Simantirakis, George

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orcid::0000-0002-1478-0058
  • Simantirakis, George (3)
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Author's Bibliography

Establishing a priori and a posteriori predictive models to assess patients’ peak skin dose in interventional cardiology. Part 2: results of the VERIDIC project

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

(2021)

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 . .

Use of out-of-field contact shielding on patients in medical imaging: A review of current guidelines, recommendations and legislative documents

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

(2021)

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 . .
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Establishing the European diagnostic reference levels for interventional cardiology

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

(2018)

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 . .
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