Sung Ki Hyuk, Jung Young-Jun, Cha Hyemi, Chung Chin Youb, Lee Kisung, Park Moon Seok
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-Gu, Sungnam, Gyeonggi, Korea.
Department of Bio-convergence Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, Korea.
J Radiat Res. 2019 Jan 1;60(1):1-6. doi: 10.1093/jrr/rry073.
This study investigated the effect of metallic tools on the scattered radiation dose delivered to surgeons' radiosensitive organs while simulating hip surgery using C-arm fluoroscopy. Two phantoms, a pelvis and a Rando phantom, were used to simulate a patient and a surgeon in this study. Photoluminescence dosimeters were inserted into the Rando phantom in the positions of the eye, thyroid and gonad. A drill was positioned above the hip of the pelvis phantom or beside the pelvis phantom of the same height. For each drill location, the scattered radiation dose was measured when the angle to the operator phantom was 45°; this was repeated when the angle was 90°. The scattered radiation doses to the eye, thyroid and gonad when the drill was placed beside the pelvis phantom with 90° angulation to the operator phantom were significantly lower than the reference values and those when the drill was placed beside the pelvis phantom at a 45° angulation to the operator phantom. The scattered radiation doses to the eye and thyroid when the drill was placed above the hip were significantly lower than the references values. Of the four different scenarios, the scattered radiation doses to the eye, thyroid and gonad were lowest when the drill was placed beside the pelvis phantom with 90° angulation. This study showed that the scattered radiation doses to radiosensitive organs were affected by the location and angle of the metallic tools in relation to the operator. Therefore, orthopedic surgeons should consider the effect of metallic tools on the scattered radiation dose during intraoperative use of C-arm fluoroscopy.
本研究在使用C形臂荧光透视模拟髋关节手术时，调查了金属工具对传递给外科医生辐射敏感器官的散射辐射剂量的影响。在本研究中，使用了两个体模，一个骨盆体模和一个兰多体模，分别模拟患者和外科医生。将光致发光剂量计插入兰多体模的眼睛、甲状腺和性腺位置。将钻头置于骨盆体模髋关节上方或相同高度的骨盆体模旁边。对于每个钻头位置，当与操作者体模的角度为45°时测量散射辐射剂量；当角度为90°时重复测量。当钻头置于骨盆体模旁边且与操作者体模呈90°角时，眼睛、甲状腺和性腺所接受的散射辐射剂量显著低于参考值，以及钻头置于骨盆体模旁边且与操作者体模呈45°角时的剂量。当钻头置于髋关节上方时，眼睛和甲状腺所接受的散射辐射剂量显著低于参考值。在四种不同的情况下，当钻头置于骨盆体模旁边且与操作者体模呈90°角时，眼睛、甲状腺和性腺所接受的散射辐射剂量最低。本研究表明，辐射敏感器官所接受的散射辐射剂量受金属工具相对于操作者的位置和角度的影响。因此，骨科医生在术中使用C形臂荧光透视时应考虑金属工具对散射辐射剂量的影响。
