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Managing patient dose during Interventional Radiology

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The case submitted by Mohammad Mudzakir Zainal Alam focuses on managing patient dose during an interventional radiology (IR) procedure, that commonly exposes patients to high radiation dose - especially during a longer procedure such as embolization or coiling.

Case objective
The purpose and objective of the case was to manage patient dose in an interventional radiology (IR) procedure without interrupting or affecting image quality during the procedure, leading to a successful intervention with minimal or reasonable radiation dose. 

Mohammad Mudzakir

Zainal Alam

 

University Malaya

Medical Centre

 

Malaya

Mohammad Mudzakir

Zainal Alam

 

University Malaya

Medical Centre

 

Malaya

The case that was submitted by Mohammad Mudzakir Zainal Alam focusses on managing patient dose during an Interventional Radiology (IR) procedure, that commonly exposes patients to high radiation dose. Especially during a longer procedure such as embolization or coiling.

Case objective
The purpose and objective of the case is to reduce patient dose in interventional radiology (IR) procedure without interrupt or effect image quality during procedure that lead to a successful intervention to the patient with minimal or reasonable radiation dose. 
This technique helped us as radiographers improve dose exposure management for the patient, rather than only focusing on collimation and source image distance (SID).”

––  Mohammad Mudzakir Zainal Alam - Radiographer

University Malaya Medical Centre, Malaya

Clinical and patient background

From my clinical experience, patients that undergo long IR procedures such as cerebral embolization, face a focusing exposure at the head area that involves the eyes, hair and neck area. This may cause some unexpected effects to the patient such as loss of hair and occasional skin redness. This is due to the high radiation exposure during long time X-ray screening by the radiologist. 

Dose management methods and techniques that were used

In order to manage the dose to the patient at the head area, that consists of the sensitive eyes and thyroid, we consulted our radiologist and made a practice attempt to use a digital zoom application instead of the normal magnification zoom button, particularly during coil placement and deployment at the aneurysm. Furthermore, with addition of fluoroscopic mode selection that consists of low, medium and high at the control panel, the selection of low mode during catheter navigation and placement, helped a lot in order to manage dose to the patient without affecting image quality during the procedure. These two application techniques definitely helped us as radiographers to manage receiving dose to the patient, beyond only focusing on collimation and source image distance (SID).


Conclusions and results

After the methods and techniques were implemented on several patients using the same procedure, the dose parameter (total dose) at monitoring console were effectively managed when compared with previous procedures that were performed without the new techniques. This is based on dose data that was recorded the machine for each exposure made by the radiologist.

Discussion of case outcome(s) and future implications

The outcome from the technique that we developed showed improvements in managing radiation dose to the patient during IR procedures, even though sometimes it is very difficult to consult a radiologist during critical moments. Especially during coil placement. As radiographer in an IR environment, the best thing that we do to manage radiation dose to the patient, is also beneficial to others and ourselves. The important thing is that the patient is receiving safe treatment in our hands without any complication. 

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