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. 2023 Apr 5;3(1):e234.
doi: 10.1002/deo2.234. eCollection 2023 Apr.

Radiation exposure to staff during fluoroscopic endoscopic procedures

Mohamed Khaldoun Badawy  1   2 , Ellen Henely-Smith  1 , Solaiman Hasmat  1
Affiliations

Radiation exposure to staff during fluoroscopic endoscopic procedures

Mohamed Khaldoun Badawy et al. DEN Open. .

Abstract

Objectives: Fluoroscopically guided procedures utilize ionizing radiation to assist in the diagnosis and treatment of the patient. The use of ionizing radiation is not without risk to the operator and other staff members present during endoscopic procedures. This study simulates radiation exposure during endoscopic retrograde cholangiopancreatography procedures under different shielded conditions and provides practical radiation safety recommendations, through easy-to-use visual guides.

Methods: We obtained radiation exposure measurements at varying locations with different shielding setups surrounding a mobile C-arm fluoroscopic unit while imaging a patient equivalent phantom at different heights. Heat maps were generated for the various conditions to provide visual guides for radiation protection.

Results: Different heat maps detailing various shielding methods have been generated to assist in determining the dose rate at varying locations surrounding the patient. The use of appropriate radiation protection could decrease the staff dose by up to 98%.

Conclusion: Although minor per procedure, the magnitude of radiation exposure will accumulate over the staff's working life. As such, it is recommended that precautions be taken during fluoroscopically guided endoscopy procedures to ensure radiation is kept as low as reasonably achievable.

Keywords: endoscopy; fluoroscopy; ionizing radiation; radiation exposure; radiation safety.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Experimental setup and positions used to measure the scatter radiation.
FIGURE 2
FIGURE 2
Approximated unshielded personal dose equivalent rate Hp(10) during a simulated endoscopic retrograde cholangiopancreatography procedure.
FIGURE 3
FIGURE 3
Approximated personal dose equivalent rate Hp(10) during a simulated endoscopic retrograde cholangiopancreatography procedure using a mobile lead shield between the operator and the patient.
FIGURE 4
FIGURE 4
Approximated personal dose equivalent rate Hp(10) during a simulated endoscopic retrograde cholangiopancreatography procedure using a radioprotective apron between the operator and the patient.
FIGURE 5
FIGURE 5
The dose rate to the lens of the eye, Hp(3), approximated during simulated endoscopic retrograde cholangiopancreatography procedures.
FIGURE 6
FIGURE 6
Typical staff locations within the endoscopy suite in our study setting.
FIGURE 7
FIGURE 7
Radiation dose rate to the operator during a simulated endoscopic retrograde cholangiopancreatography (ERCP) procedure.
See this image and copyright information in PMC

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