TY  - JOUR
AU  - Knežević, Željka
AU  - Majer, Marija
AU  - Baranowska, Zuzanna
AU  - Ciraj-Bjelac, Olivera
AU  - Iurlaro, Giorgia
AU  - Krzanović, Nikola
AU  - Mariotti, Francesca
AU  - Nodilo, Marijana
AU  - Neumaier, Stefan
AU  - Woloszczuk, Katarzyna
AU  - Živanović, Miloš Z.
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9934
AB  - Due to the need for harmonization of passive dosimetry and the requirements of the international standards in the area of environmental monitoring in radiation protection, multiple types of various passive dosimetry systems based on different ionizing radiation detection mechanisms were subjected to extensive performance testing. In the scope of the EMPIR project 16ENV04 Preparedness, the performance of 12 passive dosimetry systems was examined in radiation fields of different photon energies, angles of incidence and ambient dose equivalent rates in order to estimate their performance in the almost omni-directionally and energetically broad radiation field of the natural environment. The use of different detectors, holders, calibrations, measurement procedures and uncertainties, leads to differences in the measured data. Prior investigations and harmonization of passive dosimetry systems are necessary to achieve reliable and comparable dose measurements in Europe.
T2  - Radiation Measurements
T1  - Investigations into the basic properties of different passive dosimetry systems used in environmental radiation monitoring in the aftermath of a nuclear or radiological event
VL  - 146
SP  - 106615
DO  - 10.1016/j.radmeas.2021.106615
ER  - 

@article{
author = "Knežević, Željka and Majer, Marija and Baranowska, Zuzanna and Ciraj-Bjelac, Olivera and Iurlaro, Giorgia and Krzanović, Nikola and Mariotti, Francesca and Nodilo, Marijana and Neumaier, Stefan and Woloszczuk, Katarzyna and Živanović, Miloš Z.",
year = "2021",
abstract = "Due to the need for harmonization of passive dosimetry and the requirements of the international standards in the area of environmental monitoring in radiation protection, multiple types of various passive dosimetry systems based on different ionizing radiation detection mechanisms were subjected to extensive performance testing. In the scope of the EMPIR project 16ENV04 Preparedness, the performance of 12 passive dosimetry systems was examined in radiation fields of different photon energies, angles of incidence and ambient dose equivalent rates in order to estimate their performance in the almost omni-directionally and energetically broad radiation field of the natural environment. The use of different detectors, holders, calibrations, measurement procedures and uncertainties, leads to differences in the measured data. Prior investigations and harmonization of passive dosimetry systems are necessary to achieve reliable and comparable dose measurements in Europe.",
journal = "Radiation Measurements",
title = "Investigations into the basic properties of different passive dosimetry systems used in environmental radiation monitoring in the aftermath of a nuclear or radiological event",
volume = "146",
pages = "106615",
doi = "10.1016/j.radmeas.2021.106615"
}

Knežević, Ž., Majer, M., Baranowska, Z., Ciraj-Bjelac, O., Iurlaro, G., Krzanović, N., Mariotti, F., Nodilo, M., Neumaier, S., Woloszczuk, K.,& Živanović, M. Z.. (2021). Investigations into the basic properties of different passive dosimetry systems used in environmental radiation monitoring in the aftermath of a nuclear or radiological event. in Radiation Measurements, 146, 106615.
https://doi.org/10.1016/j.radmeas.2021.106615

Knežević Ž, Majer M, Baranowska Z, Ciraj-Bjelac O, Iurlaro G, Krzanović N, Mariotti F, Nodilo M, Neumaier S, Woloszczuk K, Živanović MZ. Investigations into the basic properties of different passive dosimetry systems used in environmental radiation monitoring in the aftermath of a nuclear or radiological event. in Radiation Measurements. 2021;146:106615.
doi:10.1016/j.radmeas.2021.106615 .

Knežević, Željka, Majer, Marija, Baranowska, Zuzanna, Ciraj-Bjelac, Olivera, Iurlaro, Giorgia, Krzanović, Nikola, Mariotti, Francesca, Nodilo, Marijana, Neumaier, Stefan, Woloszczuk, Katarzyna, Živanović, Miloš Z., "Investigations into the basic properties of different passive dosimetry systems used in environmental radiation monitoring in the aftermath of a nuclear or radiological event" in Radiation Measurements, 146 (2021):106615,
https://doi.org/10.1016/j.radmeas.2021.106615 . .

TY  - JOUR
AU  - O’Connor, Una M.
AU  - Carinou, Eleftheria
AU  - Clairand, Isabelle
AU  - Ciraj-Bjelac, Olivera
AU  - de Monte, Francesca
AU  - Domienik-Andrzejewska, Joanna
AU  - Ferrari, Paolo
AU  - Ginjaume, Merce
AU  - Hršak, Hrvoje
AU  - Hupe, Oliver
AU  - Knežević, Željka
AU  - Sans Merce, Marta
AU  - Sarmento, Sandra
AU  - Siiskonen, Teemu
AU  - Vanhavere, Filip
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9863
AB  - Occupational radiation doses from interventional procedures have the potential to be relatively high. The requirement to optimise these doses encourages the use of electronic or active personal dosimeters (APDs) which are now increasingly used in hospitals. They are typically used in tandem with a routine passive dosimetry monitoring programme, with APDs used for real-time readings, for training purposes and when new imaging technology is introduced. However, there are limitations when using APDs. A survey in hospitals to identify issues related to the use of APDs was recently completed, along with an extensive series of APD tests by the EURADOS Working Group 12 on Dosimetry for Medical Imaging. The aim of this review paper is to summarise the state of the art regarding the use of APDs. We also used the results of our survey and our tests to develop a set of recommendations for the use of APDs in the clinical interventional radiology/cardiology settings, and draw attention to some of the current challenges.
T2  - Physica Medica
T1  - Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals
VL  - 87
SP  - 131
EP  - 135
DO  - 10.1016/j.ejmp.2021.05.015
ER  - 

@article{
author = "O’Connor, Una M. and Carinou, Eleftheria and Clairand, Isabelle and Ciraj-Bjelac, Olivera and de Monte, Francesca and Domienik-Andrzejewska, Joanna and Ferrari, Paolo and Ginjaume, Merce and Hršak, Hrvoje and Hupe, Oliver and Knežević, Željka and Sans Merce, Marta and Sarmento, Sandra and Siiskonen, Teemu and Vanhavere, Filip",
year = "2021",
abstract = "Occupational radiation doses from interventional procedures have the potential to be relatively high. The requirement to optimise these doses encourages the use of electronic or active personal dosimeters (APDs) which are now increasingly used in hospitals. They are typically used in tandem with a routine passive dosimetry monitoring programme, with APDs used for real-time readings, for training purposes and when new imaging technology is introduced. However, there are limitations when using APDs. A survey in hospitals to identify issues related to the use of APDs was recently completed, along with an extensive series of APD tests by the EURADOS Working Group 12 on Dosimetry for Medical Imaging. The aim of this review paper is to summarise the state of the art regarding the use of APDs. We also used the results of our survey and our tests to develop a set of recommendations for the use of APDs in the clinical interventional radiology/cardiology settings, and draw attention to some of the current challenges.",
journal = "Physica Medica",
title = "Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals",
volume = "87",
pages = "131-135",
doi = "10.1016/j.ejmp.2021.05.015"
}

O’Connor, U. M., Carinou, E., Clairand, I., Ciraj-Bjelac, O., de Monte, F., Domienik-Andrzejewska, J., Ferrari, P., Ginjaume, M., Hršak, H., Hupe, O., Knežević, Ž., Sans Merce, M., Sarmento, S., Siiskonen, T.,& Vanhavere, F.. (2021). Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals. in Physica Medica, 87, 131-135.
https://doi.org/10.1016/j.ejmp.2021.05.015

O’Connor UM, Carinou E, Clairand I, Ciraj-Bjelac O, de Monte F, Domienik-Andrzejewska J, Ferrari P, Ginjaume M, Hršak H, Hupe O, Knežević Ž, Sans Merce M, Sarmento S, Siiskonen T, Vanhavere F. Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals. in Physica Medica. 2021;87:131-135.
doi:10.1016/j.ejmp.2021.05.015 .

O’Connor, Una M., Carinou, Eleftheria, Clairand, Isabelle, Ciraj-Bjelac, Olivera, de Monte, Francesca, Domienik-Andrzejewska, Joanna, Ferrari, Paolo, Ginjaume, Merce, Hršak, Hrvoje, Hupe, Oliver, Knežević, Željka, Sans Merce, Marta, Sarmento, Sandra, Siiskonen, Teemu, Vanhavere, Filip, "Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals" in Physica Medica, 87 (2021):131-135,
https://doi.org/10.1016/j.ejmp.2021.05.015 . .

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  - 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  - Vanhavere, Filip
AU  - Carinou, Eleftheria
AU  - Clairand, Isabelle
AU  - Ciraj-Bjelac, Olivera
AU  - De Monte, F
AU  - Domienik-Andrzejewska, J
AU  - Ferrari, P
AU  - Ginjaume, M
AU  - Hršak, Hrvoje
AU  - Hupe, O
AU  - Knežević, Željka
AU  - O’Connor, U
AU  - Merce, M Sans
AU  - Sarmento, S
AU  - Savary, A
AU  - Siskoonen, T
PY  - 2020
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9051
AB  - Medical staff in interventional procedures are among the professionals with the highest occupational doses. Active personal dosemeters (APDs) can help in optimizing the exposure during interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field and because of the pulsed nature of the radiation. Many parameters like the type of interventional procedure, personal habits and working techniques, protection tools used and X-ray field characteristics influence the occupational exposure and the scattered radiation around the patient. In this paper, we compare the results from three types of APDs with a passive personal dosimetry system while being used in real clinical environment by the interventional staff. The results show that there is a large spread in the ratios of the passive and active devices.
T2  - Radiation Protection Dosimetry
T1  - The use of active personal dosemeters in interventional workplaces in hospitals: comparison between active and passive dosemeters worn simultaneously by medical staff
VL  - 188
IS  - 1
SP  - 22
EP  - 29
DO  - 10.1093/rpd/ncz253
ER  - 

@article{
author = "Vanhavere, Filip and Carinou, Eleftheria and Clairand, Isabelle and Ciraj-Bjelac, Olivera and De Monte, F and Domienik-Andrzejewska, J and Ferrari, P and Ginjaume, M and Hršak, Hrvoje and Hupe, O and Knežević, Željka and O’Connor, U and Merce, M Sans and Sarmento, S and Savary, A and Siskoonen, T",
year = "2020",
abstract = "Medical staff in interventional procedures are among the professionals with the highest occupational doses. Active personal dosemeters (APDs) can help in optimizing the exposure during interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field and because of the pulsed nature of the radiation. Many parameters like the type of interventional procedure, personal habits and working techniques, protection tools used and X-ray field characteristics influence the occupational exposure and the scattered radiation around the patient. In this paper, we compare the results from three types of APDs with a passive personal dosimetry system while being used in real clinical environment by the interventional staff. The results show that there is a large spread in the ratios of the passive and active devices.",
journal = "Radiation Protection Dosimetry",
title = "The use of active personal dosemeters in interventional workplaces in hospitals: comparison between active and passive dosemeters worn simultaneously by medical staff",
volume = "188",
number = "1",
pages = "22-29",
doi = "10.1093/rpd/ncz253"
}

Vanhavere, F., Carinou, E., Clairand, I., Ciraj-Bjelac, O., De Monte, F., Domienik-Andrzejewska, J., Ferrari, P., Ginjaume, M., Hršak, H., Hupe, O., Knežević, Ž., O’Connor, U., Merce, M. S., Sarmento, S., Savary, A.,& Siskoonen, T.. (2020). The use of active personal dosemeters in interventional workplaces in hospitals: comparison between active and passive dosemeters worn simultaneously by medical staff. in Radiation Protection Dosimetry, 188(1), 22-29.
https://doi.org/10.1093/rpd/ncz253

Vanhavere F, Carinou E, Clairand I, Ciraj-Bjelac O, De Monte F, Domienik-Andrzejewska J, Ferrari P, Ginjaume M, Hršak H, Hupe O, Knežević Ž, O’Connor U, Merce MS, Sarmento S, Savary A, Siskoonen T. The use of active personal dosemeters in interventional workplaces in hospitals: comparison between active and passive dosemeters worn simultaneously by medical staff. in Radiation Protection Dosimetry. 2020;188(1):22-29.
doi:10.1093/rpd/ncz253 .

Vanhavere, Filip, Carinou, Eleftheria, Clairand, Isabelle, Ciraj-Bjelac, Olivera, De Monte, F, Domienik-Andrzejewska, J, Ferrari, P, Ginjaume, M, Hršak, Hrvoje, Hupe, O, Knežević, Željka, O’Connor, U, Merce, M Sans, Sarmento, S, Savary, A, Siskoonen, T, "The use of active personal dosemeters in interventional workplaces in hospitals: comparison between active and passive dosemeters worn simultaneously by medical staff" in Radiation Protection Dosimetry, 188, no. 1 (2020):22-29,
https://doi.org/10.1093/rpd/ncz253 . .

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  - 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 . .

TY  - JOUR
AU  - Farah, Jad
AU  - Trianni, A.
AU  - Ciraj-Bjelac, Olivera
AU  - Clairand, Isabelle
AU  - De Angelis, C.
AU  - Delle Canne, S.
AU  - Hadid, L.
AU  - Huet, C.
AU  - Jarvinen, Hannu
AU  - Negri, A.
AU  - Novak, L.
AU  - Pinto, M.
AU  - Siiskonen, Teemu
AU  - Waryn, M. J.
AU  - Knežević, Željka
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/647
AB  - Purpose: To investigate the optimal use of XR-RV3 GafChromic (R) films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment. Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach. The considered sources of uncertainties include scanner, film, and fitting-related errors. The work focused on studying film behavior with clinical high-dose-rate pulsed beams (previously unavailable in the literature) together with reference standard laboratory beams. Results: First, the performance analysis of six different scanner models has shown that scan uniformity perpendicular to the lamp motion axis and that long term stability are the main sources of scanner-related uncertainties. These could induce errors of up to 7% on the film readings unless regularly checked and corrected. Typically, scan uniformity correction matrices and reading normalization to the scanner-specific and daily background reading should be done. In addition, the analysis on multiple film batches has shown that XR-RV3 films have generally good uniformity within one batch ( LT 1.5%), require 24 h to stabilize after the irradiation and their response is roughly independent of dose rate ( LT 5%). However, XR-RV3 films showed large variations (up to 15%) with radiation quality both in standard laboratory and in clinical conditions. As such, and prior to conducting patient skin dose measurements, it is mandatory to choose the appropriate calibration beam quality depending on the characteristics of the x-ray systems that will be used clinically. In addition, yellow side film irradiations should be preferentially used since they showed a lower dependence on beam parameters compared to white side film irradiations. Finally, among the six different fit equations tested in this work, typically used third order polynomials and more rational and simplistic equations, of the form dose inversely proportional to pixel value, were both found to provide satisfactory results. Fitting-related uncertainty was clearly identified as a major contributor to the overall film dosimetry uncertainty with up to 40% error on the dose estimate. Conclusions: The overall uncertainty associated with the use of XR-RV3 films to determine skin dose in the interventional environment can realistically be estimated to be around 20% (k = 1). This uncertainty can be reduced to within 5% if carefully monitoring scanner, film, and fitting-related errors or it can easily increase to over 40% if minimal care is not taken. This work demonstrates the importance of appropriate calibration, reading, fitting, and other film-related and scan-related processes, which will help improve the accuracy of skin dose measurements in interventional procedures. (C) 2015 American Association of Physicists in Medicine.
T2  - Medical Physics
T1  - Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors
VL  - 42
IS  - 7
SP  - 4211
EP  - 4226
DO  - 10.1118/1.4922132
ER  - 

@article{
author = "Farah, Jad and Trianni, A. and Ciraj-Bjelac, Olivera and Clairand, Isabelle and De Angelis, C. and Delle Canne, S. and Hadid, L. and Huet, C. and Jarvinen, Hannu and Negri, A. and Novak, L. and Pinto, M. and Siiskonen, Teemu and Waryn, M. J. and Knežević, Željka",
year = "2015",
abstract = "Purpose: To investigate the optimal use of XR-RV3 GafChromic (R) films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment. Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach. The considered sources of uncertainties include scanner, film, and fitting-related errors. The work focused on studying film behavior with clinical high-dose-rate pulsed beams (previously unavailable in the literature) together with reference standard laboratory beams. Results: First, the performance analysis of six different scanner models has shown that scan uniformity perpendicular to the lamp motion axis and that long term stability are the main sources of scanner-related uncertainties. These could induce errors of up to 7% on the film readings unless regularly checked and corrected. Typically, scan uniformity correction matrices and reading normalization to the scanner-specific and daily background reading should be done. In addition, the analysis on multiple film batches has shown that XR-RV3 films have generally good uniformity within one batch ( LT 1.5%), require 24 h to stabilize after the irradiation and their response is roughly independent of dose rate ( LT 5%). However, XR-RV3 films showed large variations (up to 15%) with radiation quality both in standard laboratory and in clinical conditions. As such, and prior to conducting patient skin dose measurements, it is mandatory to choose the appropriate calibration beam quality depending on the characteristics of the x-ray systems that will be used clinically. In addition, yellow side film irradiations should be preferentially used since they showed a lower dependence on beam parameters compared to white side film irradiations. Finally, among the six different fit equations tested in this work, typically used third order polynomials and more rational and simplistic equations, of the form dose inversely proportional to pixel value, were both found to provide satisfactory results. Fitting-related uncertainty was clearly identified as a major contributor to the overall film dosimetry uncertainty with up to 40% error on the dose estimate. Conclusions: The overall uncertainty associated with the use of XR-RV3 films to determine skin dose in the interventional environment can realistically be estimated to be around 20% (k = 1). This uncertainty can be reduced to within 5% if carefully monitoring scanner, film, and fitting-related errors or it can easily increase to over 40% if minimal care is not taken. This work demonstrates the importance of appropriate calibration, reading, fitting, and other film-related and scan-related processes, which will help improve the accuracy of skin dose measurements in interventional procedures. (C) 2015 American Association of Physicists in Medicine.",
journal = "Medical Physics",
title = "Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors",
volume = "42",
number = "7",
pages = "4211-4226",
doi = "10.1118/1.4922132"
}

Farah, J., Trianni, A., Ciraj-Bjelac, O., Clairand, I., De Angelis, C., Delle Canne, S., Hadid, L., Huet, C., Jarvinen, H., Negri, A., Novak, L., Pinto, M., Siiskonen, T., Waryn, M. J.,& Knežević, Ž.. (2015). Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. in Medical Physics, 42(7), 4211-4226.
https://doi.org/10.1118/1.4922132

Farah J, Trianni A, Ciraj-Bjelac O, Clairand I, De Angelis C, Delle Canne S, Hadid L, Huet C, Jarvinen H, Negri A, Novak L, Pinto M, Siiskonen T, Waryn MJ, Knežević Ž. Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. in Medical Physics. 2015;42(7):4211-4226.
doi:10.1118/1.4922132 .

Farah, Jad, Trianni, A., Ciraj-Bjelac, Olivera, Clairand, Isabelle, De Angelis, C., Delle Canne, S., Hadid, L., Huet, C., Jarvinen, Hannu, Negri, A., Novak, L., Pinto, M., Siiskonen, Teemu, Waryn, M. J., Knežević, Željka, "Characterization of XR-RV3 GafChromic (R) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors" in Medical Physics, 42, no. 7 (2015):4211-4226,
https://doi.org/10.1118/1.4922132 . .

TY  - JOUR
AU  - Miljanic, S.
AU  - Ranogajec-Komor, M.
AU  - Knežević, Željka
AU  - Stuhec, M.
AU  - Prokić, Miloš
PY  - 2006
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/6623
AB  - Recently, two new types of tissue equivalent thermoluminescent detectors (TLDs) have aroused attention: LiF:Mg,Cu,Na,Si and Li2B4O7:Cu,Ag,P. In this work the characteristics of both detectors were compared with the characteristics of the well-known type LiF:Mg,Ti detector, TLD-100. The following properties were investigated: the glow curve structures, relative sensitivity, batch homogeneity and uniformity, detection threshold, reproducibility of the response, linearity in the wide dose range and fading. Also, the energy dependence for medium and low energy X rays was determined in the range of mean energies between 33 and 116 keV. The results confirmed tissue equivalency of both new types in the investigated range of photon energies. LiF:Mg,Cu,Na,Si detector has very high sensitivity (similar to 75 times higher than that of TLD-100) and is convenient for use in a very low range of doses. Li2B4O7:Cu,Ag,P detector shows some improvements in comparison with the previously prepared types of lithium borate. The most important is the five times higher sensitivity than that of TLD-100. This detector is also very promising, especially in medical dosimetry.
T2  - Radiation Protection Dosimetry
T1  - Comparative study of LiF : Mg,Cu,Na,Si and Li2B4O7 : Cu,Ag,P TL detectors
VL  - 119
IS  - 1-4
SP  - 191
EP  - 196
DO  - 10.1093/rpd/nci557
ER  - 

@article{
author = "Miljanic, S. and Ranogajec-Komor, M. and Knežević, Željka and Stuhec, M. and Prokić, Miloš",
year = "2006",
abstract = "Recently, two new types of tissue equivalent thermoluminescent detectors (TLDs) have aroused attention: LiF:Mg,Cu,Na,Si and Li2B4O7:Cu,Ag,P. In this work the characteristics of both detectors were compared with the characteristics of the well-known type LiF:Mg,Ti detector, TLD-100. The following properties were investigated: the glow curve structures, relative sensitivity, batch homogeneity and uniformity, detection threshold, reproducibility of the response, linearity in the wide dose range and fading. Also, the energy dependence for medium and low energy X rays was determined in the range of mean energies between 33 and 116 keV. The results confirmed tissue equivalency of both new types in the investigated range of photon energies. LiF:Mg,Cu,Na,Si detector has very high sensitivity (similar to 75 times higher than that of TLD-100) and is convenient for use in a very low range of doses. Li2B4O7:Cu,Ag,P detector shows some improvements in comparison with the previously prepared types of lithium borate. The most important is the five times higher sensitivity than that of TLD-100. This detector is also very promising, especially in medical dosimetry.",
journal = "Radiation Protection Dosimetry",
title = "Comparative study of LiF : Mg,Cu,Na,Si and Li2B4O7 : Cu,Ag,P TL detectors",
volume = "119",
number = "1-4",
pages = "191-196",
doi = "10.1093/rpd/nci557"
}

Miljanic, S., Ranogajec-Komor, M., Knežević, Ž., Stuhec, M.,& Prokić, M.. (2006). Comparative study of LiF : Mg,Cu,Na,Si and Li2B4O7 : Cu,Ag,P TL detectors. in Radiation Protection Dosimetry, 119(1-4), 191-196.
https://doi.org/10.1093/rpd/nci557

Miljanic S, Ranogajec-Komor M, Knežević Ž, Stuhec M, Prokić M. Comparative study of LiF : Mg,Cu,Na,Si and Li2B4O7 : Cu,Ag,P TL detectors. in Radiation Protection Dosimetry. 2006;119(1-4):191-196.
doi:10.1093/rpd/nci557 .

Miljanic, S., Ranogajec-Komor, M., Knežević, Željka, Stuhec, M., Prokić, Miloš, "Comparative study of LiF : Mg,Cu,Na,Si and Li2B4O7 : Cu,Ag,P TL detectors" in Radiation Protection Dosimetry, 119, no. 1-4 (2006):191-196,
https://doi.org/10.1093/rpd/nci557 . .