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

OBJECTIVES: Vascular and interventional radiology procedures are characterized by high exposure of personnel to ionizing radiation. This study assessed the exposure of medical personnel to ionizing radiation during vascular radiology and mechanical thrombectomy procedures. MATERIAL AND METHODS: During vascular radiology procedures, the exposure of 4 groups of workers participating in the procedures was analyzed, i.e., the main operating physician, an assistant physician, a sterile nurse, and a nurse. Measurements of exposure to ionizing radiation were performed using thermoluminescent dosimetry. RESULTS: The registered effective dose during 1 treatment in individual groups is, respectively: mean (M) ± standard deviation (SD) 75±15 µSv, 24±5 µSv, 13±3 µSv, and 8±2 µSv. During mechanical thrombectomy, the operating physician receives an effective dose of M±SD 9±2 µSv. The equivalent doses for the lenses for the operating physician and the doctor assisting during vascular radiology procedures are M±SD 1419±285 µSv and 987±198 µSv, respectively, and for the hands, including the left and right hands, M±SD 4605±930 µSv, 1420±284 µSv, 1898±380 µSv, 1371±274 µSv. CONCLUSIONS: If the principles of optimizing radiological protection are not applied during vascular radiology procedures, the permissible dose limits and operational limits equivalent to doses to lenses and hands may be exceeded. Exposure during vascular radiology procedures is comparable to exposure during nuclear medicine procedures in terms of the use of glucose labeled with radioactive fluorine. Int J Occup Med Environ Health. 2024;37(4).

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

OBJECTIVES: During computed tomography (CT), a large amount of ionizing radiation is emitted to ensure high quality of the obtained radiological image. This study measured the dose distribution around the CT scanner and the exposure of people staying near the CT scanner during the examination. MATERIAL AND METHODS: The measurements used an anthropomorphic phantom to assess human exposure to ionizing radiation. The probability of inducing leukemia and other cancers as a result of absorbing doses recorded around the CT device was also calculated. RESULTS: The highest exposure to scattered radiation in the proximity of the CT scanner is recorded at the gantry of the tomograph, i.e., 55.7 µGy, and the lowest, below lower detection limit of 6 µGy at the end of the diagnostic table. The whole-body detector placed on the anthropomorphic phantom located at the diagnostic table right next to the CT gantry recorded 59.5 µSv and at the end of the table 1.5 µSv. The average doses to the lenses in these locations were: 32.1 µSv and 2.9 µSv, respectively. CONCLUSIONS: The probability of induction of leukemia or other types of cancer is low, but the need for people to stay in the examination room during a CT examination should be limited to the necessary minimum. Int J Occup Med Environ Health. 2024;37(3):326-34.

Analysis of ionizing radiation doses received by patients during electrocardiological procedures.

Medical procedures in the field of electrocardiology belong to a large group of cardiological procedures. Performing them involves exposure to ionizing radiation. In this study, five medical procedures in the field of electrocardiology performed in three medical facilities were analyzed in terms of patients' exposure to ionizing radiation. A total of 178 patients were analyzed. Depending on the type of procedure, the recorded doses ranged from 7.4 to 614.62 mGy. The majority of electrocardiological procedures are pacemaker implantations 38% and RF ablation 33%. The results obtained show a significant dispersion of the recorded dose values in the same type of treatment. This is reflected, for example, in the high coefficient of variation for doses in RF ablation. The type of X-ray machine used during the procedure also influences the dose values. Although the exposure of patients undergoing electrocardiological procedures to ionizing radiation is much lower than in the case of cardiac vascular procedures, it may reach a similar level, especially in the case of implantation of devices regulating the correct functioning of the heart.

Analysis of the threshold image contrast obtained with the CDMAM 3.4 and CDMAM 4.0 phantoms.

Quality control in mammography is a very important element. One of the parameters indicating the appropriate image quality is the threshold image contrast. The CDMAM phantom is used to measure this parameter. It is currently available in two versions 3.4 and 4.0. The aim of this work is to compare the threshold image contrast readings obtained with the CDMAM 3.4 and CDMAM 4.0 phantoms. In the measurements, 9 CDMAM 4.0 phantoms were used to check the difference in indications of individual copies. The phantom whose readings were closest to the average of all readings was used for comparative measurements with the CDMAM 3.4 phantom. Measurements were made on 40 mammography devices. The obtained images were read with the software provided by the phantom manufacturer and the CDMAM Analysis v2.3.0 (NCCPM) software. The average percentage difference between the minimum and maximum values indicated by the CDMAM 4.0 phantoms was 10.09%. Using the CDMAM Analysis v2.3.0 (NCCPM) software, the average difference in readings between the CDMAM 3.4 and CDMAM 4.0 phantoms is 7.93%, and when using the software provided by the phantom manufacturer, it is as much as 60.15%. The obtained results of the threshold image contrast are affected by the type of software used for reading and the accuracy of the execution of individual elements of the phantom. It is recommended to use CDMAM Analysis v2.3.0 (NCCPM) software or the latest software provided by the phantom manufacturer to read the phantom images.

Comparison of Radionuclide Impurities Activated during Irradiation of 18O-Enriched Water in Tantalum and Silver Targets during the Production of 18F in a Cyclotron.

During the production of 18F, as a result of the interaction of the beam of protons and secondary neutrons with the structural elements of the target body, many radionuclide impurities are created in the cyclotron. As part of this work, we theoretically predicted which isotopes would be activated in the target tantalum or silver bodies. Subsequently, we used gamma spectrometry analysis to verify these predictions. The results were compared with the work of other authors who studied titanium and niobium as materials for making the target body. Tantalum has been evaluated as the most favorable in terms of generating radionuclide impurities during the production of 18F by irradiation of 18O-enriched water in accelerated proton cyclotrons. Only three radionuclides were identified in the tested samples: 181W, 181Hf, and 182Ta with a half-life of fewer than 120 days. The remaining reactions led to the formation of stable isotopes.

Exposure to ionizing radiation by service personnel working with cyclotrons used to produce radiopharmaceuticals in PET diagnostics.

OBJECTIVES: While working with cyclotrons used for the production of radiopharmaceuticals, workers can experience significant exposure to the adverse effects of ionizing radiation. The aim of this paper was to determine the typical level of such exposure received by such personnel while servicing cyclotrons. MATERIAL AND METHODS: Exposure was assessed using TLD detectors placed in an anthropomorphic phantom, as well as dose meter to determine whole body and eye lens exposure. The phantom was placed in locations receiving the greatest exposure to ionizing radiation during service activities. The time spent by employees during servicing was assessed based on routine visits by service technicians. The obtained results were compared with readings of detectors worn by employees during service activities. RESULTS: The highest equivalent doses in the thoracic area were found to be received by the lungs (211.16 µSv/year). In the head and neck area, the highest dose was measured in the eye lens (3410 µSv/year). The effective dose for the whole body was found to be 1154.4 µSv/year, based on the phantom, and 149 µSv per service visit (1192 µSv/year), based on the dose meters carried by the workers. CONCLUSIONS: Service workers are exposed to significant doses of ionizing radiation, representing a clear radiological protection issue. To reduce exposure to eye lenses, it is recommended to use protective goggles when working with highly-radioactive elements. Int J Occup Med Environ Health. 2022;35(6):753-60.

LEVELS OF EXPOSURE TO IONIZING RADIATION AMONG THE PERSONNEL ENGAGED IN CYCLOTRON OPERATION AND THE PERSONNEL ENGAGED IN THE PRODUCTION OF RADIOPHARMACEUTICALS, BASED ON RADIATION MONITORING SYSTEM.

This paper aims to determine the levels of exposure to neutron and photon radiation among the personnel engaged in cyclotron operation and the personnel engaged in the production of radiopharmaceuticals, with the use of the environmental radiation monitoring system (RMS) installed in the positron emission tomography laboratory. The annual exposures of employees operating the cyclotron measured with the use of the RMS system are: 1.39 ± 0.16 mSv in case of photon radiation and 2.61 ± 0.14 mSv in case of neutron radiation. In the case of employees in the radiopharmaceuticals' production zone, the annual exposures measured by means of the RMS system are 0.15 ± 0.03 mSv in case of photon radiation and 0.11 ± 0.01 mSv in case of neutron radiation. The exposure levels among the personnel engaged in cyclotron operation and the personnel engaged in the production of radiopharmaceuticals are below the permissible radiation dose limits.

The photo-transferred thermoluminescence phenomenon in case of emergency dose assessment.

A major disadvantage of dose reconstruction by means of thermoluminescence (TL) is the fact that during readout of any TL material exposed to ionizing radiation (i.e., during measuring the glow curve), the radiation-induced signal gets lost. Application of the photo-transferred thermoluminescence phenomenon (PTTL) may offer a solution to this problem. In PTTL, the residual signal that is not destroyed by conventional TL readout (because it comes from deeper electron traps) can be readout through simultaneous stimulation by UV light and heating, allowing to obtain information about the absorbed dose in a second run. The present paper describes the application of PTTL for emergency dose assessment. For this, MTS-N thermoluminescent detectors (LiF: Mg, Ti) were exposed using a high-energy Clinac 2300 medical linear accelerator to doses of 100 mGy, 300 mGy, 500 mGy, 700 mGy and 1000 mGy. Irradiation with UV radiation allowed the determination of the optimal heating time of 3 h, while the optimal temperature was identified to be 70 °C. The results obtained demonstrated the usefulness of the PTTL method for emergency dose assessment. The efficiency of the PTTL method was determined as 19%. Finally it was found that the detector background after UV exposure should not be underestimated during routine dose measurements.

THE STRUCTURE OF Hp(0.07) VALUES OBTAINED BY THE NUCLEAR MEDICINE PERSONNEL DURING 18F-FDG PRODUCTION AND INJECTION.

The production of 18F-FDG is a multi-stage process, which includes not only obtaining the marker and labelling the radiopharmaceutical but also carrying out the quality control of the obtained compound. The staff can be exposed to ionizing radiation at any stage of production. This article presents the results of hands exposure of staff members employed in a facility, where 18F-FDG is produced and injected into patients. High-sensitivity thermoluminescent detectors (MCP-N) were used for measurements. The measurements were conducted with regard to the occupational structure the employees and the performed procedures. The obtained results showed that the highest risk of radiation exposure for personnel was associated with the quality control of the radiopharmaceutical. The daily doses registered by MCP-N detectors on fingertips reached 4.5 mSv, which may result in exceeding the annual radiation limit of 500 mSv.

Analysis of dose distribution in organs at risk in patients with prostate cancer treated with the intensity-modulated radiation therapy and arc technique.

This study describes a comparative analysis of treatment plans in 48 patients with prostate cancer treated with ionizing radiation. Each patient was subjected to the intensity-modulated radiation therapy (IMRT) and arc technique. In each treatment plan, the organs at risk were assessed: the urinary bladder, rectum and heads of the femur, as well as the volume of normal tissue. The following features were compared: treatment time, conformity indices for the planning target volume, mean doses and standard deviation in organs at risk, and organ volumes for each particular dose. The treatment period in the arc technique is 13.7% shorter than in the IMRT technique. Comparing the results of the IMRT and arc techniques (arc vs. IMRT), the mean values were 29.21 ± 12.91 Gy versus 28.36 ± 13.79 Gy for the bladder, 20.36 ± 3.16 Gy versus 18.17 ± 5.11 Gy for the right femoral head, and 18.98 ± 3.28 Gy versus 16.67 ± 5.15 Gy for the left femoral head. For the rectum, lower values were obtained after application of the arc technique, not the IMRT technique: 35.84 ± 12.28 Gy versus 35.90 ± 13.05 Gy. The results indicate that the applied therapy has a statistically significant influence on the volume for a particular dose with regard to the urinary bladder. It is advisable to apply the IMRT technique to patients who need the femur heads and urinary bladder protected by exposing them to low irradiation doses.

Effect of anode/filter combination on average glandular dose in mammography.

A comparative analysis of the mean glandular doses was conducted in 100 female patients who underwent screening mammography in 2011 and 2013. Siemens Mammomat Novation with the application of the W/Rh anode/filter combination was used in 2011, whereas in 2013 anode/filter combination was Mo/Mo or Mo/Rh. The functioning of mammography was checked and the effectiveness of the automatic exposure control (AEC) system was verified by measuring compensation of changes in the phantom thickness and measuring tube voltage. On the base of exposure parameters, an average glandular dose for each of 100 female patients was estimated. The images obtained by using AEC system had the acceptable threshold contrast visibility irrespective of the applied anode/filter combination. Mean glandular doses in the females, examined with the application of the W/Rh anode/filter combination, were on average 23.6% lower than that of the Mo/Mo or Mo/Rh anode/filter combinations. It is recommended to use a combination of the W/Rh anode /filter which exhibited lower mean glandular doses.

The analysis of prognostic factors affecting post-radiation acute reaction after conformal radiotherapy for non-small cell lung cancer.

INTRODUCTION: The aim was to evaluate the risk of acute side effects in the lung after 3-dimensional conformal radiotherapy (3D-CRT) in patients treated for non-small cell lung cancer (NSCLC). An attempt was made to single out clinical factors and factors related to treatment technique which may induce acute post-radiation pneumonitis. MATERIAL AND METHODS: The analysis concerned 34 consecutive patients who underwent radical radiation therapy for NSCLC. Intensity of early toxicity was evaluated using modified RTOG/EORTC toxicity score. The endpoint for this analysis was the occurrence of radiation pneumonitis of grade 2 or higher. Factors related to treatment techniques were included in the statistical analysis. RESULTS: Fifty-three percent of patients included in the study suffered from acute post-radiation pneumonitis. The results of the study revealed the existence of lung tissue sensitivity to low doses of ionizing radiation. The multivariate analysis showed that total lung volume receiving a low dose of 10 Gy increased the risk of post-radiation pneumonitis (p = 0.01). CONCLUSIONS: Acute post-radiation pneumonitis was a relevant clinical problem in patients who underwent radical radiotherapy for non-small cell lung cancer. The lung volume receiving a dose of 10 Gy was the most important dosimetric factor which influenced the post-radiation acute pneumonitis.