TY  - JOUR
AU  - Feghali, Joelle Ann
AU  - Delépierre, Julie
AU  - Ciraj-Bjelac, Olivera
AU  - Dabin, Jérémie
AU  - Deleu, Marine
AU  - De Monte, Francesca
AU  - Dobrić, Milan R.
AU  - Gallagher, Aoife
AU  - Hadid-Beurrier, Lama
AU  - Henry, Patrick
AU  - Hršak, Hrvoje
AU  - Kiernan, Tom
AU  - Kumar, Rajesh
AU  - Knežević, Željka
AU  - Maccia, Carlo
AU  - Majer, Marija
AU  - Malchair, Françoise
AU  - Noble, Stéphane
AU  - Obrad, Davor
AU  - Merce, Marta Sans
AU  - Sideris, Georgios
AU  - Simantirakis, George
AU  - Spaulding, Christian
AU  - Tarantini, Giuseppe
AU  - Van Ngoc Ty, Claire
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/10111
AB  - Optimizing patient exposure in interventional cardiology is key to avoid skin injuries.PurposeTo establish predictive models of peak skin dose (PSD) during percutaneous coronary intervention (PCI), chronic total occlusion percutaneous coronary intervention (CTO), and transcatheter aortic valve implantation (TAVI) procedures.Material and MethodsA total of 534 PCI, 219 CTO, and 209 TAVI were collected from 12 hospitals in eight European countries. Independent associations between PSD and clinical and technical dose determinants were examined for those procedures using multivariate statistical analysis. A priori and a posteriori predictive models were built using stepwise multiple linear regressions. A fourfold cross-validation was performed, and models? performance was evaluated using the root mean square error (RMSE), mean absolute percentage error (MAPE), coefficient of determination (R²), and linear correlation coefficient (r).ResultsMultivariate analysis proved technical parameters to overweight clinical complexity indices with PSD mainly affected by fluoroscopy time, tube voltage, tube current, distance to detector, and tube angulation for PCI. For CTO, these were body mass index, tube voltage, and fluoroscopy contribution. For TAVI, these parameters were sex, fluoroscopy time, tube voltage, and cine acquisitions. When benchmarking the predictive models, the correlation coefficients were r?=?0.45 for the a priori model and r?=?0.89 for the a posteriori model for PCI. These were 0.44 and 0.67, respectively, for the CTO a priori and a posteriori models, and 0.58 and 0.74, respectively, for the TAVI a priori and a posteriori models.ConclusionA priori predictive models can help operators estimate the PSD before performing the intervention while a posteriori models are more accurate estimates and can be useful in the absence of skin dose mapping solutions
T2  - Acta Radiologica
T1  - Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project
DO  - 10.1177/02841851211062089
ER  - 

@article{
author = "Feghali, Joelle Ann and Delépierre, Julie and Ciraj-Bjelac, Olivera and Dabin, Jérémie and Deleu, Marine and De Monte, Francesca and Dobrić, Milan R. and Gallagher, Aoife and Hadid-Beurrier, Lama and Henry, Patrick and Hršak, Hrvoje and Kiernan, Tom and Kumar, Rajesh and Knežević, Željka and Maccia, Carlo and Majer, Marija and Malchair, Françoise and Noble, Stéphane and Obrad, Davor and Merce, Marta Sans and Sideris, Georgios and Simantirakis, George and Spaulding, Christian and Tarantini, Giuseppe and Van Ngoc Ty, Claire",
year = "2021",
abstract = "Optimizing patient exposure in interventional cardiology is key to avoid skin injuries.PurposeTo establish predictive models of peak skin dose (PSD) during percutaneous coronary intervention (PCI), chronic total occlusion percutaneous coronary intervention (CTO), and transcatheter aortic valve implantation (TAVI) procedures.Material and MethodsA total of 534 PCI, 219 CTO, and 209 TAVI were collected from 12 hospitals in eight European countries. Independent associations between PSD and clinical and technical dose determinants were examined for those procedures using multivariate statistical analysis. A priori and a posteriori predictive models were built using stepwise multiple linear regressions. A fourfold cross-validation was performed, and models? performance was evaluated using the root mean square error (RMSE), mean absolute percentage error (MAPE), coefficient of determination (R²), and linear correlation coefficient (r).ResultsMultivariate analysis proved technical parameters to overweight clinical complexity indices with PSD mainly affected by fluoroscopy time, tube voltage, tube current, distance to detector, and tube angulation for PCI. For CTO, these were body mass index, tube voltage, and fluoroscopy contribution. For TAVI, these parameters were sex, fluoroscopy time, tube voltage, and cine acquisitions. When benchmarking the predictive models, the correlation coefficients were r?=?0.45 for the a priori model and r?=?0.89 for the a posteriori model for PCI. These were 0.44 and 0.67, respectively, for the CTO a priori and a posteriori models, and 0.58 and 0.74, respectively, for the TAVI a priori and a posteriori models.ConclusionA priori predictive models can help operators estimate the PSD before performing the intervention while a posteriori models are more accurate estimates and can be useful in the absence of skin dose mapping solutions",
journal = "Acta Radiologica",
title = "Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project",
doi = "10.1177/02841851211062089"
}

Feghali, J. A., Delépierre, J., Ciraj-Bjelac, O., Dabin, J., Deleu, M., De Monte, F., Dobrić, M. R., Gallagher, A., Hadid-Beurrier, L., Henry, P., Hršak, H., Kiernan, T., Kumar, R., Knežević, Ž., Maccia, C., Majer, M., Malchair, F., Noble, S., Obrad, D., Merce, M. S., Sideris, G., Simantirakis, G., Spaulding, C., Tarantini, G.,& Van Ngoc Ty, C.. (2021). Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project. in Acta Radiologica.
https://doi.org/10.1177/02841851211062089

Feghali JA, Delépierre J, Ciraj-Bjelac O, Dabin J, Deleu M, De Monte F, Dobrić MR, Gallagher A, Hadid-Beurrier L, Henry P, Hršak H, Kiernan T, Kumar R, Knežević Ž, Maccia C, Majer M, Malchair F, Noble S, Obrad D, Merce MS, Sideris G, Simantirakis G, Spaulding C, Tarantini G, Van Ngoc Ty C. Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project. in Acta Radiologica. 2021;.
doi:10.1177/02841851211062089 .

Feghali, Joelle Ann, Delépierre, Julie, Ciraj-Bjelac, Olivera, Dabin, Jérémie, Deleu, Marine, De Monte, Francesca, Dobrić, Milan R., Gallagher, Aoife, Hadid-Beurrier, Lama, Henry, Patrick, Hršak, Hrvoje, Kiernan, Tom, Kumar, Rajesh, Knežević, Željka, Maccia, Carlo, Majer, Marija, Malchair, Françoise, Noble, Stéphane, Obrad, Davor, Merce, Marta Sans, Sideris, Georgios, Simantirakis, George, Spaulding, Christian, Tarantini, Giuseppe, Van Ngoc Ty, Claire, "Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project" in Acta Radiologica (2021),
https://doi.org/10.1177/02841851211062089 . .

TY  - JOUR
AU  - Candela-Juan, Cristian
AU  - Ciraj-Bjelac, Olivera
AU  - Sans Merce, Marta
AU  - Dabin, Jérémie
AU  - Faj, Dario
AU  - Gallagher, Aoife
AU  - de las Heras Gala, Hugo
AU  - Knežević, Željka
AU  - Malchair, Françoise
AU  - De Monte, Francesca
AU  - Simantirakis, George
AU  - Theodorakou, Chrysoula
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9822
AB  - The use of patient contact-shielding has become a topic of intensive scientific debate. While it has been common practice during the last decades, some studies have questioned the efficiency of using such shielding while others have highlighted the inconsistencies in its application. The objective of this work is to review current recommendations and legislative documents on the use of out-of-field shielding in X-ray imaging, including those from national authorities and from international and national organisations and professional bodies. The review, performed within the framework of the activities of EURADOS Working Group 12, covers available recommendations on use of contact shielding in adult, pregnant and paediatric patients in general radiography, fluoroscopy, computed tomography, mammography and dental radiology. It includes a comprehensive search of 83 documents from 32 countries and 6 international organisations over the last 39 years. In general, using shielding is recommended only under two conditions: if it does not compromise the diagnostic task and the performance of the procedure and/or if it reassures the patient and comforters that they are appropriately protected against potentially harmful effects of radiation. There are very few specific regulatory requirements to use shielding in a particular imaging modality, although they may consider use of shielding either as part of good radiological practice or as requirements for availability of protective or ancillary tools, without further specification of their use. There is a wide variety of positions among documents that recommend out-of-field shielding, those that do not recommend it and those that are not specific. Therefore, evidence-based consensus is still needed to ensure best and consistent practice.
T2  - Physica Medica
T1  - Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents
VL  - 86
SP  - 44
EP  - 56
DO  - 10.1016/j.ejmp.2021.05.017
ER  - 

@article{
author = "Candela-Juan, Cristian and Ciraj-Bjelac, Olivera and Sans Merce, Marta and Dabin, Jérémie and Faj, Dario and Gallagher, Aoife and de las Heras Gala, Hugo and Knežević, Željka and Malchair, Françoise and De Monte, Francesca and Simantirakis, George and Theodorakou, Chrysoula",
year = "2021",
abstract = "The use of patient contact-shielding has become a topic of intensive scientific debate. While it has been common practice during the last decades, some studies have questioned the efficiency of using such shielding while others have highlighted the inconsistencies in its application. The objective of this work is to review current recommendations and legislative documents on the use of out-of-field shielding in X-ray imaging, including those from national authorities and from international and national organisations and professional bodies. The review, performed within the framework of the activities of EURADOS Working Group 12, covers available recommendations on use of contact shielding in adult, pregnant and paediatric patients in general radiography, fluoroscopy, computed tomography, mammography and dental radiology. It includes a comprehensive search of 83 documents from 32 countries and 6 international organisations over the last 39 years. In general, using shielding is recommended only under two conditions: if it does not compromise the diagnostic task and the performance of the procedure and/or if it reassures the patient and comforters that they are appropriately protected against potentially harmful effects of radiation. There are very few specific regulatory requirements to use shielding in a particular imaging modality, although they may consider use of shielding either as part of good radiological practice or as requirements for availability of protective or ancillary tools, without further specification of their use. There is a wide variety of positions among documents that recommend out-of-field shielding, those that do not recommend it and those that are not specific. Therefore, evidence-based consensus is still needed to ensure best and consistent practice.",
journal = "Physica Medica",
title = "Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents",
volume = "86",
pages = "44-56",
doi = "10.1016/j.ejmp.2021.05.017"
}

Candela-Juan, C., Ciraj-Bjelac, O., Sans Merce, M., Dabin, J., Faj, D., Gallagher, A., de las Heras Gala, H., Knežević, Ž., Malchair, F., De Monte, F., Simantirakis, G.,& Theodorakou, C.. (2021). Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents. in Physica Medica, 86, 44-56.
https://doi.org/10.1016/j.ejmp.2021.05.017

Candela-Juan C, Ciraj-Bjelac O, Sans Merce M, Dabin J, Faj D, Gallagher A, de las Heras Gala H, Knežević Ž, Malchair F, De Monte F, Simantirakis G, Theodorakou C. Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents. in Physica Medica. 2021;86:44-56.
doi:10.1016/j.ejmp.2021.05.017 .

Candela-Juan, Cristian, Ciraj-Bjelac, Olivera, Sans Merce, Marta, Dabin, Jérémie, Faj, Dario, Gallagher, Aoife, de las Heras Gala, Hugo, Knežević, Željka, Malchair, Françoise, De Monte, Francesca, Simantirakis, George, Theodorakou, Chrysoula, "Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents" in Physica Medica, 86 (2021):44-56,
https://doi.org/10.1016/j.ejmp.2021.05.017 . .

TY  - JOUR
AU  - Siiskonen, Teemu
AU  - Gallagher, Aoife
AU  - Ciraj-Bjelac, Olivera
AU  - Novak, Leos
AU  - Sans Merce, Marta
AU  - Farah, Jad
AU  - Dabin, Jérémie
AU  - Malchair, Françoise
AU  - Knežević, Željka
AU  - Kortesniemi, Mika
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9838
AB  - Cone beam computed tomography (CBCT) has been available since the late 1990s for use in dentistry. European legislation requires optimisation of protection and the use of diagnostic reference levels (DRLs) as well as regular quality control (QC) of the imaging devices, which is well outlined in existing international recommendations. Nevertheless, the level of application is not known. Earlier studies have indicated that few European countries have established DRLs and that patient doses (exposure parameters) have not been properly optimised. The EURADOS Working Group 12-Dosimetry in Medical Imaging undertook a survey to identify existing practices in Member States. Questionnaires were developed to identify equipment types, clinical procedures performed, and exposure settings used. The surveys were circulated to 22 countries resulting in 28 responses from 13 countries. Variations were identified in the exposure factors and in the doses delivered to patients for similar clinical indicators. Results confirm that patient doses are still not properly optimised and DRLs are largely not established. There is a need to promote the importance of performing QC testing of dental CBCT equipment and to further optimise patient exposure by establishment and use of DRLs as a part of a continuous optimisation process.
T2  - Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
T1  - A European perspective on dental cone beam computed tomography systems with a focus on optimisation utilising diagnostic reference levels
VL  - 41
IS  - 2
DO  - 10.1088/1361-6498/abdd05
ER  - 

@article{
author = "Siiskonen, Teemu and Gallagher, Aoife and Ciraj-Bjelac, Olivera and Novak, Leos and Sans Merce, Marta and Farah, Jad and Dabin, Jérémie and Malchair, Françoise and Knežević, Željka and Kortesniemi, Mika",
year = "2021",
abstract = "Cone beam computed tomography (CBCT) has been available since the late 1990s for use in dentistry. European legislation requires optimisation of protection and the use of diagnostic reference levels (DRLs) as well as regular quality control (QC) of the imaging devices, which is well outlined in existing international recommendations. Nevertheless, the level of application is not known. Earlier studies have indicated that few European countries have established DRLs and that patient doses (exposure parameters) have not been properly optimised. The EURADOS Working Group 12-Dosimetry in Medical Imaging undertook a survey to identify existing practices in Member States. Questionnaires were developed to identify equipment types, clinical procedures performed, and exposure settings used. The surveys were circulated to 22 countries resulting in 28 responses from 13 countries. Variations were identified in the exposure factors and in the doses delivered to patients for similar clinical indicators. Results confirm that patient doses are still not properly optimised and DRLs are largely not established. There is a need to promote the importance of performing QC testing of dental CBCT equipment and to further optimise patient exposure by establishment and use of DRLs as a part of a continuous optimisation process.",
journal = "Journal of Radiological Protection: Official Journal of the Society for Radiological Protection",
title = "A European perspective on dental cone beam computed tomography systems with a focus on optimisation utilising diagnostic reference levels",
volume = "41",
number = "2",
doi = "10.1088/1361-6498/abdd05"
}

Siiskonen, T., Gallagher, A., Ciraj-Bjelac, O., Novak, L., Sans Merce, M., Farah, J., Dabin, J., Malchair, F., Knežević, Ž.,& Kortesniemi, M.. (2021). A European perspective on dental cone beam computed tomography systems with a focus on optimisation utilising diagnostic reference levels. in Journal of Radiological Protection: Official Journal of the Society for Radiological Protection, 41(2).
https://doi.org/10.1088/1361-6498/abdd05

Siiskonen T, Gallagher A, Ciraj-Bjelac O, Novak L, Sans Merce M, Farah J, Dabin J, Malchair F, Knežević Ž, Kortesniemi M. A European perspective on dental cone beam computed tomography systems with a focus on optimisation utilising diagnostic reference levels. in Journal of Radiological Protection: Official Journal of the Society for Radiological Protection. 2021;41(2).
doi:10.1088/1361-6498/abdd05 .

Siiskonen, Teemu, Gallagher, Aoife, Ciraj-Bjelac, Olivera, Novak, Leos, Sans Merce, Marta, Farah, Jad, Dabin, Jérémie, Malchair, Françoise, Knežević, Željka, Kortesniemi, Mika, "A European perspective on dental cone beam computed tomography systems with a focus on optimisation utilising diagnostic reference levels" in Journal of Radiological Protection: Official Journal of the Society for Radiological Protection, 41, no. 2 (2021),
https://doi.org/10.1088/1361-6498/abdd05 . .

TY  - JOUR
AU  - Malchair, Françoise
AU  - Dabin, Jérémie
AU  - Deleu, Marine
AU  - Merce, Marta Sans
AU  - Ciraj-Bjelac, Olivera
AU  - Gallagher, Aoife
AU  - Maccia, Carlo
PY  - 2020
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9714
AB  - PurposeIn interventional cardiology, patients may be exposed to high doses to the skin resulting in skin burns following single or multiple procedures. Reviewing and analysing available software (online or offline) may help medical physicists assessing the maximum skin dose to the patient together with the dose distribution during (or after) these procedures.Method and resultsCapabilities and accuracy of available software were analysed through an extensive bibliography search and contacts with both vendor and authors. Their markedly differed among developers. In total, 22 software were identified and reviewed according to their algorithms and their capabilities. Special attention was dedicated to their main features and limitations of interest for the intended clinical use. While the accuracy of the 12 software products validated with measurements on phantoms was acceptable (within ± 25%), the agreement was poor for the two products validated on patients (within ± 43% and ± 76%, respectively). In addition, no software has been validated on angiographic units from all manufacturers, though several software developers claimed vendor-independent transportability. Only one software allows for multiple procedures dose calculation.ConclusionLarge differences among vendors made it clear that work remains to be done before an accurate and reliable skin dose mapping is available for all patients.
T2  - Physica Medica
T1  - Review of skin dose calculation software in interventional cardiology
VL  - 80
SP  - 75
EP  - 83
DO  - 10.1016/j.ejmp.2020.09.023
ER  - 

@article{
author = "Malchair, Françoise and Dabin, Jérémie and Deleu, Marine and Merce, Marta Sans and Ciraj-Bjelac, Olivera and Gallagher, Aoife and Maccia, Carlo",
year = "2020",
abstract = "PurposeIn interventional cardiology, patients may be exposed to high doses to the skin resulting in skin burns following single or multiple procedures. Reviewing and analysing available software (online or offline) may help medical physicists assessing the maximum skin dose to the patient together with the dose distribution during (or after) these procedures.Method and resultsCapabilities and accuracy of available software were analysed through an extensive bibliography search and contacts with both vendor and authors. Their markedly differed among developers. In total, 22 software were identified and reviewed according to their algorithms and their capabilities. Special attention was dedicated to their main features and limitations of interest for the intended clinical use. While the accuracy of the 12 software products validated with measurements on phantoms was acceptable (within ± 25%), the agreement was poor for the two products validated on patients (within ± 43% and ± 76%, respectively). In addition, no software has been validated on angiographic units from all manufacturers, though several software developers claimed vendor-independent transportability. Only one software allows for multiple procedures dose calculation.ConclusionLarge differences among vendors made it clear that work remains to be done before an accurate and reliable skin dose mapping is available for all patients.",
journal = "Physica Medica",
title = "Review of skin dose calculation software in interventional cardiology",
volume = "80",
pages = "75-83",
doi = "10.1016/j.ejmp.2020.09.023"
}

Malchair, F., Dabin, J., Deleu, M., Merce, M. S., Ciraj-Bjelac, O., Gallagher, A.,& Maccia, C.. (2020). Review of skin dose calculation software in interventional cardiology. in Physica Medica, 80, 75-83.
https://doi.org/10.1016/j.ejmp.2020.09.023

Malchair F, Dabin J, Deleu M, Merce MS, Ciraj-Bjelac O, Gallagher A, Maccia C. Review of skin dose calculation software in interventional cardiology. in Physica Medica. 2020;80:75-83.
doi:10.1016/j.ejmp.2020.09.023 .

Malchair, Françoise, Dabin, Jérémie, Deleu, Marine, Merce, Marta Sans, Ciraj-Bjelac, Olivera, Gallagher, Aoife, Maccia, Carlo, "Review of skin dose calculation software in interventional cardiology" in Physica Medica, 80 (2020):75-83,
https://doi.org/10.1016/j.ejmp.2020.09.023 . .