title: Radiation doses to operators performing transjugular intrahepatic portosystemic shunt using a flat-panel detector-based system and ultrasound guidance for portal vein targeting.
abstract: OBJECTIVE
  The aim of this study was to prospectively evaluate effective dose (E) of operators performing transjugular intrahepatic portosystemic shunts (TIPS) in a single centre. Patients' radiation exposure was also collected.
  
  
  METHODS
  Between 8/2015 and 6/2016, 45 consecutive TIPS were performed in adult patients using a flat-panel detector-based system (FPDS) and real-time ultrasound guidance (USG) for portal vein targeting. Electronic personal dosimeters were used to measure radiation doses to the primary and assistant operators, anaesthesia nurse and radiographer. Patients' radiation exposure was measured with dose area product (DAP); fluoroscopy time (FT) was also collected.
  
  
  RESULTS
  Mean E for the primary operator was 1.40 μSv (SD 2.68, median 0.42, range 0.12 - 12.18), for the assistant operator was 1.29 μSv (SD 1.79, median 0.40, range 0.10 - 4.89), for the anaesthesia nurse was 0.21 μSv (SD 0.67, median 0.10, range 0.03 - 3.99), for the radiographer was 0.42 μSv (SD 0.71, median 0.25, range 0.03 - 2.67). Mean patient DAP was 59.31 GyCm2(SD 56.91, median 31.58, range 7.66 - 281.40); mean FT was 10.20 min (SD 7.40, median 10.40, range 3.8 - 31.8).
  
  
  CONCLUSIONS
  The use of FPDS and USG for portal vein targeting allows a reasonably low E to operators performing TIPS.
  
  
  CONCLUSIONS
  • The operators' E vary according to the complexity of the procedure. • FPDS and USG allow a reasonably low E to TIPS operators. • FPDS and USG have an important role in reducing the occupational exposure.
authors: Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy. rmiraglia@ismett.edu.
authors: Roberto
authors: R
authors: Miraglia
authors: Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors: Roberta
authors: R
authors: Gerasia
authors: Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors: Luigi
authors: L
authors: Maruzzelli
authors: Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors: Mario
authors: M
authors: D'Amico
authors: Radiology Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Ernesto Tricomi 5, 90127, Palermo, Italy.
authors: Angelo
authors: A
authors: Luca
mesh_terms: D000368:Aged; D005260:Female; D005471:Fluoroscopy / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009719:Nurse Anesthetists; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D061646:Operative Time; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000601:surgery; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D000072177:Radiologists; D015642:Radiology, Interventional; D025321:Surgery, Computer-Assisted; D014463:Ultrasonography
keywords: Liver; Occupational exposure; Radiation protection; TIPS; Ultrasound