Radiation exposure during C-arm-guided (fluoroscopy) small animal orthopaedic surgery

https://doi.org/10.17221/15/2018-VETMEDCitation:Sung S., Lim S., Min K., Jung Y., Cho Y., Kim M., Kim N., Lee K. (2018): Radiation exposure during C-arm-guided (fluoroscopy) small animal orthopaedic surgery. Veterinarni Medicina, 63: 527-531.
download PDF

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.

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 George S., Bueno Reuben A., Wolfe Scott W. (2005): Radiation Exposure in Hand Surgery: Mini Versus Standard C-Arm. The Journal of Hand Surgery, 30, 1310-1316  https://doi.org/10.1016/j.jhsa.2005.06.023
 
Barber J., McNulty J. P. (2012): Investigation into scatter radiation dose levels received by a restrainer in small animal radiography. Journal of Small Animal Practice, 53, 578-585  https://doi.org/10.1111/j.1748-5827.2012.01257.x
 
Boekhout-Ta Christina L., Kim Stanley E., Cross Alan R., Evans Richard, Pozzi Antonio (2017): Closed reduction and fluoroscopic-assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats*. Veterinary Surgery, 46, 103-110  https://doi.org/10.1111/vsu.12582
 
Canato G.R., Drumond L.F., Paschuk S.A., Asfora V.K., Andrade M.E.A., Denyak V., Schelin H.R. (2014): Occupational exposure assessment in procedures of portable digital veterinary radiology for small size animals. Radiation Physics and Chemistry, 95, 284-287  https://doi.org/10.1016/j.radphyschem.2013.05.042
 
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 Stephen C., Lewis Daniel D., Winter Matthew D. (2015): Fluoroscopic-Assisted Olecranon Fracture Repair in Three Dogs. Case Reports in Veterinary Medicine, 2015, 1-11  https://doi.org/10.1155/2015/542842
 
Mahajan Anupam (2015): Occupational Radiation Exposure from C Arm Fluoroscopy During Common Orthopaedic Surgical Procedures and its Prevention. JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, , -  https://doi.org/10.7860/JCDR/2015/10520.5672
 
Mehlman Charles T., DiPasquale Thomas G. (1997): Radiation Exposure to the Orthopaedic Surgical Team During Fluoroscopy: "How Far Away Is Far Enough?". Journal of Orthopaedic Trauma, 11, 392-398  https://doi.org/10.1097/00005131-199708000-00002
 
Park M. S., Lee K. M., 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  https://doi.org/10.1093/rpd/ncr149
 
Rohwedder Thomas, Fischer Martin, Böttcher Peter (2017): In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Veterinary Journal, 7, 221-  https://doi.org/10.4314/ovj.v7i3.4
 
Singer Gordon (2005): Occupational Radiation Exposure to the Surgeon. Journal of the American Academy of Orthopaedic Surgeons, 13, 69-76  https://doi.org/10.5435/00124635-200501000-00009
 
TONKS CATHERINE A., TOMLINSON JAMES L., COOK JAMES L. (2008): Evaluation of Closed Reduction and Screw Fixation in Lag Fashion of Sacroiliac Fracture-Luxations. Veterinary Surgery, 37, 603-607  https://doi.org/10.1111/j.1532-950X.2008.00414.x
 
Tremains Michael R., Georgiadis Gregory M., Dennis Michael J. (2001): Radiation Exposure with Use of the Inverted-C-Arm Technique in Upper-Extremity Surgery. The Journal of Bone and Joint Surgery-American Volume, 83, 674-678  https://doi.org/10.2106/00004623-200105000-00005
 
Tuohy Christopher J., Weikert Douglas R., Watson Jeffry T., Lee Donald H. (2011): Hand and Body Radiation Exposure With the Use of Mini C-Arm Fluoroscopy. The Journal of Hand Surgery, 36, 632-638  https://doi.org/10.1016/j.jhsa.2010.12.022
 
WHEELER JASON L., LEWIS DANIEL D., CROSS ALAN R., SEREDA COLIN W. (2007): Closed Fluoroscopic-Assisted Spinal Arch External Skeletal Fixation for the Stabilization of Vertebral Column Injuries in Five Dogs. Veterinary Surgery, 36, 442-448  https://doi.org/10.1111/j.1532-950X.2007.00290.x
 
download PDF

© 2020 Czech Academy of Agricultural Sciences | Prohlášení o přístupnosti