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. 2011 Jan-Feb;17(1):23-9.
doi: 10.4103/1319-3767.74456.

Reduction of radiation doses to patients and staff during endoscopic retrograde cholangiopancreatography

Abdelmoneim Sulieman  1 , Georgios Paroutoglou, Andreas Kapsoritakis, Anargeyros Kapatenakis, Spiros Potamianos, Marianna Vlychou, Kiki Theodorou
Affiliations

Reduction of radiation doses to patients and staff during endoscopic retrograde cholangiopancreatography

Abdelmoneim Sulieman et al. Saudi J Gastroenterol. 2011 Jan-Feb.

Abstract

Background/aim: Endoscopic retrograde cholangiopancreatography (ERCP) is associated with a considerable radiation exposure for patients and staff. While optimization of the radiation dose is recommended, few studies have been published. The purpose of this study has been to measure patient and staff radiation dose, to estimate the effective dose and radiation risk using digital fluoroscopic images. Entrance skin dose (ESD), organ and effective doses were estimated for patients and staff.

Materials and methods: Fifty-seven patients were studied using digital X-ray machine and thermoluminescent dosimeters (TLD) to measure ESD at different body sites. Organ and surface dose to specific radiosensitive organs was carried out. The mean, median, minimum, third quartile and the maximum values are presented due to the asymmetry in data distribution.

Results: The mean ESD, exit and thyroid surface dose were estimated to be 75.6 mGy, 3.22 mGy and 0.80 mGy, respectively. The mean effective dose for both gastroenterologist and assistant is 0.01 mSv. The mean patient effective dose was 4.16 mSv, and the cancer risk per procedure was estimated to be 2 × 10(-5).

Conclusion: ERCP with fluoroscopic technique demonstrate improved dose reduction, compared to the conventional radiographic based technique, reducing the surface dose by a factor of 2, without compromising the diagnostic findings. The radiation absorbed doses to the different organs and effective doses are relatively low.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Patient setup, lead apron and examiners positions during ERCP examination. 1. Gastroenterologist; 2. assistant gastroenterologist; M1., endoscopic monitor; M2. fluoroscopic monitor. T1 X ray tube. T2,Table, and L lead apron
Figure 2
Figure 2
(a) A comparison of ESD and effective dose for ERCP patients with those published, previously. (b) A comparison of thyroid and eye lens doses for staff with previous studies
See this image and copyright information in PMC

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