Korean J Urol.  2008 Feb;49(2):155-159.

Scattered Radiation Doses to the Patients and Medical Practitioneer from Extracorporeal Shock Wave Lithotripsy

Affiliations
  • 1Department of Urology, College of Medicine, Soonchunhyang University, Seoul, Korea. wonjya@hosp.sch.ac.kr

Abstract

PURPOSE
We estimated scattered radiation doses to the patients and medical practitioneer and revealed risk factors associated with increasing radiation doses during extracorporeal shock wave lithotripsy(ESWL). MATERIALS AND METHODS: At first, we measured radiation doses 2 times using thermoluminescence dosimeter to simulative patients and medical practitioneer without any shield during 10 minutes of ESWL and determined mean radiation dose/minute. From June to August 2007 at our institution, we prospectively measured radiation exposured time during respective ESWL for treatment of urinary stones. Thereafter, we calculated practical radiation doses to patients and medical practitioneer from respective mean radiation dose/minute. We also analyzed which factors were associated with increasing radiation doses. RESULTS: A total of 50 ESWL were analyzed from 38 patients. Mean radiation dose/minute to simulative patients and medical practitioneer was 16.20, 0.006mSv respectively. At 1 time ESWL, median radiation exposured time was 360 seconds(130-980), therefore, median radiation dose to patients and medical practitioneer was calculated as 97.20mSv(35.10-264.60), and 0.04mSv(0.01-0.08) respectively. Larger stone size had a correlation with increasing radiation dose and additional pain control group had higher radiation dose than otherwise. CONCLUSIONS: During ESWL, patients were relatively exposed to high radiation which were roughly corresponded to that of 3 times of computed tomography. But the radiation dose to medical practitioneer was insignificant consider international guideline. Medical practitioneer should be aware of radiation hazard and try to minimize radiation dose to the patients at the time of ESWL.

Keyword

Lithotripsy; Radiation

MeSH Terms

Humans
Lithotripsy
Prospective Studies
Risk Factors
Shock
Urinary Calculi

Reference

1. Tolly DA, Downey P. Current advances in shock wave lithotripsy. Curr Opin Urol. 1999. 9:319–323.
2. Lingeman JE, Coury TA, Newman DM, Kahnoski RJ, Mertz JH, Mosbaugh PG, et al. Comparison of results and morbidity of percutaneous nephrostolithotomy and extracorporeal shock wave lithotripsy. J Urol. 1987. 138:485–490.
3. Bury RF. Radiation hazards in urological practice. BJU Int. 2002. 89:505–509.
4. National commission on radiological protection and measurement report 60. Recommendation of the international commission on radiological protection. 1991. Oxford: Pergamon.
5. Ramakumar S, Jarrett TW. Radiation safety for urologist. AUA Update Series. 2000. 19:201–208.
6. Lee JK. System of dose limitation for radiation protection. Korean Med Assoc. 1987. 30:608–616.
7. Chie EK, Lee MM. Radiation exposure of operation in intracoronary radiotherapy using 188Re. J Korean Assoc Radiat Prot. 2000. 25:191–195.
8. Zorzetto M, Bernardi G, Morocutti G, Fontanelli A. Radiation exposure to patients and operators during diagnostic catheterization and coronary angioplasty. Cathet Cardiovasc Diagn. 1997. 40:348–351.
9. Dash H, Leaman DM. Operator radiation exposure during percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1984. 4:725–728.
10. Wall BF, Hart D. Revised radiation doses for typical X-ray examinations. Br J Radial. 1997. 70:437–439.
11. Hellawell GO, Mutch SJ, Thevendran G, Wells E, Morgan RJ. Radiation exposure and the urologist: what are the risks? J Urol. 2005. 174:948–952.
12. Logarakis NF, Jewett MA, Luymes J, Honey RJ. Variation in clinical outcome following shock wave lithotripsy. J Urol. 2000. 163:721–725.
13. Griffith DP, Gleeson MJ, Politis G, Glaze S. Effectiveness of radiation control program for Dornier HM3 lithotriptor. Urology. 1989. 33:20–25.
14. Huda W, Bew J, Saydak AP. Radiation doses in extracorporeal shock wave lithotripsy. Br J Radiol. 1989. 62:921–926.
15. Sandilos P, Tsalafoutas I, Koutsokalis G, Karaiskos P, Georgiou E, Yakoumakis E, et al. Radiation doses to patients from extracorporeal shock xave lithotripsy. Health Phys. 2006. 90:583–587.
16. Talati J, Khan S, Biyabani R, Khan RA, Naz I, Abbas F, et al. Reduction of radiation exposure to patients in the follow-up of shockwave lithotripsy. BJU Int. 2000. 85:404–407.
17. Medical and dental guidance notes: a good practice guide on all aspects of ionising radiation protection in the clinical envirnment. 2002. Institute of Physics and Engineering in Medicine.
Full Text Links
  • KJU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr