Naslov
Efficacy and feasibility of out-of-plane patient shielding during CT scanning

Autori
Klasić, Branimir ; Brnić, Zoran ; Knežević, Željka ; Plaščak, Jasmina ; Vidjak, Vinko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
ECR 2013 - book of abstracts, European Radiology 2013 / - Beč : Europsko radiološko društvo, 2013

Skup
European Congress of Radiology 2013

Mjesto i datum
Beč, Austrija, 13.04.2013. - 15.04.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Radioprotection / Radiation dose ; CT ; Radiation safety ; Dosimetric comparison

Sažetak
The efficacy of lead cover shielding for reduction of scatter to various superficial organs was already confirmed for many imaging procedures (5, 6, 7, 8, 9, 10). Our measurement results show quite a wide range of values. This should primarily be attributed to the fact that our research was conducted in vivo, where the anatomical differences between individual patients can significantly affect the measured dose. In our research, we ensured that dosimeters were laid precisely over the specific radiosensitive tissues, such as distributed on the body of each individual patient (like Brnic et al.) and not always on same predetermined position (like Beaconsfield et al.). We believe that our method of measurement is more suitable to the actual situation in daily clinical practice. In contrast, measurements on phantoms are much more uniform because dosimetry is done always in the same position on the phantom, which always has standard physical characteristics. Our measured scatter doses were higher in comparison to most authors (5, 8, 9). The percentage of scatter dose reduction in our study was lower than in most of the older researches (7, 8, 9). This is partly because their measurements were performed mostly on phantoms. The difference was also due to non-standardized ways of shielding and dosimeter placement. Some recent phantom studies (11) have shown scatter radiation dose reduction comparable to our values. In our opinion this is due to the fact that they are mainly concentrated on the relationship between the dose reduction and the distance from the scanning area. In our study, the percentage of dose reduction also correlates with distance from the scanning area. Although the level of exposure reduction is relatively low when compared to total dose of CT examination, the procedure might have significant transcend effects. It is out of discussion that exposure reduction, although low, undoubtedly fit to ALARA concept, and lead to reduction of stochastic risks, however small this reduction to be. This reduction is even more desirable in younger patients, especially those who undergo repeated CTs in the course of their treatment (e.g. malignant hematological disorders), and the cumulative breast and thyroid dose can significantly raise the risk of malignancy of these organs (12). As many of those patients with a good survival prognosis are fertile, the protection of their gonads should be an imperative, keeping in mind possible latency of gene mutations and appearance of its effects in offsprings after generations. Simple protection measures, as the one described, help to build an atmosphere of radiation protection discipline, which is easy to lose if not permanently corroborated Page 13 of 16by emphasizing its efficacy, simplicity and necessity. Traditionally, in many counties technologist have a limited awareness on protection of patients, many of them being unconscious about the doses delivered to patients in routine CT scanning. Everyday practice of patients covering, might serve as a "reminder" on the dose problem, forcing them to be alert of other protection principles (justification, optimization). It is well documented, that simple procedures of a special care of the patient could have positive psychological impact in staff-to-patient transfer, reducing anxiety (13). Patient satisfaction with imaging procedures is closely correlated to the feeling of safety, therefore, the act of covering may help built an atmosphere of confidence among patients and staff, thus alleviating the cooperation and compensating possible shortages which can emerge in everyday patient care. Contraindications for patient shielding against scatter are rare, if any of them can be considered absolute. The feasibility of this procedure is compromised in urgent procedures, uncooperable or agitated patients, children, patient with bandages, tubings and catheters. In rare situations the apron may collide with patient table translation through gantry, or disturb/hinder the manipulation of patient in emergent situations (the need for resuscitation etc.). The procedure is also not recommended in patients with high risk factors for severe contrast adverse effects, as the masking of patient skin prevents early recognition of possible urticaria which can be a sign of more severe threatening adverse reaction. As the procedure of out-of-plane body shielding is simple and low-cost it is reasonable to promote this measure widely in clinical practice. Like a smile that costs nothing, is available anywhere and gives a lot - patient shielding may have a similar power.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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