idaho Engineering Laboratory (INEL). MAR panelists studied RESP documents and discussed their concerns with Environmental Monitoring Unit (EMU) staff and other panel members. These concerns were subsequently consolidated into a collection of recommendations with supporting discussions. Recommendations focus on specific monitoring activities, as well as the overall program. The MAR report also contains pertinent comments that should not require further action

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.)

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

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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.

Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

Science.gov (United States)

Narayan, Anand; Lobner, Katie; Fritz, Jan

2018-02-01

The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Off label use of devices and drugs in interventional radiology

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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.

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.

Evidence-based anatomical review areas derived from systematic analysis of cases from a radiological departmental discrepancy meeting.

Science.gov (United States)

Chin, S C; Weir-McCall, J R; Yeap, P M; White, R D; Budak, M J; Duncan, G; Oliver, T B; Zealley, I A

2017-10-01

To produce short checklists of specific anatomical review sites for different regions of the body based on the frequency of radiological errors reviewed at radiology discrepancy meetings, thereby creating "evidence-based" review areas for radiology reporting. A single centre discrepancy database was retrospectively reviewed from a 5-year period. All errors were classified by type, modality, body system, and specific anatomical location. Errors were assigned to one of four body regions: chest, abdominopelvic, central nervous system (CNS), and musculoskeletal (MSK). Frequencies of errors in anatomical locations were then analysed. There were 561 errors in 477 examinations; 290 (46%) errors occurred in the abdomen/pelvis, 99 (15.7%) in the chest, 117 (18.5%) in the CNS, and 125 (19.9%) in the MSK system. In each body system, the five most common location were chest: lung bases on computed tomography (CT), apices on radiography, pulmonary vasculature, bones, and mediastinum; abdominopelvic: vasculature, colon, kidneys, liver, and pancreas; CNS: intracranial vasculature, peripheral cerebral grey matter, bone, parafalcine, and the frontotemporal lobes surrounding the Sylvian fissure; and MSK: calvarium, sacrum, pelvis, chest, and spine. The five listed locations accounted for >50% of all perceptual errors suggesting an avenue for focused review at the end of reporting. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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

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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).

Radiological diagnosis of pulmonary sequestration: review of six cases, including one bilateral

International Nuclear Information System (INIS)

Brito Pacheco, E.M. de; Cazerta, N.M.G.; Marins, J.L.C.; Prando, A.

1989-01-01

Radiological diagnosis of pulmonary sequestration: review of six cases, including one bilateral. Pulmonary sequestration is an uncommon disorder consisting of aberrant pulmonary tissue that has no normal connection with the bronchial tree or with the pulmonary arteries, but is supplied by a systemic artery which usually arises from the aorta. Six cases of pulmonary sequestration are presented and the radiological manifestation of this rare congenital disorder are discussed. These sequestrations were intralobar/unilateral in four patients, extralobar/unilateral in one and extralobar/bilateral in the other patient. Special attention is given to the extremely uncommon bilateral sequestration. To our knowledge only four cases of this form of disease has been described in the literature. (author) [pt

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.

[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.

Assessment of radiological referral practice and effect of computer-based guidelines on radiological requests in two emergency departments

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Carton, Matthieu; Auvert, Bertran; Guerini, Henri; Boulard, Jean-Christophe; Heautot, Jean-Francois; Landre, Marie-France; Beauchet, Alain; Sznajderi, Marc; Brun-Ney, Dominique; Chagnon, Sophie

2002-02-01

AIM: To assess medical emergency radiology referral practice compared with a set of French guidelines and to measure the efficiency of computer-based guidelines on unnecessary medical imaging. MATERIALS AND METHODS: All radiological requests were computerized in the medical emergency departments of two French teaching hospitals. During control periods, radiological requests were recorded but no action was taken. During intervention periods, reminder displays on screen indicated the appropriate recommendations. Three control and three intervention periods of 1 month each were conducted. The percentage of requests that did not conform to the guidelines and variation related to periods of control and intervention were measured. RESULTS: The proportion of requests that did not conform to the guidelines was 33{center_dot}2% when the guidelines were inactive and decreased to 26{center_dot}9% when the recommendations were active (P < 0{center_dot}0001). The three imaging examinations (chest radiographs, abdominal plain radiographs and CT of the brain) accounted for more than 80% of all requests; more than 50% of abdominal plain radiographs requests did not conform with recommendations while this percentage was respectively 24{center_dot}9% and 15{center_dot}8% for chest radiographs and computed tomography (CT) of the brain. Seven situations accounted for 70% of non-conforming radiological referrals; in these situations, junior practitioners' knowledge was inadequate. CONCLUSION: While the computer provided advice that was tailored to the needs of individual patients, concurrent with care, the effect of our intervention was weak. However, our study identified the few situations that were responsible for the majority of unnecessary radiological requests; we expect that this result could help clinicians and radiologists to develop more specific actions for these situations. Carton, M. et al. (2002). Clinical Radiology (2002)

Assessment of radiological referral practice and effect of computer-based guidelines on radiological requests in two emergency departments

International Nuclear Information System (INIS)

Carton, Matthieu; Auvert, Bertran; Guerini, Henri; Boulard, Jean-Christophe; Heautot, Jean-Francois; Landre, Marie-France; Beauchet, Alain; Sznajderi, Marc; Brun-Ney, Dominique; Chagnon, Sophie

2002-01-01

AIM: To assess medical emergency radiology referral practice compared with a set of French guidelines and to measure the efficiency of computer-based guidelines on unnecessary medical imaging. MATERIALS AND METHODS: All radiological requests were computerized in the medical emergency departments of two French teaching hospitals. During control periods, radiological requests were recorded but no action was taken. During intervention periods, reminder displays on screen indicated the appropriate recommendations. Three control and three intervention periods of 1 month each were conducted. The percentage of requests that did not conform to the guidelines and variation related to periods of control and intervention were measured. RESULTS: The proportion of requests that did not conform to the guidelines was 33·2% when the guidelines were inactive and decreased to 26·9% when the recommendations were active (P < 0·0001). The three imaging examinations (chest radiographs, abdominal plain radiographs and CT of the brain) accounted for more than 80% of all requests; more than 50% of abdominal plain radiographs requests did not conform with recommendations while this percentage was respectively 24·9% and 15·8% for chest radiographs and computed tomography (CT) of the brain. Seven situations accounted for 70% of non-conforming radiological referrals; in these situations, junior practitioners' knowledge was inadequate. CONCLUSION: While the computer provided advice that was tailored to the needs of individual patients, concurrent with care, the effect of our intervention was weak. However, our study identified the few situations that were responsible for the majority of unnecessary radiological requests; we expect that this result could help clinicians and radiologists to develop more specific actions for these situations. Carton, M. et al. (2002). Clinical Radiology (2002)

The evidence base for psychological interventions for rheumatoid arthritis: A systematic review of reviews.

Science.gov (United States)

Prothero, Louise; Barley, Elizabeth; Galloway, James; Georgopoulou, Sofia; Sturt, Jackie

2018-06-01

Psychological interventions are an important but often overlooked adjunctive treatment option for patients with rheumatoid arthritis. Findings from systematic reviews of psychological interventions for this patient group are conflicting. A systematic review of reviews can explain inconsistencies between studies and provide a clearer understanding of the effects of interventions. To: 1) determine the effectiveness of psychological interventions in improving biopsychosocial outcomes for adults with rheumatoid arthritis, 2) determine the relationship between the intensity of the psychological interventions (number of sessions, duration of sessions, duration of intervention) on outcomes, and 3) assess the impact of comparator group (usual care, education only) on outcomes. We conducted a systematic review of reviews using the following inclusion criteria: 1) randomised controlled trials of psychological interventions (including cognitive behavioural therapy, supportive counselling, psychotherapy, self-regulatory techniques, mindfulness-based cognitive therapy and disclosure therapy) provided as an adjunct to medication, 2) included rheumatoid arthritis patients aged ≥ 18 years, 3) reported findings for at least 1 of the primary outcomes: pain, fatigue, psychological status, functional disability and disease activity and 4) were published in English between January 2000 and March 2015 (updated January 2018). We searched in MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects. Reference lists were searched for additional reviews. Study selection and 50% of the quality assessments were performed by two independent reviewers. Methodological quality was measured using the Assessment of Multiple Systematic Reviews checklist. Data extraction was conducted by one reviewer using a predesigned data extraction form. Eight systematic reviews met inclusion criteria (one review was excluded due to

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

Importance of establishing radiation protection culture in Radiology Department.

Science.gov (United States)

Ploussi, Agapi; Efstathopoulos, Efstathios P

2016-02-28

The increased use of ionization radiation for diagnostic and therapeutic purposes, the rapid advances in computed tomography as well as the high radiation doses delivered by interventional procedures have raised serious safety and health concerns for both patients and medical staff and have necessitated the establishment of a radiation protection culture (RPC) in every Radiology Department. RPC is a newly introduced concept. The term culture describes the combination of attitudes, beliefs, practices and rules among the professionals, staff and patients regarding to radiation protection. Most of the time, the challenge is to improve rather than to build a RPC. The establishment of a RPC requires continuing education of the staff and professional, effective communication among stakeholders of all levels and implementation of quality assurance programs. The RPC creation is being driven from the highest level. Leadership, professionals and associate societies are recognized to play a vital role in the embedding and promotion of RPC in a Medical Unit. The establishment of a RPC enables the reduction of the radiation dose, enhances radiation risk awareness, minimizes unsafe practices, and improves the quality of a radiation protection program. The purpose of this review paper is to describe the role and highlight the importance of establishing a strong RPC in Radiology Departments with an emphasis on promoting RPC in the Interventional Radiology environment.

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.

Contribution of the french society of radiological protection to the current reflections on the possible improvement of the radiological risk management system

International Nuclear Information System (INIS)

Lecomte, J.F.; Schieber, C.

2000-01-01

Following the invitation by IRPA to comment the article by Prof. R. Clarke entitled 'Control of Low Level Radiation Exposures: Time for a Change?', the Board of the French Radiological Protection Society (SFRP) has decided to set up a specific Working Group. This Group consists of some twenty members representing the stakeholders involved in radiological protection in France. Its goal is, starting from an analysis of R. Clarke's text, to formulate questions and proposals to assist ICRP in making its radiological protection system more understandable and more efficient. The aim of this review is not to restart from scratch but to consolidate and improve the existing system. The Working Group has therefore focused its thoughts on the following four points: 1. The basis of the radiological risk management system. In the absence of scientific certainty as to the effects of low doses of radiation, a prudent attitude has been adopted as to the manner of managing the radiological risk, based on the hypothesis that the dose-effect relationship is linear with no threshold. The Group discusses this basic assumption and its implications on the elaboration of the objectives of the radiological risk management system. 2. Exposure situations. Exposure situations are multifarious and the existing system divides them into categories for management purpose (e.g. practice/intervention; natural/artificial; medical/public/occupational; actual exposure/potential exposure; etc.). Some of these divisions are pertinent but some are less so and the Group examines if another way of conceptualising exposures situations could be more efficient. 3. Risk management indicators and tools. The radiological protection system provides the professionals with a series of indicators and tools, enabling them to manage exposure situations (dose, dose limit, dose constraint, individual dose, collective dose, investigation level, action level, interventional level, exemption level, clearance level

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

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

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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.

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)

Global view on the radiological protection of patients: PAHO position paper

International Nuclear Information System (INIS)

Borras, C.

2001-01-01

The Pan American Health Organization/World Health Organization (PAHO/WHO), founded in 1902, initiated a radiological health programme in the 1950s. Within this programme, there are currently three lines of work: (a) radiology services; (b) radiation safety; and (c) radiological emergencies. Radiology services deals with health services for diagnostic and interventional imaging, and for radiation therapy. Radiation safety studies the three types of exposures to both ionizing and non-ionizing radiation: occupational; medical; and public. Radiological emergencies involve radioactive waste management programmes and emergency plans. The radiological protection of patients is addressed in each of these areas: (a) when analysing the infrastructure of radiology services; and (b) when determining medical exposures; and (c) when investigating overexposures in interventional or therapeutic procedures or under-doses in radiation therapy. (author)

Retrospective analysis and think of original papers of gastrointestinal imageology for 46 years in chinese journal of radiology

International Nuclear Information System (INIS)

Cheng Yingsheng; Shang Kezhong

2001-01-01

Objective: To retrospectively analyze and think the original papers of gastrointestinal (GI) imageology for 46 years in Chinese Journal of Radiology (CJR), meeting a huge challenge of Chinese GI imageology in alternation of generations. Methods: From October 1953 to October 1999, a review of original articles of GI imageology in CJR was conducted. Results: Within 46 years of GI imageology evolution, 211 published original articles of CJR included 79 original papers of radiography and single contrast radiography, 73 original papers of double contrast radiography, 21 original paper of interventional radiology, 15 original papers of CT and MR and CR (computed radiography), 9 original papers of experiment study, and 4 original papers of comprehensive imaging applications. There were different dominant imaging applications at different times, radiography and single contrast radiography in fifties and sixties, double contrast radiography and CT diagnosis in seventies and eighties, and comprehensive applications of CT and MR and CR and interventional radiology in nineties. Conclusion: In GI imageology for 46 years, double contrast radiography in X-ray diagnosis was the main method of imaging diagnosis, CT and MR and CR diagnosis were important means of recruit; interventional radiology was an important section of GI imageology in nineties

A project: 'Radiological protection in radiology', IAEA - Universidad Central de Venezuela

International Nuclear Information System (INIS)

Diaz, A.R.; Salazar, G.; Fermin, R.; Gonzalez, M.

2001-01-01

For several years a reference center of the UCV has been working on the project VEN/9/007 on dose reduction in diagnostic radiology sponsored by the IAEA. The dose and quality image was evaluated for different types of radiological study (conventional radiology, CT, mammography, interventional radiology) in different facilities at Caracas and others regions of the Venezuela. TL dosimeters were used to assess dose and reduction in dose. Based on the recommendations given by CEC documents on diagnostic quality criteria, a quality control program in radiological protection of patients and staff has been developed, for example: Pilot study by using TLD in personnel radiation monitoring. Comparative study between high and low kVp in chest. Evaluation and dose reduction in chest pediatric. Reduction of radiation dose in studies of billiards via Quality Image and reduction of the dose in studies of colon by enema. Radiation dose of staff in fluoroscopy procedures. Evaluation and dose reduction in dental radiography in public Institutions. A mammography accreditation program for Venezuela, applied to public hospitals. (author)

Interventions to Reduce Adult Nursing Turnover: A Systematic Review of Systematic Reviews.

Science.gov (United States)

Halter, Mary; Pelone, Ferruccio; Boiko, Olga; Beighton, Carole; Harris, Ruth; Gale, Julia; Gourlay, Stephen; Drennan, Vari

2017-01-01

Nurse turnover is an issue of concern in health care systems internationally. Understanding which interventions are effective to reduce turnover rates is important to managers and health care organisations. Despite a plethora of reviews of such interventions, strength of evidence is hard to determine. We aimed to review literature on interventions to reduce turnover in nurses working in the adult health care services in developed economies. We conducted an overview (systematic review of systematic reviews) using the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Applied Social Sciences Index and Abstracts, CINAHL plus and SCOPUS and forward searching. We included reviews published between 1990 and January 2015 in English. We carried out parallel blinded selection, extraction of data and assessment of bias, using the Assessment of Multiple Systematic Reviews. We carried out a narrative synthesis. Despite the large body of published reviews, only seven reviews met the inclusion criteria. These provide moderate quality review evidence, albeit from poorly controlled primary studies. They provide evidence of effect of a small number of interventions which decrease turnover or increase retention of nurses, these being preceptorship of new graduates and leadership for group cohesion. We highlight that a large body of reviews does not equate with a large body of high quality evidence. Agreement as to the measures and terminology to be used together with well-designed, funded primary research to provide robust evidence for nurse and human resource managers to base their nurse retention strategies on is urgently required.

The international pediatric radiology 5th conjoint meeting

International Nuclear Information System (INIS)

Anon.

2006-01-01

The review course will feature a series of informative refresher courses on topics such as head and neck imaging, musculoskeletal intervention and emergency radiology. In addition, we will feature Special Focus Sessions on the important topics of radiation effects, fetal imaging, and the challenges of radiography in the digital age. The educational program will be rounded out by four State-of-the-Art sessions on CT radiation dose, imaging in pediatric oncology, the cardiovascular and urogenital systems, and the dysplastic hip. Three New Horizons sessions have been created which will study the rapid developments in molecular imaging and advanced MRI. A Film Panel of multinational experts has been formed to review unknown cases of interest. (orig.)

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)

Paediatric Crohn's disease: a radiological review

International Nuclear Information System (INIS)

Ali, S.I.; Carty, H.M.L.

2000-01-01

Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close co-operation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution. (orig.)

Portal hypertension: a review of portosystemic collateral pathways and endovascular interventions

International Nuclear Information System (INIS)

Pillai, A.K.; Andring, B.; Patel, A.; Trimmer, C.; Kalva, S.P.

2015-01-01

The portal vein is formed at the confluence of the splenic and superior mesenteric vein behind the head of the pancreas. Normal blood pressure within the portal system varies between 5 and 10 mmHg. Portal hypertension is defined when the gradient between the portal and systemic venous blood pressure exceeds 5 mmHg. The most common cause of portal hypertension is cirrhosis. In cirrhosis, portal hypertension develops due to extensive fibrosis within the liver parenchyma causing increased vascular resistance. In addition, the inability of the liver to metabolise certain vasodilators leads to hyperdynamic splanchnic circulation resulting in increased portal blood flow. Decompression of the portal pressure is achieved by formation of portosystemic collaterals. In this review, we will discuss the pathophysiology, anatomy, and imaging findings of spontaneous portosystemic collaterals and clinical manifestations of portal hypertension with emphasis on the role of interventional radiology in the management of complications related to portal hypertension

Gout. Radiological aspects

International Nuclear Information System (INIS)

Restrepo Suarez, Jose Felix; Pena Cortes, Mario; Rondon Herrera, Federico; Iglesias Gamarra, Antonio; Calvo Paramo, Enrique

2000-01-01

In this paper we reviewed the clinical and radiological aspects of gout, showing the most frequent radiological findings that can guide to the correct diagnosis of the disease. The cases that we presented here have been analyzed for many years in our rheumatology service, Universidad Nacional de Colombia, Hospital San Juan de Dios, Bogota

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

Radiological evaluation of dysphagia

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Ott, D.J.; Gelfand, D.W.; Wu, W.C.; Chen, Y.M.

1986-11-21

Dysphagia is a common complaint in patients presenting for radiological or endoscopic examination of the esophagus and is usually due to functional or structural abnormalities of the esophageal body or esophagogastric region. The authors review the radiological evaluation of the esophagus and esophagogastric region in patients with esophageal dysphagia and discuss the roentgenographic techniques used, radiological efficacy for common structural disorders, and evaluation of esophageal motor function. Comparison is made with endoscopy in assessing dysphagia, with the conclusion that the radiological examination be used initially in patients with this complaint.

Radiological evaluation of dysphagia

International Nuclear Information System (INIS)

Ott, D.J.; Gelfand, D.W.; Wu, W.C.; Chen, Y.M.

1986-01-01

Dysphagia is a common complaint in patients presenting for radiological or endoscopic examination of the esophagus and is usually due to functional or structural abnormalities of the esophageal body or esophagogastric region. The authors review the radiological evaluation of the esophagus and esophagogastric region in patients with esophageal dysphagia and discuss the roentgenographic techniques used, radiological efficacy for common structural disorders, and evaluation of esophageal motor function. Comparison is made with endoscopy in assessing dysphagia, with the conclusion that the radiological examination be used initially in patients with this complaint

A century of urinary tract radiology in Australasia

International Nuclear Information System (INIS)

Hare, W.S.C.

1995-01-01

In 1900, the Australasian Medical Gazette included as a supplement, a hazy illustration provided by Dr. Herschel Harris of a bladder stone, and this was the first urinary radiograph illustrated in the local literature. One hundred years later, the uroradiologists have at their disposition a wide range of imaging modalities, which ensures a high level of diagnostic accuracy, and interventions techniques, which assist in treatment. This review illustrate how the Australasian radiology contributed to the spectacular evolution of technology and through its application, to a better understanding of urinary disease processes. 63 refs., 5 figs

Practice-level quality improvement interventions in primary care: a review of systematic reviews.

Science.gov (United States)

Irwin, Ryan; Stokes, Tim; Marshall, Tom

2015-11-01

To present an overview of effective interventions for quality improvement in primary care at the practice level utilising existing systematic reviews. Quality improvement in primary care involves a range of approaches from the system-level to patient-level improvement. One key setting in which quality improvement needs to occur is at the level of the basic unit of primary care--the individual general practice. Therefore, there is a need for practitioners to have access to an overview of the effectiveness of quality improvement interventions available in this setting. A tertiary evidence synthesis was conducted (a review of systematic reviews). A systematic approach was used to identify and summarise published literature relevant to understanding primary-care quality improvement at the practice level. Quality assessment was via the Critical Appraisal Skills Programme tool for systematic reviews, with data extraction identifying evidence of effect for the examined interventions. Included reviews had to be relevant to quality improvement at the practice level and relevant to the UK primary-care context. Reviews were excluded if describing system-level interventions. A range of measures across care structure, process and outcomes were defined and interpreted across the quality improvement interventions. Audit and feedback, computerised advice, point-of-care reminders, practice facilitation, educational outreach and processes for patient review and follow-up all demonstrated evidence of a quality improvement effect. Evidence of an improvement effect was higher where baseline performance was low and was particularly demonstrated across process measures and measures related to prescribing. Evidence was not sufficient to suggest that multifaceted approaches were more effective than single interventions. Evidence exists for a range of quality improvement interventions at the primary-care practice level. More research is required to determine the use and impact of quality

Evidence-based radiology: a new approach to evaluate the clinical practice of radiology

International Nuclear Information System (INIS)

Puig, S.; Felder-Puig, R.

2006-01-01

Over the last several years, the concept and methodology of evidence-based medicine (EBM) have received significant attention in the scientific community. However, compared to therapeutic medical disciplines, EBM-based radiological publications are still underrepresented. This article summarizes the principles of EBM and discusses the possibilities of their application in radiology. The presented topics include the critical appraisal of studies on the basis on EBM principles, the explanation of EBM-relevant statistical outcome parameters (e.g., ''likelihood ratio'' for diagnostic and ''number needed to treat'' for interventional procedures), as well as the problems facing evidence-based radiology. Evidence-based evaluation of radiological procedures does not only address aspects of cost-effectiveness, but is also particularly helpful in identifying patient-specific usefulness. Therefore it should become an integral part of radiologist training. (orig.)

Recent trend of diagnostic radiology

International Nuclear Information System (INIS)

Kim, S.Y.; Kim, H.K.

1979-01-01

Present status and recent trend of diagnostic radiology have been reviewed. The interrelationships and Characteristics of various fields of radiology such as computed tomography, X-ray radiology, and nuclear medicine were discussed. The mevit of computed tomography and the promising use of short lived, accelerator produced radionuclides, and radiotherapy in nuclear medicine were emphasized. (author)

A systematic review of systematic reviews on interventions for caregivers of people with chronic conditions.

Science.gov (United States)

Corry, Margarita; While, Alison; Neenan, Kathleen; Smith, Valerie

2015-04-01

To evaluate the effectiveness of interventions to support caregivers of people with selected chronic conditions. Informal caregivers provide millions of care hours each week contributing to significant healthcare savings. Despite much research evaluating a range of interventions for caregivers, their impact remains unclear. A systematic review of systematic reviews of interventions to support caregivers of people with selected chronic conditions. The electronic databases of PubMed, CINAHL, British Nursing Index, PsycINFO, Social Science Index (January 1990-May 2014) and The Cochrane Library (Issue 6, June 2014), were searched using Medical Subject Heading and index term combinations of the keywords caregiver, systematic review, intervention and named chronic conditions. Papers were included if they reported a systematic review of interventions for caregivers of people with chronic conditions. The methodological quality of the included reviews was independently assessed by two reviewers using R-AMSTAR. Data were independently extracted by two reviewers using a pre-designed data extraction form. Narrative synthesis of review findings was used to present the results. Eight systematic reviews were included. There was evidence that education and support programme interventions improved caregiver quality of life. Information-giving interventions improved caregiver knowledge for stroke caregivers. Education, support and information-giving interventions warrant further investigation across caregiver groups. A large-scale funded programme for caregiver research is required to ensure that studies are of high quality to inform service development across settings. © 2014 John Wiley & Sons Ltd.

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

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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.

Adrenal lesions encountered in current medical practice − a review of their radiological imaging

Directory of Open Access Journals (Sweden)

Vanesha Naidu

2013-11-01

Full Text Available Modern radiological technology has transformed the way that adrenal lesions are currently investigated. The contemporary radiologist has been catapulted to the forefront in the management of adrenal disease. With the increasing use of cross-sectional imaging, adrenal lesions are being serendipitously discovered in radiological studies undertaken for non-adrenal-related conditions – the so-called adrenal ‘incidentaloma’. This review discusses the imaging modalities available for characterising these lesions, highlighting current concepts and controversies in differentiating benign from malignant pathology. The article also provides a brief overview of the spectrum of adrenal pathology commonly encountered in the adult population.

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

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

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.

A systematic review of psychoneuroimmunology-based interventions.

Science.gov (United States)

Moraes, Lucam J; Miranda, Márcia B; Loures, Liliany F; Mainieri, Alessandra G; Mármora, Cláudia Helena C

2018-07-01

Psychoneuroimmunology-based interventions are used to attenuated disease progression and/or side effects of pharmacological treatment. This systematic review evaluates the different therapeutic and/or clinical psychoneuroimmunology-based interventions associated to both psychological, neuroendocrine and immunological variables. The review was conducted for all English, Portuguese and Spanish language articles published between 2005 and 2015. Independent investigators analyzed 42 studies concerning human psychoneuroimmunology-based interventions. Decreased levels of cortisol, epinephrine and norepinephrine (stress-related hormones) were associated to interventions like yoga, meditation, tai chi, acupuncture, mindfulness, religious/spiritual practices, cognitive behavior therapy, coping and physical exercises. Moreover, those interventions were also associated to reductions in inflammatory processes and levels of pro-inflammatory cytokines in cancer, HIV, depression, anxiety, wound healing, sleep disorder, cardiovascular diseases and fibromyalgia. Despite the associations between PNI variables and clinical/therapeutic interventions, only one study evidenced significant effects on a disease progression.

Ethical values in radiological protection

International Nuclear Information System (INIS)

Oughton, D.H.

1996-01-01

Issues like consent, equity, control and responsibility are important for an ethical evaluation of radiation risks. This paper discusses the incorporation of ethical values in radiological protection policy and compares how ICRP recommendations promote their use in practice and intervention cases. The paper contends that in cases of intervention, where the overall aim is dose reduction, social and ethical factors are often alluded to when evaluating costs of an action. However, possible ethical or social benefits of intervention measures are seldom raised. On the other hand, when assessing a practice, wherein the net effect is an increase in radiation dose, one is more likely to find an appeal to ethical factors on the benefits side of the equation than with the costs. The paper concludes that all decisions concerning radiological protection should consider both positive and negative ethical aspects. (author)

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.

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.

Externally Acquired Radiological Data for the Clinical Routine - A Review of the Reimbursement Situation in Germany.

Science.gov (United States)

Schreyer, Andreas G; Steinhäuser, René T; Rosenberg, Britta

2018-02-07

 Interdisciplinary radiological conferences and boards can improve therapeutic pathways. Because of the reinterpretation and presentation of external image data, which already was read, an additional workload is created which is currently not considered by health care providers. In this review we discuss the ongoing basics and possibilities in health economy for a radiological second opinion for the outpatient and inpatient sector in Germany.  Based on up-to-date literature and jurisdiction, we discuss the most important questions for the reimbursement for second opinions and conference presentations of external image data in an FAQ format. Additionally, we focus on the recently introduced E-Health law accordingly.  Radiological services considering second opinion or board presentation of externally acquired image data are currently not adequately covered by health care providers. In particular, there is no reimbursement possibility for the inpatient sector. Only patients with private insurance or privately paid second opinions can be charged when these patients visit the radiologist directly.  Currently there is no adequate reimbursement possibility for a radiological second opinion or image demonstrations in clinical conferences. It will be essential to integrate adequate reimbursement by health care providers in the near future because of the importance of radiology as an essential diagnostic and therapeutic medical partner.   · Currently there is no reimbursement for image interpretation and presentation in boards.. · Second opinions can only be reimbursed for patients with private insurance or privately recompensed.. · The E-Health law allows reimbursement for tele-counsel in very complex situations.. · It will be crucial to integrate radiological second opinion in future reimbursement policies by health care providers.. · Schreyer AG, Steinhäuser RT, Rosenberg B. Externally Acquired Radiological Data for the Clinical Routine - A Review of

Interventions to promote cycling: systematic review.

Science.gov (United States)

Yang, Lin; Sahlqvist, Shannon; McMinn, Alison; Griffin, Simon J; Ogilvie, David

2010-10-18

To determine what interventions are effective in promoting cycling, the size of the effects of interventions, and evidence of any associated benefits on overall physical activity or anthropometric measures. Systematic review. Published and unpublished reports in any language identified by searching 13 electronic databases, websites, reference lists, and existing systematic reviews, and papers identified by experts in the field. Review methods Controlled "before and after" experimental or observational studies of the effect of any type of intervention on cycling behaviour measured at either individual or population level. Twenty five studies (of which two were randomised controlled trials) from seven countries were included. Six studies examined interventions aimed specifically at promoting cycling, of which four (an intensive individual intervention in obese women, high quality improvements to a cycle route network, and two multifaceted cycle promotion initiatives at town or city level) were found to be associated with increases in cycling. Those studies that evaluated interventions at population level reported net increases of up to 3.4 percentage points in the population prevalence of cycling or the proportion of trips made by bicycle. Sixteen studies assessing individualised marketing of "environmentally friendly" modes of transport to interested households reported modest but consistent net effects equating to an average of eight additional cycling trips per person per year in the local population. Other interventions that targeted travel behaviour in general were not associated with a clear increase in cycling. Only two studies assessed effects of interventions on physical activity; one reported a positive shift in the population distribution of overall physical activity during the intervention. Community-wide promotional activities and improving infrastructure for cycling have the potential to increase cycling by modest amounts, but further controlled