Low-dose Technology Research Articles

PD10-10 DON'T SKIRT THE QUESTION: LEAD BED SKIRTS IN THE OR, AN INTERVENTION

You have accessJournal of UrologyImaging/Radiology: Uroradiology I (PD10)1 Sep 2021PD10-10 DON'T SKIRT THE QUESTION: LEAD BED SKIRTS IN THE OR, AN INTERVENTION Jacob Thatcher, Thomas Mueller, and Katelyn Klimowich Jacob ThatcherJacob Thatcher More articles by this author , Thomas MuellerThomas Mueller More articles by this author , and Katelyn KlimowichKatelyn Klimowich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001978.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Fluoroscopy is an important tool in endourology. Residents spend a significant amount of time using fluoroscopy. Using extrapolated data collected from our OR using real time Geiger counters we showed that despite using low dose technology, leaded aprons and thyroid shields, the standard dose a resident receives over one year is 11% over the annual total radiation dose limit to the eyes and near the annual total dose radiation for the entire body. This doesn’t include the omnipresent ambient radiation exposure. The aim of our current study is to investigate the reduction in radiation exposure to the primary surgeon and anesthesia when a lead skirt is installed around the table. METHODS: We placed lead skirts circumferentially around the operating room table and placed Radex One Quarta Geiger Dosimeters at the level of the eyes, buttocks, anesthesia outer chest pocket and adjacent to the x-ray tube. We collected real time radiation exposure for each procedure. We compared these data with data collected using the same configuration without the lead operating room table skirt. RESULTS: Radiation exposure to various body parts during eighty-one endourologic procedures over a six-month period was tabulated. The normalized average was then compared. The highest amount of radiation received was to the eyes - 8.42μGy, followed by groin - 1.76μGy, backside - 1.53μGy, and inner chest - 1.07μGy per procedure. By simply installing a leaded skirt around the four sides of the table, we show that this attenuates the scattered dose radiation to all areas. Most notably, the reduction in radiation to the eyes is reduced from 8.42 to 1.46, a nearly 500% reduction in radiation (table 1). Similarly, radiation to the buttocks is reduced by almost 200%. Though these data are preliminary, they reflect a potential intervention that is simple, cost effective and revolutionary in fluoroscopy. CONCLUSIONS: Residents are exposed to high amounts of radiation during fluoroscopic procedures, which could be harmful. Dose exposure varies by body region. We show that the radiation to anesthesia is nearly equivalent to that of the primary surgeon. Installing a lead skirt around the table significantly reduces radiation scatter in the operating room. This represents a cheap and practical intervention to improve operating room safety. This intervention can be implemented across multiple specialties. Source of Funding: Rowan School of Medicine Grant © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e130-e131 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacob Thatcher More articles by this author Thomas Mueller More articles by this author Katelyn Klimowich More articles by this author Expand All Advertisement Loading ...

Influence of Ultra-Low-Dose and Iterative Reconstructions on the Visualization of Orbital Soft Tissues on Maxillofacial CT.

Dose reduction on CT scans for surgical planning and postoperative evaluation of midface and orbital fractures is an important concern. The purpose of this study was to evaluate the variability of various low-dose and iterative reconstruction techniques on the visualization of orbital soft tissues. Contrast-to-noise ratios of the optic nerve and inferior rectus muscle and subjective scores of a human cadaver were calculated from CT with a reference dose protocol (CT dose index volume = 36.69 mGy) and a subsequent series of low-dose protocols (LDPs I-4: CT dose index volume = 4.18, 2.64, 0.99, and 0.53 mGy) with filtered back-projection (FBP) and adaptive statistical iterative reconstruction (ASIR)-50, ASIR-100, and model-based iterative reconstruction. The Dunn Multiple Comparison Test was used to compare each combination of protocols (α = .05). Compared with the reference dose protocol with FBP, the following statistically significant differences in contrast-to-noise ratios were shown (all, P ≤ .012) for the following: 1) optic nerve: LDP-I with FBP; LDP-II with FBP and ASIR-50; LDP-III with FBP, ASIR-50, and ASIR-100; and LDP-IV with FBP, ASIR-50, and ASIR-100; and 2) inferior rectus muscle: LDP-II with FBP, LDP-III with FBP and ASIR-50, and LDP-IV with FBP, ASIR-50, and ASIR-100. Model-based iterative reconstruction showed the best contrast-to-noise ratio in all images and provided similar subjective scores for LDP-II. ASIR-50 had no remarkable effect, and ASIR-100, a small effect on subjective scores. Compared with a reference dose protocol with FBP, model-based iterative reconstruction may show similar diagnostic visibility of orbital soft tissues at a CT dose index volume of 2.64 mGy. Low-dose technology and iterative reconstruction technology may redefine current reference dose levels in maxillofacial CT.