Estimation of the Dose of Radiation Received by Patient and Physician During a Videofluoroscopic Swallowing Study

Videofluoroscopic swallowing study (VFSS) is considered the standard diagnostic imaging technique to investigate swallowing disorders and dysphagia. Few studies have been reported concerning the dose of radiation a patient receives and the scattering radiation dose received by a physician during VFSS. In this study, we investigated the dose of radiation (entrance skin dose, ESD) estimated to be received by a patient during VFSS using a human phantom (via a skin-dose monitor sensor placed on the neck of the human phantom). We also investigated the effective dose (ED) and dose equivalent (DE) received by a physician (wearing two personal dosimeters) during an actual patient procedure. One dosimeter (whole body) was worn under a lead apron at the chest, and the other (specially placed to measure doses received by the lens of the eye) outside the lead apron on the neck collar to monitor radiation doses in parts of the body not protected by the lead apron. The ESD for the patient was 7.8 mGy in 5 min. We estimated the average patient dose at 12.79 mGy per VFSS procedure. The physician ED and DE during VFSS were 0.9 mSv/year and 2.3 mSv/year, respectively. The dose of radiation received by the physician in this study was lower than regulatory dose limits. However, in accordance with the principle that radiation exposure should be as low as reasonably achievable, every effort should be made (e.g., wearing lead glasses) to reduce exposure doses.

[1]  J. Valentin,et al.  Avoidance of radiation injuries from medical interventional procedures. , 2000, Annals of the ICRP.

[2]  Adam Workman,et al.  Radiation Doses to Patients during Pharyngeal Videofluoroscopy , 1998, Dysphagia.

[3]  Masayuki Zuguchi,et al.  Comparison of dose at an interventional reference point between the displayed estimated value and measured value , 2011, Radiological physics and technology.

[4]  Bonnie Martin-Harris,et al.  Clinical Utility of the Modified Barium Swallow , 2000, Dysphagia.

[5]  R. Sievert,et al.  Book Reviews : Recommendations of the International Commission on Radiological Protection (as amended 1959 and revised 1962). I.C.R.P. Publication 6. 70 pp. PERGAMON PRESS. Oxford, London and New York, 1964. £1 5s. 0d. [TB/54] , 1964 .

[6]  Masayuki Zuguchi,et al.  Total entrance skin dose: an effective indicator of maximum radiation dose to the skin during percutaneous coronary intervention. , 2007, AJR. American journal of roentgenology.

[7]  Masayuki Zuguchi,et al.  Occupational dose in interventional radiology procedures. , 2013, AJR. American journal of roentgenology.

[8]  Paula Leslie,et al.  Radiation Dose in Videofluoroscopic Swallow Studies , 2006, Dysphagia.

[9]  Donald L. Miller,et al.  Recommendations for occupational radiation protection in interventional cardiology , 2013, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[10]  Koon Ho Torrance Chau,et al.  Patient Dose During Videofluoroscopy Swallowing Studies in a Hong Kong Public Hospital , 2009, Dysphagia.

[11]  T. Ishibashi,et al.  Evaluation of patient radiation dose during cardiac interventional procedures: What is the most effective method? , 2009, Acta radiologica.

[12]  C J Martin,et al.  ICRP Publication 113. Education and training in radiological protection for diagnostic and interventional procedures. , 2009, Annals of the ICRP.

[13]  S. Takahashi,et al.  Effect of radiation monitoring method and formula differences on estimated physician dose during percutaneous coronary intervention , 2009, Acta radiologica.

[14]  K. Choi,et al.  Patients’ Radiation Dose During Videofluoroscopic Swallowing Studies According to Underlying Characteristics , 2013, Dysphagia.

[15]  L. Chan,et al.  Scattered radiation level during videofluoroscopy for swallowing study. , 2002, Clinical radiology.

[16]  Donna C. Tippett,et al.  A protocol for the videofluorographic swallowing study , 2005, Dysphagia.

[17]  Jack Valentin,et al.  The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. , 2007, Annals of the ICRP.

[18]  J. Valentin,et al.  Abstract: Avoidance of radiation injuries from medical interventional procedures, ICRP Publication 85 , 2000 .

[19]  R. Vetter.  ICRP Publication 103, The Recommendations of the International Commission on Radiological Protection , 2008 .

[20]  M T Crawley,et al.  Patient and operator dose during fluoroscopic examination of swallow mechanism. , 2004, The British journal of radiology.

[21]  Masayuki Zuguchi,et al.  Relationship between fluoroscopic time, dose-area product, body weight, and maximum radiation skin dose in cardiac interventional procedures. , 2006, AJR. American journal of roentgenology.