title: Reduction of radiation doses to patients and staff during endoscopic retrograde cholangiopancreatography.
abstract: OBJECTIVE
  Endoscopic retrograde cholangiopancreatography (ERCP) is associated with a considerable radiation exposure for patients and staff. While optimization of the radiation dose is recommended, few studies have been published. The purpose of this study has been to measure patient and staff radiation dose, to estimate the effective dose and radiation risk using digital fluoroscopic images. Entrance skin dose (ESD), organ and effective doses were estimated for patients and staff.
  
  
  METHODS
  Fifty-seven patients were studied using digital X-ray machine and thermoluminescent dosimeters (TLD) to measure ESD at different body sites. Organ and surface dose to specific radiosensitive organs was carried out. The mean, median, minimum, third quartile and the maximum values are presented due to the asymmetry in data distribution.
  
  
  RESULTS
  The mean ESD, exit and thyroid surface dose were estimated to be 75.6 mGy, 3.22 mGy and 0.80 mGy, respectively. The mean effective dose for both gastroenterologist and assistant is 0.01 mSv. The mean patient effective dose was 4.16 mSv, and the cancer risk per procedure was estimated to be 2 × 10(-5).
  
  
  CONCLUSIONS
  ERCP with fluoroscopic technique demonstrate improved dose reduction, compared to the conventional radiographic based technique, reducing the surface dose by a factor of 2, without compromising the diagnostic findings. The radiation absorbed doses to the different organs and effective doses are relatively low.
authors.affiliation: Department of Medical Physics, University of Thessaly, University Hospital of Larissa, P.O.Box 1425, Larissa 41110, Greece. abdelmoneim_a@yahoo.com
authors.forename: Abdelmoneim
authors.initials: A
authors.lastname: Sulieman
authors.forename: Georgios
authors.initials: G
authors.lastname: Paroutoglou
authors.forename: Andreas
authors.initials: A
authors.lastname: Kapsoritakis
authors.forename: Anargeyros
authors.initials: A
authors.lastname: Kapatenakis
authors.forename: Spiros
authors.initials: S
authors.lastname: Potamianos
authors.forename: Marianna
authors.initials: M
authors.lastname: Vlychou
authors.forename: Kiki
authors.initials: K
authors.lastname: Theodorou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D005373:Film Dosimetry; D005762:Gastroenterology; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D008875:Middle Aged; D016273:Occupational Exposure; D011446:Prospective Studies; D011829:Radiation Dosage; D013819:Thermoluminescent Dosimetry