Real-time radiation monitor can reduce radiation exposure for medical workers

It’s a sound that saves. A “real-time” radiation monitor that alerts by beeping in response to radiation exposure during cardiac-catheterization procedures significantly reduces the amount of exposure that medical workers receive, UT Southwestern Medical Center researchers found.

In a randomized study, the researchers divided 505 patients undergoing either diagnostic coronary angiography or percutaneous coronary intervention, such as stent placement, into two groups. In half the procedures, medical workers used the current gold standard for radiation monitoring, which is a “dosimetry” badge that is worn by a medical worker for a month and then sent off for the cumulative radiation dose to be read. In the other half, medical workers wore a device called Bleeper Sv, which beeps approximately once every 15 minutes in response to low background radiation, and beeps once every 20 seconds when exposure is higher, or continuously, if it is very high.

In settings where the medical workers wore the device that gives the real-time auditory feedback, radiation exposure was consistently decreased by approximately one-third.

“Radiation is invisible,” said Dr. Emmanouil Brilakis, Associate Professor of Internal Medicine at UT Southwestern and senior author of the paper. “Use of a radiation detection device can provide real-time ‘visualization’ of radiation exposure, enabling operators to take actions to reduce radiation exposure.”

Among actions that medical workers can take to reduce radiation exposure are reducing the frame rate (the number of X-ray images taken per second to create a “movie” of the coronary arteries), decreasing fluoroscopy time, repositioning the patient, repositioning the medical worker, adjusting the position of the radiation shield, and using additional shielding.

“Using devices that provide real-time radiation-exposure feedback can help the operator adopt safer radiation practices,” said Dr. Brilakis, who is also Director of the Cardiac Catheterization Laboratories at the VA North Texas Health Care System. “In our study, this was achieved in a real-life setting among unselected patients using a low-cost device that can be used with any X-ray system.”

Physicians and other medical workers on cardiac-catheterization teams will likely participate in hundreds of procedures a year. The dose limit for occupational exposure is 20 mSv per year for five years, but no dose is safe and all doses are considered to contribute to cancer risk.

“It has been shown that people who are chronically exposed to radiation in cardiac catheterization labs are more likely to develop left-sided brain tumors,” said Dr. Brilakis. “The reduction in operator exposure observed in our study is likely to translate into a decreased risk for long-term adverse clinical events.”

The results of the RadiCure study appear in the Dec. 16 issue of Circulation: Cardiovascular Interventions.

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/287142.php

 

 

 

Children being given unnecessary chest X-rays

Researchers at Mayo Clinic found that some children are receiving chest X-rays that may be unnecessary and offer no clinical benefit to the patient, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA).

“Chest X-rays can be a valuable exam when ordered for the correct indications,” said Ann Packard, M.D., radiologist at the Mayo Clinic in Rochester, Minn. “However, there are several indications where pediatric chest X-rays offer no benefit and likely should not be performed to decrease radiation dose and cost.”

Dr. Packard and co-author, Kristen B. Thomas, M.D., head of the pediatric division at Mayo Clinic and assistant professor of radiology at Mayo Medical School, reviewed data from 719 pediatric chest X-ray exams ordered between 2008 and 2014 in Mayo Clinic’s inpatient, outpatient and emergency room settings. The patients undergoing the exams ranged in age from newborn to 17 years old.

Of the 719 X-ray exams, 377 exams were ordered for chest pain, 98 indicated syncope (fainting) or presyncope, 21 indicated spells (a general feeling of being unwell or under distress), 37 indicated postural orthostatic hypotension (POTS)–a condition in whichblood pressure drops suddenly when the individual stands up from sitting or lying down, 185 indicated dizziness, and one exam indicated cyclical vomiting. Eighty-two of the 719 exams were excluded due to congenital or other known heart disease, and other causes.

The researchers found that in approximately 88 percent of the remaining 637 patients, the exam did not alter clinical treatment.

None of the patients who underwent X-rays for indications including syncope, spells, POTS, dizziness or cyclical vomiting had any finding that affected treatment. Thirty-nine of the 330 non-excluded X-rays for chest pain were positive for pneumonia, bronchial inflammation, trauma, or other conditions.

“Approximately 12 percent of the chest X-rays for chest pain were positive and included respiratory symptoms such as cough, fever or trauma,” Dr. Packard said. “There were no positive findings in any chest X-ray for syncope, dizziness, spells, cyclical vomiting or POTS for the past five years, even in our tertiary care center with referrals for rare diseases or unusual presentations.”

Optimizing radiation exposure and cost effectiveness are important topics in today’s healthcare environment, particularly in a pediatric population, Dr. Packard noted.

“This study addresses both of these issues, which is important not only for physicians but also for young patients and their parents,” she said. “I would like this research to help guide clinicians and deter them from ordering unnecessary exams which offer no clinical benefit to the patient.”

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286442.php