Management of doses from medical exposures in interventional radiology: an integrative review
Gerenciamento das doses decorrentes de exposições médicas na radiologia intervencionista: uma revisão integrativa
DOI:
https://doi.org/10.15392/2319-0612.2022.1858Keywords:
Radiologia intervencionista, Lesões por radiação, Proteção radiológica, Dosimetria de pacientesAbstract
Interventional radiology (IR) uses minimally invasive image-guided procedures that may require a long duration and deliver high radiation doses to the patient. The most current studies on management and dose reduction in IR have shown to be of fundamental importance in radiation protection practices. The objective of this study was to survey what has been published in the national and international literature on the doses received by patients undergoing IR procedures. It consisted of an integrative review study carried out in Scielo, Pubmed, and INIS databases in the time frame of 2016-2021, using as descriptors: interventional radiology, radiation injuries, radiological protection, dosimetry; and their equivalents in English: interventional radiology, radiation injuries, radiological protection, and dosimetry. The initial sample consisted of 68 full articles related to the theme, published during the study period. Of these, 11 articles were selected and made up the final sample. The results indicate that the use of software in dose management and monitoring has proven to be an important tool in radiological protection. The implementation of dose reduction strategies and increased awareness about the use and effects of radiation result in significantly lower doses to both professionals and patients. No national study on dose management has been identified, highlighting the need to promote the subject in the country. The main recommendations identified were the introduction of technologies and the training of the workers involved.
- Views: 241
- PDF Downloads: 229
Downloads
References
BUSHONG, S. C. Health physics. In: BUSHONG, S. C. Radiologic science for technologists: physics, biology and protection, 9th ed., St.Louis: Mosby, 2010. p. 430-493.
CONTER - CONSELHO NACIONAL DE TÉCNICOS EM RADIOLOGIA. Entenda o papel de técnicos e tecnólogos na Hemodinâmica. 2019. Disponível em: <http://conter.gov.br/site/noticia/profissional-x-06-08-2019> Acesso em 13 fev. 2021.
MELO, F. A. A importância do uso do dosímetro nos profissionais médicos no
serviço de hemodinâmica. Brazilian Journal of Radiation Sciences, v. 3, n.1A, 2015.
Disponível em: <https://www.bjrs.org.br/revista/index.php/REVISTA/article/view/58>. Acesso em
abr 2021.
ROCHE, A. Radioprotection du patient en radiologie interventionnelle. Journal de radiologie, v. 91, n. 11, p. 1231-1235, 2010. Disponível em: https://www.sciencedirect.com/science/article/abs/pii/S0221036310701797 Acesso em 23 jun. 2021. DOI: https://doi.org/10.1016/S0221-0363(10)70179-7
CNEN - Comissão Nacional De Energia Nuclear. Apostila educativa: Radiações Ionizantes e a vida. Rio de Janeiro, 2020.
LEYTON, F., CANEVARO, L., DOURADO, A., CASTELLO, H., BACELAR, A., NAVARRO, M. T., VAÑÓ, E., NOGUEIRA, M. S., BATISTA, W. O., FURQUIM, T. A. C., LYKAWKA, R., MELO, C. S., BORGES, F., RODRIGUES, B. Riscos da Radiação X e a Importância da Proteção Radiológica na Cardiologia Intervencionista: Uma Revisão Sistemática. Rev. Bras. Cardiol. Invasiva, São Paulo, v. 22, n. 1, p. 87-98, Mar. 2014. DOI: https://doi.org/10.1590/0104-1843000000015
BUNDY, J.J., MCCRACKEN, I.W., SHIN, D.S., MONROE, E. J., JOHNSON, G. E.,INGRAHAM, C. R., KANAL K. M., BUNDY, R. A., JONES, S. T., VALJI, K., CHICK, J. F. B.
Fluoroscopically-guided interventions with radiation doses exceeding 5000 mGy reference point air kerma: a dosimetric analysis of 89,549 interventional radiology, neurointerventional radiology, vascular surgery, and neurosurgery encounters. CVIR Endovasc. 2020. Disponível em: <https://link.springer.com/article/10.1186/s42155-020-00159-6> Acesso em 03 out. 2021.
BRASIL. AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA (ANVISA). Resolução da Diretoria Colegiada nº 330. Diretoria Colegiada da Agência Nacional de Vigilância Sanitária. Ministério da Saúde. 2019a. Disponível em: Acesso em 28 ago. 2021.
UNSCEAR - UNITED NATIONS SCIENTIFIC COMMITTEE ON THE EFFECTS OF ATOMIC RADIATION. UNSCEAR's Global Survey of Radiation Exposure. 2020. Disponível em: <http://www.survey.unscear.org/doku.php>. Acesso em 2 set 2021.
SILVA, M. S. R., KHOURYII H. J., BORRÁSIII C., OLIVEIRA A. F., VIANNA H. F. P.,
OLIVEIRA F. R. A., JAPYASSÚ F. A A., MOTA F. B. Dosimetria de pacientes e médicos
em intervenções coronárias percutâneas em Recife, Pernambuco, Brasil. Radiologia Brasileira, São Paulo, 2011. Disponível em: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-39842011000200008&lng=pt&nrm=iso>. Acesso em 16 maio 2021.
CORRIGALL, R. S., MARTIN, C. J., SCOTT, I. Observations of tissue reactions following neuroradiology interventional procedures. Journal of Radiological Protection, v. 40, n. 1, p. N9, 2020. Disponível em: <https://iopscience.iop.org/article/10.1088/1361-6498/ab5bf4> Acesso em 2 ago. 2021. DOI: https://doi.org/10.1088/1361-6498/ab5bf4
SANTA CATARINA. Secretaria do Estado da Santa de Santa Catarina. Diretoria deVigilância Sanitária do Estado de Santa Catarina (DIVS/SC). Resolução Normativa nº 002. Diretoria de Vigilância Sanitária da Secretaria de Estado da Saúde de Santa Catarina. p. 14. 2015.
UNSCEAR - UNITED NATIONS SCIENTIFIC COMMITTEE ON THE EFFECTS OF ATOMIC RADIATION, 2017. UNSCEAR’s global survey of radiation exposure. Medical Exposure: a user manual. Version October, 2017.
BANERJEE, I., et al. An investigation of procedural radiation dose level awareness and personal training experience in communicating ionizing radiation examinations benefits and risks to patients in two European cardiac centers. Health physics, v. 117, n. 1, p. 76-83, 2019. DOI: https://doi.org/10.1097/HP.0000000000001049
ICRP - INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION, 2013. Radiological protection in cardiology. ICRP Publication 120. Ann. ICRP 42(1). DOI: https://doi.org/10.1016/j.icrp.2012.09.001
JASCHKE, W., SCHMUTH, M., TRIANNI, A., BARTAL, G. Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know. Cardiovasc Intervent Radiol. v40. p. 1131–1140. 2017. DOI: https://doi.org/10.1007/s00270-017-1674-5
HARRIES D., PLATTEN D.J. Improving the effectiveness and efficiency of a skin dose investigation protocol in interventional radiology. BMJ Open Quality. 2020. Disponível em: <https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000722.full.pdf>. Acesso em 25 nov. 2021. DOI: https://doi.org/10.1136/bmjoq-2019-000722
PERRY, B. C., INGRAHAM, C. R., STEWART, B. K., VALJI, K., & KANAL, K. M. Monitoring and Follow-Up of High Radiation Dose Cases in Interventional Radiology. Academic Radiology. 2018. Disponível em: <https://www.sciencedirect.com/science/article/abs/pii/S1076633218302320>. Acesso em 01 out. 2021.
HEILMAIER C., ZUBER N., BERTHOLD C., KARA L., WEISHAUPT D. Establishing Local Diagnostic Reference Levels In Ir Procedures with Dose Management Software. Journal of Vascular and Interventional Radiology. Mar; 28(3):429-441. 2017. Disponível em: <https://pubmed.ncbi.nlm.nih.gov/28034700/>. Acesso em 26 dez. 2021. DOI: https://doi.org/10.1016/j.jvir.2016.10.006
HEILMAIER, C., KARA, L., ZUBER, N., BERTHOLD, C., WEISHAUPT, D. Combined Use of a Patient Dose Monitoring System and a Real-Time Occupational Dose Monitoring System for Fluoroscopically Guided Interventions. Journal of Vascular and Interventional Radiology, 27(4), 584–592. 2016. DOI: https://doi.org/10.1016/j.jvir.2015.11.033
RANA, V. K., RUDIN, S., & BEDNAREK, D. R. A tracking system to calculate patient skin dose in realtime during neurointerventional procedures using a biplane x-ray imaging system. Medical Physics. 43(9), 5131–5144. 2016. DOI: https://doi.org/10.1118/1.4960368
GREFFIER J., et al. Assessment of Patient's Peak Skin Dose Using Gafchromic Films During Interventional Cardiology Procedures: Routine Experience Feedback. Radiat Prot Dosimetry. 174(3):395-405. 2017. Disponível em: <https://pubmed.ncbi.nlm.nih.gov/29697513/>. Acesso em 23 nov. 2021.
Zhonghua Sun, Aini AbAziz, Ahmad Khairuddin Md Yusof, "Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction", BioMed Research International, vol. 2013. Disponível em: <https://www.hindawi.com/journals/bmri/2013/976962/> Acesso em 24 jan. 2022. DOI: https://doi.org/10.1155/2013/976962
ICRP- INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION, 2009. Education and Training in Radiological Protection for Diagnostic and Interventional Procedures. ICRP Publication 113. Ann. ICRP 39 (5). DOI: https://doi.org/10.1016/j.icrp.2011.01.001
SÁNCHEZ, R. M., VAÑÓ, E., GARCÍA, L. E., & FERNÁNDEZ, J. M. Reducing the risk of skin injuries in cardiac catheterization procedures: Optimization proposal for obese patients. Physica Medica, 53, 94–102. 2018. Disponível em: <https://pubmed.ncbi.nlm.nih.gov/30241760>. Acesso 1 nov. 2021. DOI: https://doi.org/10.1016/j.ejmp.2018.08.012
SCHNEIDER, T., WYSE E., PEARL, M.S. Analysis of radiation doses incurred during diagnostic cerebral angiography after the implementation of dose reduction strategies. J Neurointerv Surg. 2017. 9(4):384-388. DOI: https://doi.org/10.1136/neurintsurg-2015-012204
MILLER, D. L., et al. Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. Cardiovascular and interventional radiology, v. 33, n. 2, p. 230-239, 2010. DOI: https://doi.org/10.1007/s00270-009-9756-7
O'HORA, L., RYAN M.L., RAINFORD, L. Survey Of Key Radiation Safety Practices In Interventional Radiology: AN IRISH AND ENGLISH STUDY. Radiat Prot Dosimetry. 1;183(4):431-442. 2019. DOI: https://doi.org/10.1093/rpd/ncy162
BIJWAARD H., VALK D., DE WAARD-SCHALKX I. Radiation Protection for Interventional Fluoroscopy: Results of a Survey Among Dutch Hospitals. Health Phys. v. 114(6), p. 627-631, 2018. DOI: https://doi.org/10.1097/HP.0000000000000837
ICRP - INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION, 2017. Diagnostic Reference Levels in Medical Imaging. ICRP Publication 135. Ann. ICRP 46(1). DOI: https://doi.org/10.1177/0146645317717209
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Brazilian Journal of Radiation Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing: The BJRS articles are licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
