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
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  - Sans Merce, Marta
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/123456789/10112
AB  - Patients can be exposed to high skin doses during complex interventional cardiology (IC) procedures.PurposeTo identify which clinical and technical parameters affect patient exposure and peak skin dose (PSD) and to establish dose reference levels (DRL) per clinical complexity level in IC procedures.Material and MethodsValidation and Estimation of Radiation skin Dose in Interventional Cardiology (VERIDIC) project analyzed prospectively collected patient data from eight European countries and 12 hospitals where percutaneous coronary intervention (PCI), chronic total occlusion PCI (CTO), and transcatheter aortic valve implantation (TAVI) procedures were performed. A total of 62 clinical complexity parameters and 31 technical parameters were collected, univariate regressions were performed to identify those parameters affecting patient exposure and define DRL accordingly.ResultsPatient exposure as well as clinical and technical parameters were collected for a total of 534 PCI, 219 CTO, and 209 TAVI. For PCI procedures, body mass index (BMI), number of stents ≥2, and total stent length >28?mm were the most prominent clinical parameters, which increased the PSD value. For CTO, these were total stent length >57?mm, BMI, and previous anterograde or retrograde technique that failed in the same session. For TAVI, these were male sex, BMI, and number of diseased vessels. DRL values for Kerma-area product (PKA), air kerma at patient entrance reference point (Ka,r), fluoroscopy time (FT), and PSD were stratified, respectively, for 14 clinical parameters in PCI, 10 in CTO, and four in TAVI.ConclusionPrior knowledge of the key factors influencing the PSD will help optimize patient radiation protection in IC.
T2  - Acta Radiologica
T1  - Patient exposure dose in interventional cardiology per clinical and technical complexity levels. Part 1: results of the VERIDIC project
DO  - 10.1177/02841851211061438
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 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 Sans Merce, Marta and Sideris, Georgios and Simantirakis, George and Spaulding, Christian and Tarantini, Giuseppe and Van Ngoc Ty, Claire",
year = "2021",
abstract = "Patients can be exposed to high skin doses during complex interventional cardiology (IC) procedures.PurposeTo identify which clinical and technical parameters affect patient exposure and peak skin dose (PSD) and to establish dose reference levels (DRL) per clinical complexity level in IC procedures.Material and MethodsValidation and Estimation of Radiation skin Dose in Interventional Cardiology (VERIDIC) project analyzed prospectively collected patient data from eight European countries and 12 hospitals where percutaneous coronary intervention (PCI), chronic total occlusion PCI (CTO), and transcatheter aortic valve implantation (TAVI) procedures were performed. A total of 62 clinical complexity parameters and 31 technical parameters were collected, univariate regressions were performed to identify those parameters affecting patient exposure and define DRL accordingly.ResultsPatient exposure as well as clinical and technical parameters were collected for a total of 534 PCI, 219 CTO, and 209 TAVI. For PCI procedures, body mass index (BMI), number of stents ≥2, and total stent length >28?mm were the most prominent clinical parameters, which increased the PSD value. For CTO, these were total stent length >57?mm, BMI, and previous anterograde or retrograde technique that failed in the same session. For TAVI, these were male sex, BMI, and number of diseased vessels. DRL values for Kerma-area product (PKA), air kerma at patient entrance reference point (Ka,r), fluoroscopy time (FT), and PSD were stratified, respectively, for 14 clinical parameters in PCI, 10 in CTO, and four in TAVI.ConclusionPrior knowledge of the key factors influencing the PSD will help optimize patient radiation protection in IC.",
journal = "Acta Radiologica",
title = "Patient exposure dose in interventional cardiology per clinical and technical complexity levels. Part 1: results of the VERIDIC project",
doi = "10.1177/02841851211061438"
}

Feghali, J. A., Delépierre, J., Ciraj-Bjelac, O., Dabin, J., Deleu, M., De Monte, F., Dobrić, M., 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., Sans Merce, M., Sideris, G., Simantirakis, G., Spaulding, C., Tarantini, G.,& Van Ngoc Ty, C.. (2021). Patient exposure dose in interventional cardiology per clinical and technical complexity levels. Part 1: results of the VERIDIC project. in Acta Radiologica.
https://doi.org/10.1177/02841851211061438

Feghali JA, Delépierre J, Ciraj-Bjelac O, Dabin J, Deleu M, De Monte F, Dobrić M, 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, Sans Merce M, Sideris G, Simantirakis G, Spaulding C, Tarantini G, Van Ngoc Ty C. Patient exposure dose in interventional cardiology per clinical and technical complexity levels. Part 1: results of the VERIDIC project. in Acta Radiologica. 2021;.
doi:10.1177/02841851211061438 .

Feghali, Joelle Ann, Delépierre, Julie, Ciraj-Bjelac, Olivera, Dabin, Jérémie, Deleu, Marine, De Monte, Francesca, Dobrić, Milan, 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, Sans Merce, Marta, Sideris, Georgios, Simantirakis, George, Spaulding, Christian, Tarantini, Giuseppe, Van Ngoc Ty, Claire, "Patient exposure dose in interventional cardiology per clinical and technical complexity levels. Part 1: results of the VERIDIC project" in Acta Radiologica (2021),
https://doi.org/10.1177/02841851211061438 . .

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  - Kržanović, Nikola
AU  - Blideanu, Valentin
AU  - Ciraj-Bjelac, Olivera
AU  - Plagnard, Johann
AU  - Schoonjans, Werner
AU  - Živanović, Miloš Z.
AU  - Dabin, Jérémie
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9554
AB  - Interventional procedures in radiology and cardiology are associated with high dose to the patient. Accurate dosimetry is essential and calibration of the equipment is a means to provide the necessary accuracy of dose assessment. The objective of this work is to investigate the performance of dosimeters used in interventional procedures in different standard and non-standard X-ray radiation qualities, and to investigate potential uncertainties related to dose measurements, thus improving accuracy of patient dosimetry in interventional procedures. Four new reference radiation qualities dedicated to interventional cardiology applications have been established, allowing calibration of dosimeters used in clinical conditions with appropriate traceability to primary standards. Testing of solid-state semiconductor detectors and thermoluminescent dosimeter properties, e.g. influence of photon energy, angle of incidence and dose rate, was performed in the standard and non-standard radiation qualities. Both dosimeter types showed good performance in the non-standard beams during all performance tests. Solid-state dosimeters displayed weak dependence on energy, angle of incidence and dose rate, in the range defined by the manufacturer and requirements of the international standard. Thermoluminescent dosimeters displayed excellent linearity and angular dependence. The influence of energy dependence on measurement uncertainty can be reduced if appropriate radiation quality is selected for calibration. © 2021 Elsevier Ltd
T2  - Radiation Measurements
T1  - Performance testing of dosimeters used in interventional radiology: Results from the VERIDIC project
VL  - 141
SP  - 106515
DO  - 10.1016/j.radmeas.2021.106515
ER  - 

@article{
author = "Kržanović, Nikola and Blideanu, Valentin and Ciraj-Bjelac, Olivera and Plagnard, Johann and Schoonjans, Werner and Živanović, Miloš Z. and Dabin, Jérémie",
year = "2021",
abstract = "Interventional procedures in radiology and cardiology are associated with high dose to the patient. Accurate dosimetry is essential and calibration of the equipment is a means to provide the necessary accuracy of dose assessment. The objective of this work is to investigate the performance of dosimeters used in interventional procedures in different standard and non-standard X-ray radiation qualities, and to investigate potential uncertainties related to dose measurements, thus improving accuracy of patient dosimetry in interventional procedures. Four new reference radiation qualities dedicated to interventional cardiology applications have been established, allowing calibration of dosimeters used in clinical conditions with appropriate traceability to primary standards. Testing of solid-state semiconductor detectors and thermoluminescent dosimeter properties, e.g. influence of photon energy, angle of incidence and dose rate, was performed in the standard and non-standard radiation qualities. Both dosimeter types showed good performance in the non-standard beams during all performance tests. Solid-state dosimeters displayed weak dependence on energy, angle of incidence and dose rate, in the range defined by the manufacturer and requirements of the international standard. Thermoluminescent dosimeters displayed excellent linearity and angular dependence. The influence of energy dependence on measurement uncertainty can be reduced if appropriate radiation quality is selected for calibration. © 2021 Elsevier Ltd",
journal = "Radiation Measurements",
title = "Performance testing of dosimeters used in interventional radiology: Results from the VERIDIC project",
volume = "141",
pages = "106515",
doi = "10.1016/j.radmeas.2021.106515"
}

Kržanović, N., Blideanu, V., Ciraj-Bjelac, O., Plagnard, J., Schoonjans, W., Živanović, M. Z.,& Dabin, J.. (2021). Performance testing of dosimeters used in interventional radiology: Results from the VERIDIC project. in Radiation Measurements, 141, 106515.
https://doi.org/10.1016/j.radmeas.2021.106515

Kržanović N, Blideanu V, Ciraj-Bjelac O, Plagnard J, Schoonjans W, Živanović MZ, Dabin J. Performance testing of dosimeters used in interventional radiology: Results from the VERIDIC project. in Radiation Measurements. 2021;141:106515.
doi:10.1016/j.radmeas.2021.106515 .

Kržanović, Nikola, Blideanu, Valentin, Ciraj-Bjelac, Olivera, Plagnard, Johann, Schoonjans, Werner, Živanović, Miloš Z., Dabin, Jérémie, "Performance testing of dosimeters used in interventional radiology: Results from the VERIDIC project" in Radiation Measurements, 141 (2021):106515,
https://doi.org/10.1016/j.radmeas.2021.106515 . .

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 . .

TY  - CONF
AU  - Ciraj-Bjelac, Olivera
AU  - Kržanović, Nikola
AU  - Živanović, Miloš Z.
AU  - Blideanu, Valentin
AU  - De Monte, Francesca
AU  - Deleu, Marine
AU  - Feghali Joelle, Ann
AU  - Gallagher, Aoife
AU  - Knežević, Željka
AU  - Maccia, Carlo
AU  - Malchair, Francoise
AU  - Plagnard, Johann
AU  - Sans Merce, Marta
AU  - Simantirakis, Georgios
AU  - Dabin, Jeremie
PY  - 2019
UR  - https://plus.sr.cobiss.net/opac7/bib/279687436
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/8712
AB  - Interventne procedure u radiologiji i kardiologiji povezani su sa visokim dozama za kožu pacijenta i potencijalnim radijacionim povredama kože. Različita metodologije i rešenja razvijene us za procenu maksimalne doze za kožu, čija se svojsvta, uključujuši i tačnost značajno razlikuju. U radu su prokazani ciljevi, metode i preminiran a rešenja projekta VERIDIC usmerenoj na validaciju zaličitih ofline i online softvera za procenu doze za kožu pacijenta u intervenatnoj kardiologiji.
AB  - In interventional cardiology (IC), patients may be exposed to high doses to the skin resulting in tissue reactions (skin burns) following single or multiple procedures. To address this issue, online and offline software has been developed to estimate the maximum skin dose (MSD) to the patient from IC procedures. However, the capabilities and accuracy of such skin dose calculation (SDC) software to estimate MSD and 2D dose distributions markedly differ among vendors. Hence, this project focuses onthe harmonisation of RDSR (radiation dose structured report) and on the validation of SDC software products in IC, which will optimise radiation protection of patients. The outcome of the project will include the standards for digital dose reporting, development of protocols for acceptance testing and Quality Control (QC)of SDC software and setting of diagnostic reference levels per clinical complexity, assessing thefrequency of high-dose procedures as well as dose reduction strategies based on the multi-centric data collection. This paper focuses on the work performed to investigate performance of solid state dosimeters used in clinical environment.
PB  - Београд : Институт за нуклеарне науке "Винча" : Друштво за заштиту од зрачења Србије и Црне Горе
C3  - 30. симпозијум ДЗЗСЦГ : зборник радова
T1  - VERIDIC: validacija i procena doze na površini kože za pacijente u interventnoj kardiologiji
T1  - VERIDIC: validation and estimation of radiation skin dose in interventional cardiology
SP  - 386
EP  - 393
UR  - https://hdl.handle.net/21.15107/rcub_vinar_8712
ER  - 

@conference{
author = "Ciraj-Bjelac, Olivera and Kržanović, Nikola and Živanović, Miloš Z. and Blideanu, Valentin and De Monte, Francesca and Deleu, Marine and Feghali Joelle, Ann and Gallagher, Aoife and Knežević, Željka and Maccia, Carlo and Malchair, Francoise and Plagnard, Johann and Sans Merce, Marta and Simantirakis, Georgios and Dabin, Jeremie",
year = "2019",
abstract = "Interventne procedure u radiologiji i kardiologiji povezani su sa visokim dozama za kožu pacijenta i potencijalnim radijacionim povredama kože. Različita metodologije i rešenja razvijene us za procenu maksimalne doze za kožu, čija se svojsvta, uključujuši i tačnost značajno razlikuju. U radu su prokazani ciljevi, metode i preminiran a rešenja projekta VERIDIC usmerenoj na validaciju zaličitih ofline i online softvera za procenu doze za kožu pacijenta u intervenatnoj kardiologiji., In interventional cardiology (IC), patients may be exposed to high doses to the skin resulting in tissue reactions (skin burns) following single or multiple procedures. To address this issue, online and offline software has been developed to estimate the maximum skin dose (MSD) to the patient from IC procedures. However, the capabilities and accuracy of such skin dose calculation (SDC) software to estimate MSD and 2D dose distributions markedly differ among vendors. Hence, this project focuses onthe harmonisation of RDSR (radiation dose structured report) and on the validation of SDC software products in IC, which will optimise radiation protection of patients. The outcome of the project will include the standards for digital dose reporting, development of protocols for acceptance testing and Quality Control (QC)of SDC software and setting of diagnostic reference levels per clinical complexity, assessing thefrequency of high-dose procedures as well as dose reduction strategies based on the multi-centric data collection. This paper focuses on the work performed to investigate performance of solid state dosimeters used in clinical environment.",
publisher = "Београд : Институт за нуклеарне науке "Винча" : Друштво за заштиту од зрачења Србије и Црне Горе",
journal = "30. симпозијум ДЗЗСЦГ : зборник радова",
title = "VERIDIC: validacija i procena doze na površini kože za pacijente u interventnoj kardiologiji, VERIDIC: validation and estimation of radiation skin dose in interventional cardiology",
pages = "386-393",
url = "https://hdl.handle.net/21.15107/rcub_vinar_8712"
}

Ciraj-Bjelac, O., Kržanović, N., Živanović, M. Z., Blideanu, V., De Monte, F., Deleu, M., Feghali Joelle, A., Gallagher, A., Knežević, Ž., Maccia, C., Malchair, F., Plagnard, J., Sans Merce, M., Simantirakis, G.,& Dabin, J.. (2019). VERIDIC: validacija i procena doze na površini kože za pacijente u interventnoj kardiologiji. in 30. симпозијум ДЗЗСЦГ : зборник радова
Београд : Институт за нуклеарне науке "Винча" : Друштво за заштиту од зрачења Србије и Црне Горе., 386-393.
https://hdl.handle.net/21.15107/rcub_vinar_8712

Ciraj-Bjelac O, Kržanović N, Živanović MZ, Blideanu V, De Monte F, Deleu M, Feghali Joelle A, Gallagher A, Knežević Ž, Maccia C, Malchair F, Plagnard J, Sans Merce M, Simantirakis G, Dabin J. VERIDIC: validacija i procena doze na površini kože za pacijente u interventnoj kardiologiji. in 30. симпозијум ДЗЗСЦГ : зборник радова. 2019;:386-393.
https://hdl.handle.net/21.15107/rcub_vinar_8712 .

Ciraj-Bjelac, Olivera, Kržanović, Nikola, Živanović, Miloš Z., Blideanu, Valentin, De Monte, Francesca, Deleu, Marine, Feghali Joelle, Ann, Gallagher, Aoife, Knežević, Željka, Maccia, Carlo, Malchair, Francoise, Plagnard, Johann, Sans Merce, Marta, Simantirakis, Georgios, Dabin, Jeremie, "VERIDIC: validacija i procena doze na površini kože za pacijente u interventnoj kardiologiji" in 30. симпозијум ДЗЗСЦГ : зборник радова (2019):386-393,
https://hdl.handle.net/21.15107/rcub_vinar_8712 .

TY  - JOUR
AU  - Siiskonen, Teemu
AU  - Ciraj-Bjelac, Olivera
AU  - Dabin, Jeremie
AU  - Diklić, Ana
AU  - Domienik-Andrzejewska, Joanna
AU  - Farah, Jad
AU  - Fernandez, Jose Miguel
AU  - Gallagher, Aoife
AU  - Hourdakis, Constantine J.
AU  - Jurković, Slaven
AU  - Jarvinen, Hannu
AU  - Jarvinen, J.
AU  - Knežević, Željka
AU  - Koukorava, Christina
AU  - Maccia, Carlo
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Riccardi, Lucia
AU  - Rizk, C.
AU  - Sanchez, Roberto Mariano
AU  - Sandborg, Michael
AU  - Merce, Marta Sans
AU  - Segota, D.
AU  - Sierpowska, Joanna
AU  - Simantirakis, George
AU  - Sukupova, Lucie
AU  - Thrapsanioti, Zoi
AU  - Vano, Eliseo
PY  - 2018
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7889
AB  - Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm2), percutaneous coronary intervention (PCI, 85 Gy cm2), transcatheter aortic valve implantation (TAVI, 130 Gy cm2), electrophysiological procedures (12 Gy cm2) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm2) and dual chamber (3.5 Gy cm2) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm2). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology. © 2018 Associazione Italiana di Fisica Medica
T2  - Physica Medica
T1  - Establishing the European diagnostic reference levels for interventional cardiology
VL  - 54
SP  - 42
EP  - 48
DO  - 10.1016/j.ejmp.2018.09.012
ER  - 

@article{
author = "Siiskonen, Teemu and Ciraj-Bjelac, Olivera and Dabin, Jeremie and Diklić, Ana and Domienik-Andrzejewska, Joanna and Farah, Jad and Fernandez, Jose Miguel and Gallagher, Aoife and Hourdakis, Constantine J. and Jurković, Slaven and Jarvinen, Hannu and Jarvinen, J. and Knežević, Željka and Koukorava, Christina and Maccia, Carlo and Majer, Marija and Malchair, Francoise and Riccardi, Lucia and Rizk, C. and Sanchez, Roberto Mariano and Sandborg, Michael and Merce, Marta Sans and Segota, D. and Sierpowska, Joanna and Simantirakis, George and Sukupova, Lucie and Thrapsanioti, Zoi and Vano, Eliseo",
year = "2018",
abstract = "Interventional cardiac procedures may be associated with high patient doses and therefore require special attention to protect the patients from radiation injuries such as skin erythema, cardiovascular tissue reactions or radiation-induced cancer. In this study, patient exposure data is collected from 13 countries (37 clinics and nearly 50 interventional rooms) and for 10 different procedures. Dose data was collected from a total of 14,922 interventional cardiology procedures. Based on these data European diagnostic reference levels (DRL) for air kerma-area product are suggested for coronary angiography (CA, DRL = 35 Gy cm2), percutaneous coronary intervention (PCI, 85 Gy cm2), transcatheter aortic valve implantation (TAVI, 130 Gy cm2), electrophysiological procedures (12 Gy cm2) and pacemaker implantations. Pacemaker implantations were further divided into single-chamber (2.5 Gy cm2) and dual chamber (3.5 Gy cm2) procedures and implantations of cardiac resynchronization therapy pacemaker (18 Gy cm2). Results show that relatively new techniques such as TAVI and treatment of chronic total occlusion (CTO) often produce relatively high doses, and thus emphasises the need for use of an optimization tool such as DRL to assist in reducing patient exposure. The generic DRL presented here facilitate comparison of patient exposure in interventional cardiology. © 2018 Associazione Italiana di Fisica Medica",
journal = "Physica Medica",
title = "Establishing the European diagnostic reference levels for interventional cardiology",
volume = "54",
pages = "42-48",
doi = "10.1016/j.ejmp.2018.09.012"
}

Siiskonen, T., Ciraj-Bjelac, O., Dabin, J., Diklić, A., Domienik-Andrzejewska, J., Farah, J., Fernandez, J. M., Gallagher, A., Hourdakis, C. J., Jurković, S., Jarvinen, H., Jarvinen, J., Knežević, Ž., Koukorava, C., Maccia, C., Majer, M., Malchair, F., Riccardi, L., Rizk, C., Sanchez, R. M., Sandborg, M., Merce, M. S., Segota, D., Sierpowska, J., Simantirakis, G., Sukupova, L., Thrapsanioti, Z.,& Vano, E.. (2018). Establishing the European diagnostic reference levels for interventional cardiology. in Physica Medica, 54, 42-48.
https://doi.org/10.1016/j.ejmp.2018.09.012

Siiskonen T, Ciraj-Bjelac O, Dabin J, Diklić A, Domienik-Andrzejewska J, Farah J, Fernandez JM, Gallagher A, Hourdakis CJ, Jurković S, Jarvinen H, Jarvinen J, Knežević Ž, Koukorava C, Maccia C, Majer M, Malchair F, Riccardi L, Rizk C, Sanchez RM, Sandborg M, Merce MS, Segota D, Sierpowska J, Simantirakis G, Sukupova L, Thrapsanioti Z, Vano E. Establishing the European diagnostic reference levels for interventional cardiology. in Physica Medica. 2018;54:42-48.
doi:10.1016/j.ejmp.2018.09.012 .

Siiskonen, Teemu, Ciraj-Bjelac, Olivera, Dabin, Jeremie, Diklić, Ana, Domienik-Andrzejewska, Joanna, Farah, Jad, Fernandez, Jose Miguel, Gallagher, Aoife, Hourdakis, Constantine J., Jurković, Slaven, Jarvinen, Hannu, Jarvinen, J., Knežević, Željka, Koukorava, Christina, Maccia, Carlo, Majer, Marija, Malchair, Francoise, Riccardi, Lucia, Rizk, C., Sanchez, Roberto Mariano, Sandborg, Michael, Merce, Marta Sans, Segota, D., Sierpowska, Joanna, Simantirakis, George, Sukupova, Lucie, Thrapsanioti, Zoi, Vano, Eliseo, "Establishing the European diagnostic reference levels for interventional cardiology" in Physica Medica, 54 (2018):42-48,
https://doi.org/10.1016/j.ejmp.2018.09.012 . .

TY  - JOUR
AU  - Struelens, Lara
AU  - Dabin, Jeremie
AU  - Carinou, Eleftheria
AU  - Askounis, Panagiotis
AU  - Ciraj-Bjelac, Olivera
AU  - Domienik-Andrzejewska, Joanna
AU  - Berus, Danielle
AU  - Padovani, Renato
AU  - Farah, Jad
AU  - Covens, Peter
PY  - 2018
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7654
AB  - This study describes the retrospective lens dose calculation methods developed and applied within the European epidemiological study on radiation-induced lens opacities among interventional cardiologists. While one approach focuses on self-reported data regarding working practice in combination with available procedure-specific eye lens dose values, the second approach focuses on the conversion of the individual whole-body dose to eye lens dose. In contrast with usual dose reconstruction methods within an epidemiological study, a protocol is applied resulting in an individual distribution of possible cumulative lens doses for each recruited cardiologist, rather than a single dose estimate. In this way, the uncertainty in the dose estimate (from measurement uncertainty and variability among cardiologists) is represented for each individual. Eye lens dose and whole-body dose measurements have been performed in clinical practice to validate both methods, and it was concluded that both produce acceptable results in the framework of a dose-risk evaluation study. Optimal results were obtained for the dose to the left eye using procedure-specific lens dose data in combination with information collected on working practice. This method has been applied to 421 interventional cardiologists resulting in a median cumulative eye lens dose of 15.1 cSv for the left eye and 11.4 cSv for the right eye. From the individual cumulative eye lens dose distributions obtained for each cardiologist, maxima up to 9-10 Sv were observed, although with low probability. Since whole-body dose values above the lead apron are available for only a small fraction of the cohort and in many cases not for the entire working career, the second method has only been used to benchmark the results from the first approach. This study succeeded in improving the retrospective calculation of cumulative eye lens doses in the framework of radiation-induced risk assessment of lens opacities, but it remains dependent on self-reported information, which is not always reliable for early years. However, the calculation tools developed can also be used to make an assessment of the eye lens dose in current practice.
T2  - Radiation Research
T1  - Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses
VL  - 189
IS  - 4
SP  - 399
EP  - 408
DO  - 10.1667/RR14970.1
ER  - 

@article{
author = "Struelens, Lara and Dabin, Jeremie and Carinou, Eleftheria and Askounis, Panagiotis and Ciraj-Bjelac, Olivera and Domienik-Andrzejewska, Joanna and Berus, Danielle and Padovani, Renato and Farah, Jad and Covens, Peter",
year = "2018",
abstract = "This study describes the retrospective lens dose calculation methods developed and applied within the European epidemiological study on radiation-induced lens opacities among interventional cardiologists. While one approach focuses on self-reported data regarding working practice in combination with available procedure-specific eye lens dose values, the second approach focuses on the conversion of the individual whole-body dose to eye lens dose. In contrast with usual dose reconstruction methods within an epidemiological study, a protocol is applied resulting in an individual distribution of possible cumulative lens doses for each recruited cardiologist, rather than a single dose estimate. In this way, the uncertainty in the dose estimate (from measurement uncertainty and variability among cardiologists) is represented for each individual. Eye lens dose and whole-body dose measurements have been performed in clinical practice to validate both methods, and it was concluded that both produce acceptable results in the framework of a dose-risk evaluation study. Optimal results were obtained for the dose to the left eye using procedure-specific lens dose data in combination with information collected on working practice. This method has been applied to 421 interventional cardiologists resulting in a median cumulative eye lens dose of 15.1 cSv for the left eye and 11.4 cSv for the right eye. From the individual cumulative eye lens dose distributions obtained for each cardiologist, maxima up to 9-10 Sv were observed, although with low probability. Since whole-body dose values above the lead apron are available for only a small fraction of the cohort and in many cases not for the entire working career, the second method has only been used to benchmark the results from the first approach. This study succeeded in improving the retrospective calculation of cumulative eye lens doses in the framework of radiation-induced risk assessment of lens opacities, but it remains dependent on self-reported information, which is not always reliable for early years. However, the calculation tools developed can also be used to make an assessment of the eye lens dose in current practice.",
journal = "Radiation Research",
title = "Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses",
volume = "189",
number = "4",
pages = "399-408",
doi = "10.1667/RR14970.1"
}

Struelens, L., Dabin, J., Carinou, E., Askounis, P., Ciraj-Bjelac, O., Domienik-Andrzejewska, J., Berus, D., Padovani, R., Farah, J.,& Covens, P.. (2018). Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses. in Radiation Research, 189(4), 399-408.
https://doi.org/10.1667/RR14970.1

Struelens L, Dabin J, Carinou E, Askounis P, Ciraj-Bjelac O, Domienik-Andrzejewska J, Berus D, Padovani R, Farah J, Covens P. Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses. in Radiation Research. 2018;189(4):399-408.
doi:10.1667/RR14970.1 .

Struelens, Lara, Dabin, Jeremie, Carinou, Eleftheria, Askounis, Panagiotis, Ciraj-Bjelac, Olivera, Domienik-Andrzejewska, Joanna, Berus, Danielle, Padovani, Renato, Farah, Jad, Covens, Peter, "Radiation-Induced Lens Opacities among Interventional Cardiologists: Retrospective Assessment of Cumulative Eye Lens Doses" in Radiation Research, 189, no. 4 (2018):399-408,
https://doi.org/10.1667/RR14970.1 . .

TY  - JOUR
AU  - Jarvinen, Hannu
AU  - Farah, Jad
AU  - Siiskonen, Teemu
AU  - Ciraj-Bjelac, Olivera
AU  - Dabin, Jeremie
AU  - Carinou, Eleftheria
AU  - Domienik-Andrzejewska, Joanna
AU  - Kluszczynski, Dariusz
AU  - Knežević, Željka
AU  - Kopec, Renata
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Negri, Anna
AU  - Pankowski, Piotr
AU  - Sarmento, Sandra
AU  - Trianni, Annalisa
PY  - 2018
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7621
AB  - Purpose: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. Methods: Gafchromic (R) films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (K-a,K-r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and K-a,K-r, and uncertainty of MSD were calculated. Results: About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and K-a,K-r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly > 0.8), while fluoroscopy time is not suitable (p mostly < 0.6). Generic alert levels based on DAP (Gy cm(2)) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1). Conclusions: The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.
T2  - Physica Medica
T1  - Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures
VL  - 46
SP  - 67
EP  - 74
DO  - 10.1016/j.ejmp.2018.01.010
ER  - 

@article{
author = "Jarvinen, Hannu and Farah, Jad and Siiskonen, Teemu and Ciraj-Bjelac, Olivera and Dabin, Jeremie and Carinou, Eleftheria and Domienik-Andrzejewska, Joanna and Kluszczynski, Dariusz and Knežević, Željka and Kopec, Renata and Majer, Marija and Malchair, Francoise and Negri, Anna and Pankowski, Piotr and Sarmento, Sandra and Trianni, Annalisa",
year = "2018",
abstract = "Purpose: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. Methods: Gafchromic (R) films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (K-a,K-r)) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy. The uncertainties of alert levels in terms of DAP and K-a,K-r, and uncertainty of MSD were calculated. Results: About 20-30% of all MSD values exceeded 2 Gy while only 2-6% exceeded 5 Gy. The correlations suggest that both DAP and K-a,K-r can be used as a dose indicator for alert levels (Pearson correlation coefficient p mostly > 0.8), while fluoroscopy time is not suitable (p mostly < 0.6). Generic alert levels based on DAP (Gy cm(2)) were suggested for MSD of both 2 Gy and 5 Gy (for 5 Gy: TACE 750, PCI 250 and NE 400). The suggested levels are close to the lowest values published in several other studies. The uncertainty of the MSD was estimated to be around 10-15% and of hospital-specific skin dose alert levels about 20-30% (with coverage factor k = 1). Conclusions: The generic alert levels are feasible for some cases but should be used with caution, only as the first approximation, while hospital-specific alert levels are preferred as the final approach.",
journal = "Physica Medica",
title = "Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures",
volume = "46",
pages = "67-74",
doi = "10.1016/j.ejmp.2018.01.010"
}

Jarvinen, H., Farah, J., Siiskonen, T., Ciraj-Bjelac, O., Dabin, J., Carinou, E., Domienik-Andrzejewska, J., Kluszczynski, D., Knežević, Ž., Kopec, R., Majer, M., Malchair, F., Negri, A., Pankowski, P., Sarmento, S.,& Trianni, A.. (2018). Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. in Physica Medica, 46, 67-74.
https://doi.org/10.1016/j.ejmp.2018.01.010

Jarvinen H, Farah J, Siiskonen T, Ciraj-Bjelac O, Dabin J, Carinou E, Domienik-Andrzejewska J, Kluszczynski D, Knežević Ž, Kopec R, Majer M, Malchair F, Negri A, Pankowski P, Sarmento S, Trianni A. Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. in Physica Medica. 2018;46:67-74.
doi:10.1016/j.ejmp.2018.01.010 .

Jarvinen, Hannu, Farah, Jad, Siiskonen, Teemu, Ciraj-Bjelac, Olivera, Dabin, Jeremie, Carinou, Eleftheria, Domienik-Andrzejewska, Joanna, Kluszczynski, Dariusz, Knežević, Željka, Kopec, Renata, Majer, Marija, Malchair, Francoise, Negri, Anna, Pankowski, Piotr, Sarmento, Sandra, Trianni, Annalisa, "Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures" in Physica Medica, 46 (2018):67-74,
https://doi.org/10.1016/j.ejmp.2018.01.010 . .

TY  - JOUR
AU  - Dabin, Jeremie
AU  - Negri, A.
AU  - Farah, Jad
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - De Angelis, C.
AU  - Domienik, Joanna
AU  - Jarvinen, Hannu
AU  - Kopec, R.
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Novak, L.
AU  - Siiskonen, Teemu
AU  - Vanhavere, Filip
AU  - Trianni, A.
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/860
AB  - Purpose: Point detectors are frequently used to measure patients maximum skin dose (MSD) in fluoroscopically-guided interventional procedures (IP). However, their performance and ability to detect the actual MSD are rarely evaluated. The present study investigates the sampling uncertainty associated with the use of grids of point detectors to measure MSD in IP. Method: Chemoembolisation of the liver (CE), percutaneous coronary intervention (PCI) and neuroembolisation (NE) procedures were studied. Spatial dose distributions were measured with XR-RV3 Gafchromic (R) films for 176 procedures. These distributions were used to simulate measurements performed using grids of detectors such as thermoluminescence detectors, with detector spacing from 1.4 up to 10 cm. Results: The sampling uncertainty was the highest in PCI and NE procedures. With 40 detectors covering the film area (36 cm x 44 cm), the maximum dose would be on average 86% and 63% of the MSD measured with Gafchromic (R) films in CE and PCI procedures, respectively. In NE procedures, with 27 detectors covering the film area (14 cm x 35 cm), the maximum dose measured would be on average 82% of the MSD obtained with the Gafchromic (R) films. Conclusion: Thermoluminescence detectors show good energy and dose response in clinical beam qualities. However the poor spatial resolution of such point-like dosimeters may far outweigh their good dosimetric properties. The uncertainty from the sampling procedure should be estimated when point detectors are used in IP because it may lead to strong underestimation of the MSD. (C) 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
PB  - Elsevier
T2  - Physica Medica
T1  - Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures
VL  - 31
IS  - 8
SP  - 1112
EP  - 1117
DO  - 10.1016/j.ejmp.2015.08.006
ER  - 

@article{
author = "Dabin, Jeremie and Negri, A. and Farah, Jad and Ciraj-Bjelac, Olivera and Clairand, Isabelle and De Angelis, C. and Domienik, Joanna and Jarvinen, Hannu and Kopec, R. and Majer, Marija and Malchair, Francoise and Novak, L. and Siiskonen, Teemu and Vanhavere, Filip and Trianni, A. and Knežević, Željka",
year = "2015",
abstract = "Purpose: Point detectors are frequently used to measure patients maximum skin dose (MSD) in fluoroscopically-guided interventional procedures (IP). However, their performance and ability to detect the actual MSD are rarely evaluated. The present study investigates the sampling uncertainty associated with the use of grids of point detectors to measure MSD in IP. Method: Chemoembolisation of the liver (CE), percutaneous coronary intervention (PCI) and neuroembolisation (NE) procedures were studied. Spatial dose distributions were measured with XR-RV3 Gafchromic (R) films for 176 procedures. These distributions were used to simulate measurements performed using grids of detectors such as thermoluminescence detectors, with detector spacing from 1.4 up to 10 cm. Results: The sampling uncertainty was the highest in PCI and NE procedures. With 40 detectors covering the film area (36 cm x 44 cm), the maximum dose would be on average 86% and 63% of the MSD measured with Gafchromic (R) films in CE and PCI procedures, respectively. In NE procedures, with 27 detectors covering the film area (14 cm x 35 cm), the maximum dose measured would be on average 82% of the MSD obtained with the Gafchromic (R) films. Conclusion: Thermoluminescence detectors show good energy and dose response in clinical beam qualities. However the poor spatial resolution of such point-like dosimeters may far outweigh their good dosimetric properties. The uncertainty from the sampling procedure should be estimated when point detectors are used in IP because it may lead to strong underestimation of the MSD. (C) 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.",
publisher = "Elsevier",
journal = "Physica Medica",
title = "Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures",
volume = "31",
number = "8",
pages = "1112-1117",
doi = "10.1016/j.ejmp.2015.08.006"
}

Dabin, J., Negri, A., Farah, J., Ciraj-Bjelac, O., Clairand, I., De Angelis, C., Domienik, J., Jarvinen, H., Kopec, R., Majer, M., Malchair, F., Novak, L., Siiskonen, T., Vanhavere, F., Trianni, A.,& Knežević, Ž.. (2015). Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. in Physica Medica
Elsevier., 31(8), 1112-1117.
https://doi.org/10.1016/j.ejmp.2015.08.006

Dabin J, Negri A, Farah J, Ciraj-Bjelac O, Clairand I, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Novak L, Siiskonen T, Vanhavere F, Trianni A, Knežević Ž. Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. in Physica Medica. 2015;31(8):1112-1117.
doi:10.1016/j.ejmp.2015.08.006 .

Dabin, Jeremie, Negri, A., Farah, Jad, Ciraj-Bjelac, Olivera, Clairand, Isabelle, De Angelis, C., Domienik, Joanna, Jarvinen, Hannu, Kopec, R., Majer, Marija, Malchair, Francoise, Novak, L., Siiskonen, Teemu, Vanhavere, Filip, Trianni, A., Knežević, Željka, "Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures" in Physica Medica, 31, no. 8 (2015):1112-1117,
https://doi.org/10.1016/j.ejmp.2015.08.006 . .

TY  - JOUR
AU  - Farah, Jad
AU  - Trianni, A.
AU  - Carinou, Eleftheria
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - Dabin, Jeremie
AU  - De Angelis, C.
AU  - Domienik, Joanna
AU  - Jarvinen, Hannu
AU  - Kopec, R.
AU  - Majer, Marija
AU  - Malchair, Francoise
AU  - Negri, A.
AU  - Novak, L.
AU  - Siiskonen, Teemu
AU  - Vanhavere, Filip
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/7068
AB  - To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of GT 3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.
T2  - Radiation Protection Dosimetry
T1  - Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds
VL  - 164
IS  - 1-2
SP  - 138
EP  - 142
DO  - 10.1093/rpd/ncu314
ER  - 

@article{
author = "Farah, Jad and Trianni, A. and Carinou, Eleftheria and Ciraj-Bjelac, Olivera and Clairand, Isabelle and Dabin, Jeremie and De Angelis, C. and Domienik, Joanna and Jarvinen, Hannu and Kopec, R. and Majer, Marija and Malchair, Francoise and Negri, A. and Novak, L. and Siiskonen, Teemu and Vanhavere, Filip and Knežević, Željka",
year = "2015",
abstract = "To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of GT 3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.",
journal = "Radiation Protection Dosimetry",
title = "Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds",
volume = "164",
number = "1-2",
pages = "138-142",
doi = "10.1093/rpd/ncu314"
}

Farah, J., Trianni, A., Carinou, E., Ciraj-Bjelac, O., Clairand, I., Dabin, J., De Angelis, C., Domienik, J., Jarvinen, H., Kopec, R., Majer, M., Malchair, F., Negri, A., Novak, L., Siiskonen, T., Vanhavere, F.,& Knežević, Ž.. (2015). Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. in Radiation Protection Dosimetry, 164(1-2), 138-142.
https://doi.org/10.1093/rpd/ncu314

Farah J, Trianni A, Carinou E, Ciraj-Bjelac O, Clairand I, Dabin J, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Negri A, Novak L, Siiskonen T, Vanhavere F, Knežević Ž. Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. in Radiation Protection Dosimetry. 2015;164(1-2):138-142.
doi:10.1093/rpd/ncu314 .

Farah, Jad, Trianni, A., Carinou, Eleftheria, Ciraj-Bjelac, Olivera, Clairand, Isabelle, Dabin, Jeremie, De Angelis, C., Domienik, Joanna, Jarvinen, Hannu, Kopec, R., Majer, Marija, Malchair, Francoise, Negri, A., Novak, L., Siiskonen, Teemu, Vanhavere, Filip, Knežević, Željka, "Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds" in Radiation Protection Dosimetry, 164, no. 1-2 (2015):138-142,
https://doi.org/10.1093/rpd/ncu314 . .