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. 2016 Aug;78(3):245-53.

Evaluation of radiation exposure dose at double-balloon endoscopy for the patients with small bowel disease

Asuka Nagura  1 , Masanao Nakamura  1 , Osamu Watanabe  1 , Takeshi Yamamura  2 , Kohei Funasaka  1 , Eizaburo Ohno  1 , Ryoji Miyahara  1 , Hiroki Kawashima  1 , Shuji Koyama  3 , Tomoki Hinami  4 , Hidemi Goto  1 , Yoshiki Hirooka  2
Affiliations

Evaluation of radiation exposure dose at double-balloon endoscopy for the patients with small bowel disease

Asuka Nagura et al. Nagoya J Med Sci. 2016 Aug.

Abstract

Double-balloon endoscopy (DBE) is useful for the diagnosis and treatment of small bowel diseases. Although fluoroscopy is used to confirm the position of endoscope at DBE, the endoscopist does not have the knowledge with regard to the radiation exposure dose. In this study, we evaluated the absorbed dose during DBE in patients with suspected or established small bowel diseases. This was a retrospective study in which the estimated fluoroscopic radiation absorbed doses loaded on the small bowel and skin were determined according to the data of the referential X-ray experiment with a human body phantom. The subjects were 415 DBEs preformed in total. The mean small bowel absorbed doses on antegrade and retrograde DBEs were 42.2 and 53.8 mGy, respectively, showing that the organ dose applied in retrograde DBE was significantly higher (P<0.0001). The mean skin absorbed doses of them were 79.2 and 101.0 mGy, respectively, showing that the dose was also significantly higher on retrograde DBE (P<0.0001). Of 27 cases who were applied endoscopic balloon dilation, the mean fluoroscopy time was 16.0 minutes, and mean small bowel and skin absorbed doses were 121.9 and 228.9 mGy, respectively. In conclusion, endoscopist should be careful for reducing the organ exposure dose at DBE, particularly for the lower abdominal region.

Abbreviations: Double-balloon enteroscopy (DBE), endoscopic balloon dilation (EBD), endoscopic mucosal resection (EMR), double-balloon endoscopic retrograde cholangiopancreatography (DBERCP), percutaneous coronary intervention (PCI).

Keywords: double-balloon endoscopy; endoscopic balloon dilation; radiation exposure; small bowel disease.

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Figures

Fig. 1
Fig. 1
Fluoroscopy in double-balloon endoscopy a. Confirming the position b. Shortening c. Gastrografin contrast radiography d. Endoscopic balloon dilation
Fig. 2
Fig. 2
Measurement of basic radiation exposure dose using human body phantom
Fig. 3
Fig. 3
Comparison of the small intestinal absorbed dose
Fig. 4
Fig. 4
Comparison of the skin absorbed dose
See this image and copyright information in PMC

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