The dose and risk factors for radiation exposure to medical staff during endobronchial ultrasonography with a guide sheath for peripheral pulmonary lesions under X-ray fluoroscopy.
OBJECTIVE
Therapy for lung cancer has recently evolved to include molecular targeted therapy and adequate amounts of lung cancer tissue are needed to identify particular phenotypes. For this purpose, quite a number of investigations on diagnostic bronchoscopy have been undertaken. Corollary to the increasing number of transbronchial biopsies for peripheral pulmonary nodules is the increased chances of radiation exposure during fluoroscopy. Our aim was to determine the dose and risk factors of radiation exposure to medical staff.


METHODS
Endobronchial ultrasonography with a guide sheath under X-ray fluoroscopy was performed on 132 cases of peripheral pulmonary lesions. The radiation exposure dose to medical staff (operator physicians, assistant physicians, nurses and radiological technologists) was measured.


RESULTS
The median time of fluoroscopy was 7.6 min (range 1.5-23.9). The median radiation exposure dose to operator physicians was 12 μSv/exam (range 1-99), while that of the other medical staff was lower. In a multivariate analysis, body mass index and the location of the radial ultrasound probe had significantly higher odds ratios.


CONCLUSIONS
The risk factors for an increased radiation exposure dose were patients' BMI and the location of the radial ultrasound probe. But even then, the radiation exposure dose to medical staff during endobronchial ultrasonography with a guide sheath was very low, especially for nurses and radiological technologists in whom the exposure dose was negligible.
*Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji Chuo-ku, Tokyo 104-0045, Japan, tizumo@ncc.go.jp.
Masahiro
M
Katsurada
Takehiro
T
Izumo
Yuichi
Y
Nagai
Christine
C
Chavez
Mayumi
M
Kitagawa
Jun
J
Torii
Takumi
T
Iwase
Tomohiko
T
Aso
Takaaki
T
Tsuchida
Shinji
S
Sasada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000295:instrumentation; D001999:Bronchoscopy / Q000379:methods*; D019160:Endosonography / Q000295:instrumentation; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008503:Medical Staff / Q000706:statistics & numerical data*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011829:Radiation Dosage; D012307:Risk Factors; D014965:X-Rays / Q000009:adverse effects*
EBUS-GS; body mass index; bronchoscopy; fluoroscopy; lung cancer; radial eBUS; radiation