Vet Med - Czech, 2018, 63(11):527-531 | DOI: 10.17221/15/2018-VETMED
Radiation exposure during C-arm-guided (fluoroscopy) small animal orthopaedic surgeryOriginal Paper
- 1 College of Veterinary Medicine, Chonbuk National University, Iksan, Republic of Korea
- 2 Research Ethics Center, Korea University, Seoul, Republic of Korea
- 3 College of Health Sciences, Cheongju University, Cheongju, Republic of Korea
- 4 College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
The purpose of the current study was to investigate the radiation exposure level of surgeons performing C-arm guided small animal orthopaedic surgery using thermoluminescent dosimeters located inside and outside personnel shielding devices at major body parts. A prospective study was conducted to measure the radiation exposure dose of individuals in three positions (first assistant, operating surgeon and anaesthesiologist) using thermoluminescent dosimeters placed inside and outside protective devices. The lead equivalent protective devices included panorama mask, thyroid shield, apron and arm shield placed at five anatomic sites (eye, thyroid, breast, gonad and hand). Radiation exposure was measured during 12 surgical procedures with mean kVp of 51 and mean mAs of 1.6. The equivalent doses for thyroid, breast and gonad (outside/inside in mSv) were 1.75/0.58, 2.01/0.13 and 3.03/0.11, respectively, for the first assistant and 1.69/1.46, 4.82/0.35 and 5.25/0.22 for the operating surgeon. The dose of eye, thyroid, breast, gonad and arm for the anaesthesiologist were 0.61/0.51, 0.35/0.3, 0.67/0.34, 0.72/0.29 and 0.62/0.35, respectively. The exposure dose to gonads outside the lead protection showed the highest values in all participants. With lead protection, there was a significant reduction in the exposure dose to the gonads (first assistant, 96%; operating surgeon, 96%; anaesthesiologist, 60%). These results suggest that a radiation shield is essential in veterinary surgery with C-arms, particularly for gonad protection. In addition, these results demonstrate that exposure dose decreases with increasing distance from the C-arm machine.
Keywords: veterinary orthopaedic surgery; fluoroscopic guidance; scatter radiation; protective device; surgical team; surgeon
Published: November 30, 2018 Show citation
References
- Abas AA, Rahman RA, Yahya N, Kamaruzaman E, Zainuddin K, Manap NA (2014): Occupational radiation exposure to anesthetists from fluoroscopic projections during orthopedic operative procedures. La Clinica Terapeutica 165, 253-257.
- Athwal GS, Bueno Jr RA, Wolfe SW (2005): Radiation exposure in hand surgery: Mini versus standard C-arm. The Journal of Hand Surgery 30, 1310-1316.
Go to original source...
Go to PubMed...
- Barber J, McNulty JP (2012): Investigation into scatter radiation dose levels received by a restrainer in small animal radiography. Journal of Small Animal Practice 53, 578-585.
Go to original source...
Go to PubMed...
- Boekhout-Ta CL, Kim SE, Cross AR, Evans R, Pozzi A (2017): Closed reduction and fluoroscopic-assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats. Veterinary Surgery 46, 103-110.
Go to original source...
Go to PubMed...
- Canato GR, Drumond LF, Paschuk SA, Asfora VK, Andrade MEA, Denyak V, Schelin HR (2014): Occupational exposure assessment in procedures of portable digital veterinary radiology for small size animals. Radiation Physics and Chemistry 95, 284-287.
Go to original source...
- ICRP - International Commission on Radiological Protection (2007): The 2007 recommendations of the International Commission on Radiological Protection: Publication 103. Annals of the ICRP 37. 1-332.
- ICRP - International Commission on Radiological Protection (2013): Proceedings of the Second International Symposium on the System of Radiological Protection. Annals of the ICRP 44. 1-356.
- Jones SC, Lewis DD, Winter MD (2015): Fluoroscopic-assisted olecranon fracture repair in three dogs. Case Reports in Veterinary Medicine 2015, doi: 10.1155/2015/542842.
Go to original source...
- Mahajan A, Samuel S, Saran AK, Mahajan MK, Mam MK (2015): Occupational radiation exposure from C arm fluoroscopy during common orthopaedic surgical procedures and its prevention. Journal of Clinical and Diagnostic Research 9, RC01-RC04.
Go to original source...
Go to PubMed...
- Mehlman CT, DiPasquale TG (1997): Radiation exposure to the orthopaedic surgical team during fluoroscopy: "How far away is far enough?". Journal of Orthopaedic Trauma 11, 392-398.
Go to original source...
Go to PubMed...
- Park MS, Lee KM, Lee B, Min E, Kim Y, Jeon S, Huh Y, Lee K (2012): Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. Radiation Protection Dosimetry 148, 431-438.
Go to original source...
Go to PubMed...
- Rohwedder T, Fischer M, Bottcher P (2017): In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Veterinary Journal 7, 221-228.
Go to original source...
Go to PubMed...
- Singer G (2005): Occupational radiation exposure to the surgeon. Journal of the American Academy of Orthopaedic Surgeons 13, 69-76.
Go to original source...
Go to PubMed...
- Tonks CA, Tomlinson JL, Cook JL (2008): Evaluation of closed reduction and screw fixation in lag fashion of sacroiliac fracture-luxations. Veterinary Surgery 37, 603-607.
Go to original source...
Go to PubMed...
- Tremains MR, Georgiadis GM, Dennis MJ (2001): Radiation exposure with use of the inverted-C-arm technique in upper-extremity surgery. The Journal of Bone and Joint Surgery 83, 674-678.
Go to original source...
Go to PubMed...
- Tuohy CJ, Weikert DR, Watson JT, Lee DH (2011): Hand and body radiation exposure with the use of mini C-arm fluoroscopy. The Journal of Hand Surgery 36, 632-638.
Go to original source...
Go to PubMed...
- Wheeler JL, Lewis DD, Cross AR, Sereda CW (2007): Closed fluoroscopic-assisted spinal arch external skeletal fixation for the stabilization of vertebral column injuries in five dogs. Veterinary Surgery 36, 442-448.
Go to original source...
Go to PubMed...
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