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Estimating the Radiation Dose to the Fetus in Prophylactic Internal Iliac Artery Balloon Occlusion: Three Cases.

Kai K, Hamada T, Yuge A, Kiyosue H, Nishida Y, Nasu K, Narahara H - Case Rep Obstet Gynecol (2015)

Bottom Line: Cases.Conclusion.The IIABO procedure could result in a very small increase in the risk of harmful effects to the fetus.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita 879-5593, Japan.

ABSTRACT
Background. Although radiation exposure is of great concern to expecting patients, little information is available on the fetal radiation dose associated with prophylactic internal iliac artery balloon occlusion (IIABO). Here we estimated the fetal radiation dose associated with prophylactic IIABO in Caesarean section (CS). Cases. We report our experience with the IIABO procedure in three consecutive patients with suspected placenta previa/accreta. Fetal radiation dose measurements were conducted prior to each CS by using an anthropomorphic phantom. Based on the simulated value, we calculated the fetal radiation dose as the absorbed dose. We found that the fetal radiation doses ranged from 12.88 to 31.6 mGy. The fetal radiation dose during the prophylactic IIABOs did not exceed 50 mGy. Conclusion. The IIABO procedure could result in a very small increase in the risk of harmful effects to the fetus.

No MeSH data available.


Related in: MedlinePlus

Schematic of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. FDP, flat-panel detector; SID, source-image distance.
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fig1: Schematic of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. FDP, flat-panel detector; SID, source-image distance.

Mentions: We simulated two scenarios: (1) the patient was catheterized in the angiography suite and then transferred to an operating suite and (2) the patient was catheterized in the operating suite. Fetal radiation dose measurements were obtained using an anthropomorphic phantom made by a 10 mm thick acrylic board (41436-000 XAC-type 1, Kyoto Kagaku, Kyoto, Japan). Figure 1 is a schematic diagram of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. To simulate pregnancy in the third trimester, we adjusted the overall thickness of the phantom to 25 cm. Measurements were made on an Infinix Active digital subtraction angiography (DSA) system (Toshiba, Tokyo). We measured the entrance skin dose as the interventional reference point (i.e., the isocenter). We measured the fetal dose using a manufacturer-calibrated skin dose monitor (SDM 104-101 V4.0, McMahon Medical, San Diego, CA) at 13 cm from the isocenter; the fetus was assumed to lie at about the center of the phantom [5]. The 5 cm thick board was located 90 cm from the X-ray tube, and the source-image distance was 95 cm. The simulation results are shown in Table 1. The table's column heading for the fluoroscopy “Mode” was as follows. The “Normal” mode provided high X-ray output and high image quality, and the “Low” mode provided low X-ray output and low image quality. These modes were selectivity used based on the operator's need.


Estimating the Radiation Dose to the Fetus in Prophylactic Internal Iliac Artery Balloon Occlusion: Three Cases.

Kai K, Hamada T, Yuge A, Kiyosue H, Nishida Y, Nasu K, Narahara H - Case Rep Obstet Gynecol (2015)

Schematic of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. FDP, flat-panel detector; SID, source-image distance.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4477202&req=5

fig1: Schematic of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. FDP, flat-panel detector; SID, source-image distance.
Mentions: We simulated two scenarios: (1) the patient was catheterized in the angiography suite and then transferred to an operating suite and (2) the patient was catheterized in the operating suite. Fetal radiation dose measurements were obtained using an anthropomorphic phantom made by a 10 mm thick acrylic board (41436-000 XAC-type 1, Kyoto Kagaku, Kyoto, Japan). Figure 1 is a schematic diagram of the acrylic phantom used to simulate the fetal radiation dose in the angiography suite. To simulate pregnancy in the third trimester, we adjusted the overall thickness of the phantom to 25 cm. Measurements were made on an Infinix Active digital subtraction angiography (DSA) system (Toshiba, Tokyo). We measured the entrance skin dose as the interventional reference point (i.e., the isocenter). We measured the fetal dose using a manufacturer-calibrated skin dose monitor (SDM 104-101 V4.0, McMahon Medical, San Diego, CA) at 13 cm from the isocenter; the fetus was assumed to lie at about the center of the phantom [5]. The 5 cm thick board was located 90 cm from the X-ray tube, and the source-image distance was 95 cm. The simulation results are shown in Table 1. The table's column heading for the fluoroscopy “Mode” was as follows. The “Normal” mode provided high X-ray output and high image quality, and the “Low” mode provided low X-ray output and low image quality. These modes were selectivity used based on the operator's need.

Bottom Line: Cases.Conclusion.The IIABO procedure could result in a very small increase in the risk of harmful effects to the fetus.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Oita University Faculty of Medicine, Oita 879-5593, Japan.

ABSTRACT
Background. Although radiation exposure is of great concern to expecting patients, little information is available on the fetal radiation dose associated with prophylactic internal iliac artery balloon occlusion (IIABO). Here we estimated the fetal radiation dose associated with prophylactic IIABO in Caesarean section (CS). Cases. We report our experience with the IIABO procedure in three consecutive patients with suspected placenta previa/accreta. Fetal radiation dose measurements were conducted prior to each CS by using an anthropomorphic phantom. Based on the simulated value, we calculated the fetal radiation dose as the absorbed dose. We found that the fetal radiation doses ranged from 12.88 to 31.6 mGy. The fetal radiation dose during the prophylactic IIABOs did not exceed 50 mGy. Conclusion. The IIABO procedure could result in a very small increase in the risk of harmful effects to the fetus.

No MeSH data available.


Related in: MedlinePlus