Khoury H J, Garzon W J, Andrade G, Lunelli N, Kramer R, de Barros V S M, Huda A
Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil.
Radiat Prot Dosimetry. 2015 Jul;165(1-4):263-7. doi: 10.1093/rpd/ncv075. Epub 2015 Apr 12.
The purpose of this study was to evaluate patient and medical staff absorbed doses received from transarterial chemoembolisation of hepatocellular carcinoma, which is the most common primary liver tumour worldwide. The study was performed in three hospitals in Recife, capital of the state of Pernambuco, located in the Brazilian Northeastern region. Two are public hospitals (A and B), and one is private (C). For each procedure, the number of images, irradiation parameters (kV, mA and fluoroscopy time), the air kerma-area product (PKA) and the cumulative air kerma (Ka,r) at the reference point were registered. The maximum skin dose (MSD) of the patient was estimated using radiochromic film. For the medical staff dosimetry, thermoluminescence dosemeters (TLD-100) were attached next to the eyes, close to the thyroid (above the shielding), on the thorax under the apron, on the wrist and on the feet. The effective dose to the staff was estimated using the algorithm of von Boetticher. The results showed that the mean value of the total PKA was 267.49, 403.83 and 479.74 Gy cm(2) for Hospitals A, B and C, respectively. With regard to the physicians, the average effective dose per procedure was 17 µSv, and the minimum and maximum values recorded were 1 and 41 µSy, respectively. The results showed that the feet received the highest doses followed by the hands and lens of the eye, since the physicians did not use leaded glasses and the equipment had no lead curtain.
本研究的目的是评估肝细胞癌经动脉化疗栓塞术中医护人员和患者所接受的吸收剂量，肝细胞癌是全球最常见的原发性肝癌。该研究在位于巴西东北部伯南布哥州首府累西腓的三家医院进行。两家是公立医院（A和B），一家是私立医院（C）。对于每例手术，记录图像数量、照射参数（千伏、毫安和透视时间）、参考点处的空气比释动能面积乘积（PKA）和累积空气比释动能（Ka,r）。使用放射变色胶片估算患者的最大皮肤剂量（MSD）。对于医护人员剂量测定，将热释光剂量计（TLD-100）贴在眼睛旁边、靠近甲状腺处（屏蔽上方）、铅衣下的胸部、手腕和脚部。使用冯·贝蒂歇尔算法估算工作人员的有效剂量。结果显示，A、B、C三家医院的总PKA平均值分别为267.49、403.83和479.74 Gy cm²。对于医生，每例手术的平均有效剂量为17微希沃特，记录到的最小值和最大值分别为1和41微希沃特。结果表明，脚部接受的剂量最高，其次是手部和眼睛晶状体，因为医生未使用铅眼镜且设备没有铅帘。
