Radiation exposure to patients undergoing percutaneous transhepatic cholangiography and endoscopic retrograde cholangiography: an advanced phantom study

Author:

Tunçman Duygu12,Özgür Eren3,Nayci Ali Emre4,Günay Osman5,Kesmezacar Fahrettin Fatih6,Karaçam Songül Çavdar2,Üzüm Güngör4,Demir Mustafa7,Akkuş Baki1,Elshami Wiam8ORCID,Almisned Ghada9,Tekin Huseyin Ozan810ORCID

Affiliation:

1. Istanbul University , Science Faculty, Physics Department, Balabanağa, Şehzadebaşı Cd., Vezneciler, Fatih, Istanbul 34134, Türkiye

2. Istanbul University–Cerrahpaşa , Vocational School of Health Services, Radiotherapy Program, Esentepe, C1 Cd. 15-7, No: 75/77/999 Sultangazi, Istanbul, Türkiye

3. Istanbul Training and Research Hospital , Radiology Department, Abdurrahman Nafiz Gürman Cd. No: 24, 34098 34098, Fatih, Istanbul, Türkiye

4. Istanbul Training and Research Hospital , General Surgery Department, Abdurrahman Nafiz Gürman Cd. No: 24, 34098 34098, Fatih, Istanbul, Türkiye

5. Yıldız Technical University , Electrical & Electronics Faculty, Biomedical Engineering, Davutpaşa Mah. Davutpaşa Caddesi, 34220, Esenler, Istanbul, Türkiye

6. Istanbul University – Cerrahpaşa , Vocational School of Health Services, Medical Imaging Techniques Program, Esentepe, C1 Cd. 15-7, No: 75/77/999 Sultangazi, Istanbul, Türkiye

7. Istanbul University – Cerrahpaşa , Medical Faculty, Nuclear Medicine Department, Cerrahpaşa, Koca Mustafapaşa Cd. No: 53, 34098 Fatih, Istanbul, Türkiye

8. University of Sharjah , Department of Medical Diagnostic Imaging, College of Health Sciences, University City Rd - University City Sharjah, 27272, Sharjah, United Arab Emirates

9. Princess Nourah Bint Abdulrahman University , Department of Physics, College of Science, Airport Road, King Khalid International Airport, P.O. Box 84428, Riyadh 11671, Saudi Arabia

10. Istinye University , Faculty of Engineering and Natural Sciences, Biomedical Engineering Department, Ayazağa, Azerbaycan Cd. No: 4 D:A, 34396, Sarıyer, Istanbul, Türkiye

Abstract

Abstract Fluoroscopic examinations like Endoscopic Retrograde Cholangiopancreatography (ERCP) and Percutaneous Transhepatic Cholangiography (PTC) are fundamental in diagnosing and treating hepatobiliary diseases. However, these procedures expose patients to significant radiation, highlighting the need for a detailed assessment of the radiation doses received by critical organs. The study’s primary objective is to determine the experimental doses received by critical organs in patients undergoing these procedures. This study utilized an Alderson RANDO phantom outfitted with Thermoluminescent Dosemeters (TLDs) to experimentally measure the radiation doses received by various organs during ERCP and PTC procedures. This method provided direct and accurate data on organ-specific radiation exposure, contrasting with the traditional approach of relying on theoretical simulations. The analysis revealed that PTC generally results in higher radiation doses to organs compared to ERCP. Critical organs, such as the thyroid, spleen, liver, pancreas, ovaries, and uterus, were exposed to varying levels of radiation, with the thyroid and spleen receiving particularly high doses in PTC. The study also demonstrated that the per-minute radiation exposure was consistently higher in PTC across all examined organs. The study’s findings underscore the significant radiation exposure associated with ERCP and PTC, with PTC posing a greater risk. Understanding these exposure levels is crucial for clinical decision-making, particularly when considering patients’ pre-existing conditions and sensitivity to radiation. The study highlights the need for clinicians to carefully weigh the benefits of ERCP and PTC against the potential radiological risks. It suggests a preference for ERCP in situations where radiation exposure needs to be minimized. Furthermore, the findings advocate for ongoing advancements in medical imaging techniques to reduce radiation exposure, emphasizing the importance of patient safety in fluoroscopic examinations. This research contributes significantly to informed clinical decision-making, ensuring that the selection of diagnostic and therapeutic procedures aligns with the best interest of patient health and safety.

Publisher

Oxford University Press (OUP)

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