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CC BY-NC-ND 4.0 · Endosc Int Open 2023; 11(03): E237-E246
DOI: 10.1055/a-2022-2663
Original article

Occupational radiation dose from gastrointestinal endoscopy procedures with special emphasis on eye lens doses in endoscopic retrograde cholangiopancreatography

Touko Kaasalainen
1   HUS Diagnostic Center, Radiology, University of Helsinki and Helsinki University Hospital, Finland
,
Antti Pekkarinen
2   Radiation and Nuclear Safety Authority – STUK, Helsinki, Finland
3   Department of Physics, University of Helsinki, Helsinki, Finland
4   Department of Medical Physics, Kymsote, Kymenlaakso Central Hospital, Helsinki, Finland
,
Leena Kylänpää
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Mia Rainio
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Andrea Tenca
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Kalle Jokelainen
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Nina Barner-Rasmussen
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Lauri Puustinen
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Marianne Udd
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
,
Outi Lindström
5   HUS Abdominal Center, Endoscopy Department, University of Helsinki and Helsinki University Hospital, Finland
› Author AffiliationsState Subsidy for University Hospitals in Finland
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Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) procedures may result in remarkable radiation doses to patients and staff. The aim of this prospective study was to determine occupational exposures in gastrointestinal endoscopy procedures, with a special emphasis on eye lens dose in ERCP.

Methods Altogether 604 fluoroscopy-guided procedures, of which 560 were ERCPs belonging to four American Society for Gastrointestinal Endoscopy procedural complexity levels, were performed using two fluoroscopy systems. Personal deep-dose equivalent Hp(10), shallow-dose equivalent Hp(0.07), and eye lens dose equivalent Hp(3) of eight interventionists and Hp(3) for two nurse dosimeters were measured. Thereafter, conversion coefficients from kerma-area product (KAP) for Hp(10), Hp(0.07), and Hp(3) were determined and dose equivalents per procedure to an operator and assisting staff were estimated. Further, mean conversion factors from Hp(10) and Hp(0.07) to Hp(3) were calculated.

Results The median KAP in ERCP was 1.0 Gy·cm2, with mobile c-arm yielding higher doses than a floor-mounted device (P < 0.001). The median Hp(3) per ERCP was estimated to be 0.6 µSv (max. 12.5 µSv) and 0.4 µSv (max. 12.2 µSv) for operators and assisting staff, respectively. The median Hp(10) and Hp(0.07) per procedure ranged from 0.6 to 1.8 µSv. ERCP procedural complexity level (P ≤ 0.002) and interventionist (P < 0.001) affected dose equivalents.

Conclusions Occupational dose limits are unlikely to be exceeded in gastrointestinal endoscopy practice when following radiation-hygienic working methods and focusing on dose optimization. The eye lens dose equivalent Hp(3) may be estimated with sufficient agreement from the Hp(10) and Hp(0.07).

Supplementary material



Publication History

Received: 12 January 2023

Accepted after revision: 25 January 2023

Accepted Manuscript online:
30 January 2023

Article published online:
08 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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