Radiation exposure to patient and staff in hepatic chemoembolization: risk estimation of cancer and deterministic effects.
The purpose of the study was to determine the risks of radiation-induced cancer and deterministic effects for the patient and staff in transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). Sixty-five patients with HCC underwent the first cycle of TACE. Thermoluminescence dosemeters and conversion factors were used to measure surface doses and to calculate organ doses and effective dose. For the patient, the risk of fatal cancer and severe genetic defect was in the magnitude of 10(-4) and 10(-5), respectively. Five patients showed surface doses over the first lumbar vertebra exceeding 2000 mSv and 45 patients showed doses over the spine or the liver region above 500 mSv. The risk of fatal cancer and severe genetic defect for the radiologist and assistant was in the magnitude of 10(-7) to 10(-8). They could exceed the threshold for lens opacity in the case of more than 490 and 1613 TACE yearly for a period of many years, respectively. Radiation dose could lead to local transient erythema and/or local depression of hematopoiesis in many patients after TACE. For the radiologist and assistant, risk of fatal cancer and genetic defect and lens opacity might arise when they perform interventions such as TACE intensively.
Hidajat
Nico
N
Department of Radiology, Charité Campus Virchow-Klinikum, Humboldt-University of Berlin, Berlin, Germany. nico.hidajat@gmx.de
Wust
Peter
P
Felix
Roland
R
Schröder
Ralf Jürgen
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D002386:Cataract / Q000209:etiology; D016461:Chemoembolization, Therapeutic; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000528:radiation effects; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure; D011829:Radiation Dosage; D015642:Radiology, Interventional; D018570:Risk Assessment; D013131:Spine / Q000528:radiation effects; D013819:Thermoluminescent Dosimetry