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  - Ciraj-Bjelac, Olivera
AU  - Rehani, M.
AU  - Minamoto, A.
AU  - Sim, K. H.
AU  - Liew, H. B.
AU  - Vano, Eliseo
PY  - 2012
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/5160
AB  - Background: Recent studies have reported a significant increase in eye lens opacities among staff in the cardiac catheterization laboratory but indicated further studies are needed to confirm the findings. Objective: To evaluate the prevalence of opacities in eyes of cardiologists, radiographers and nurses working in interventional cardiology. Methods: The eyes of 52 staff in interventional cardiology facilities and 34 age-and sex-matched unexposed controls were screened in a cardiology conference held in Kuala Lumpur by dilated slit-lamp examination, and posterior lens changes were graded. Individual cumulative lens X-ray exposures were calculated from responses to a questionnaire in terms of workload and working practice. Results: The prevalence of posterior lens opacities among interventional cardiologists was 53%, while in nurses and radiographers it was 45%. Corresponding relative risks were 2.6 (95% CI: 1.2-5.4) and 2.2 (95% CI: 0.98-4.9), for interventional cardiologists and support staff, respectively. Conclusions: This study confirms a statistically significant increase in radiation-associated posterior lens changes in the eyes of interventional cardiology staff. Copyright (C) 2012 S. Karger AG, Basel
T2  - Cardiology
T1  - Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology
VL  - 123
IS  - 3
SP  - 168
EP  - 171
DO  - 10.1159/000342458
ER  - 

@article{
author = "Ciraj-Bjelac, Olivera and Rehani, M. and Minamoto, A. and Sim, K. H. and Liew, H. B. and Vano, Eliseo",
year = "2012",
abstract = "Background: Recent studies have reported a significant increase in eye lens opacities among staff in the cardiac catheterization laboratory but indicated further studies are needed to confirm the findings. Objective: To evaluate the prevalence of opacities in eyes of cardiologists, radiographers and nurses working in interventional cardiology. Methods: The eyes of 52 staff in interventional cardiology facilities and 34 age-and sex-matched unexposed controls were screened in a cardiology conference held in Kuala Lumpur by dilated slit-lamp examination, and posterior lens changes were graded. Individual cumulative lens X-ray exposures were calculated from responses to a questionnaire in terms of workload and working practice. Results: The prevalence of posterior lens opacities among interventional cardiologists was 53%, while in nurses and radiographers it was 45%. Corresponding relative risks were 2.6 (95% CI: 1.2-5.4) and 2.2 (95% CI: 0.98-4.9), for interventional cardiologists and support staff, respectively. Conclusions: This study confirms a statistically significant increase in radiation-associated posterior lens changes in the eyes of interventional cardiology staff. Copyright (C) 2012 S. Karger AG, Basel",
journal = "Cardiology",
title = "Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology",
volume = "123",
number = "3",
pages = "168-171",
doi = "10.1159/000342458"
}

Ciraj-Bjelac, O., Rehani, M., Minamoto, A., Sim, K. H., Liew, H. B.,& Vano, E.. (2012). Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology. in Cardiology, 123(3), 168-171.
https://doi.org/10.1159/000342458

Ciraj-Bjelac O, Rehani M, Minamoto A, Sim KH, Liew HB, Vano E. Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology. in Cardiology. 2012;123(3):168-171.
doi:10.1159/000342458 .

Ciraj-Bjelac, Olivera, Rehani, M., Minamoto, A., Sim, K. H., Liew, H. B., Vano, Eliseo, "Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology" in Cardiology, 123, no. 3 (2012):168-171,
https://doi.org/10.1159/000342458 . .

TY  - JOUR
AU  - Rehani, Madan M.
AU  - Vano, Eliseo
AU  - Ciraj-Bjelac, Olivera
AU  - Kleiman, Norman J.
PY  - 2011
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4542
AB  - When this paper was about to go to press, the International Commission on Radiological Protection released a statement recommending a change in the threshold dose for the eye lens and dose limits for eye for occupationally exposed persons. It is clear that the earlier published threshold for radiation cataract is no longer valid. Epidemiological studies among Chernobyl clean-up workers, A bomb survivors, astronauts, residents of contaminated buildings, radiological technicians and recent surveys of staff in interventional rooms indicate that there is an increased incidence of lens opacities at doses below 1 Gy. Nevertheless, eye lens dosimetry is at a primitive stage and needs to be developed further. Despite uncertainties concerning dose threshold and dosimetry, it is possible to significantly reduce the risk of radiation cataract through the use of appropriate eye protection. By increasing awareness among those at risk and better adoption and increased usage of protective measures, radiation cataract can become preventable despite lowering of dose limits.
T2  - Radiation Protection Dosimetry
T1  - Radiation and Cataract
VL  - 147
IS  - 1-2
SP  - 300
EP  - 304
DO  - 10.1093/rpd/ncr299
ER  - 

@article{
author = "Rehani, Madan M. and Vano, Eliseo and Ciraj-Bjelac, Olivera and Kleiman, Norman J.",
year = "2011",
abstract = "When this paper was about to go to press, the International Commission on Radiological Protection released a statement recommending a change in the threshold dose for the eye lens and dose limits for eye for occupationally exposed persons. It is clear that the earlier published threshold for radiation cataract is no longer valid. Epidemiological studies among Chernobyl clean-up workers, A bomb survivors, astronauts, residents of contaminated buildings, radiological technicians and recent surveys of staff in interventional rooms indicate that there is an increased incidence of lens opacities at doses below 1 Gy. Nevertheless, eye lens dosimetry is at a primitive stage and needs to be developed further. Despite uncertainties concerning dose threshold and dosimetry, it is possible to significantly reduce the risk of radiation cataract through the use of appropriate eye protection. By increasing awareness among those at risk and better adoption and increased usage of protective measures, radiation cataract can become preventable despite lowering of dose limits.",
journal = "Radiation Protection Dosimetry",
title = "Radiation and Cataract",
volume = "147",
number = "1-2",
pages = "300-304",
doi = "10.1093/rpd/ncr299"
}

Rehani, M. M., Vano, E., Ciraj-Bjelac, O.,& Kleiman, N. J.. (2011). Radiation and Cataract. in Radiation Protection Dosimetry, 147(1-2), 300-304.
https://doi.org/10.1093/rpd/ncr299

Rehani MM, Vano E, Ciraj-Bjelac O, Kleiman NJ. Radiation and Cataract. in Radiation Protection Dosimetry. 2011;147(1-2):300-304.
doi:10.1093/rpd/ncr299 .

Rehani, Madan M., Vano, Eliseo, Ciraj-Bjelac, Olivera, Kleiman, Norman J., "Radiation and Cataract" in Radiation Protection Dosimetry, 147, no. 1-2 (2011):300-304,
https://doi.org/10.1093/rpd/ncr299 . .

TY  - JOUR
AU  - Ciraj-Bjelac, Olivera
AU  - Rehani, Madan M.
AU  - Sim, Kui Hian
AU  - Liew, Houng Bang
AU  - Vano, Eliseo
AU  - Kleiman, Norman J.
PY  - 2010
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4157
AB  - Objectives: To examine the prevalence of radiation-associated lens opacities among interventional cardiologists and nurses and correlate with occupational radiation exposure. Background: Interventional cardiology personnel are exposed to relatively high levels of X-rays and based on recent findings of radiation-associated lens opacities in other cohorts, they may be at risk for cataract without use of ocular radiation protection. Methods: Eyes of interventional cardiologists, nurses, and age-and sex-matched unexposed controls were screened by dilated slit lamp examination and posterior lens changes graded using a modified Merriam-Focht technique. Individual cumulative lens X-ray exposure was calculated from responses to a questionnaire and personal interview. Results: The prevalence of radiation-associated posterior lens opacities was 52% (29/56, 95% CI: 35-73) for interventional cardiologists, 45% (5/11, 95% CI: 15-100) for nurses, and 9% (2/22, 95% CI: 1-33) for controls. Relative risks of lens opacity was 5.7 (95% CI: 1.5-22) for interventional cardiologists and 5.0 (95% CI: 1.2-21) for nurses. Estimated cumulative ocular doses ranged from 0.01 to 43 Gy with mean and median values of 3.4 and 1.0 Gy, respectively. A strong dose-response relationship was found between occupational exposure and the prevalence of radiation-associated posterior lens changes. Conclusions: These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be utilized. (C) 2010 Wiley-Liss, Inc.
T2  - Catheterization and Cardiovascular Interventions
T1  - Risk for Radiation-Induced Cataract for Staff in Interventional Cardiology: Is There Reason for Concern?
VL  - 76
IS  - 6
SP  - 826
EP  - 834
DO  - 10.1002/ccd.22670
ER  - 

@article{
author = "Ciraj-Bjelac, Olivera and Rehani, Madan M. and Sim, Kui Hian and Liew, Houng Bang and Vano, Eliseo and Kleiman, Norman J.",
year = "2010",
abstract = "Objectives: To examine the prevalence of radiation-associated lens opacities among interventional cardiologists and nurses and correlate with occupational radiation exposure. Background: Interventional cardiology personnel are exposed to relatively high levels of X-rays and based on recent findings of radiation-associated lens opacities in other cohorts, they may be at risk for cataract without use of ocular radiation protection. Methods: Eyes of interventional cardiologists, nurses, and age-and sex-matched unexposed controls were screened by dilated slit lamp examination and posterior lens changes graded using a modified Merriam-Focht technique. Individual cumulative lens X-ray exposure was calculated from responses to a questionnaire and personal interview. Results: The prevalence of radiation-associated posterior lens opacities was 52% (29/56, 95% CI: 35-73) for interventional cardiologists, 45% (5/11, 95% CI: 15-100) for nurses, and 9% (2/22, 95% CI: 1-33) for controls. Relative risks of lens opacity was 5.7 (95% CI: 1.5-22) for interventional cardiologists and 5.0 (95% CI: 1.2-21) for nurses. Estimated cumulative ocular doses ranged from 0.01 to 43 Gy with mean and median values of 3.4 and 1.0 Gy, respectively. A strong dose-response relationship was found between occupational exposure and the prevalence of radiation-associated posterior lens changes. Conclusions: These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be utilized. (C) 2010 Wiley-Liss, Inc.",
journal = "Catheterization and Cardiovascular Interventions",
title = "Risk for Radiation-Induced Cataract for Staff in Interventional Cardiology: Is There Reason for Concern?",
volume = "76",
number = "6",
pages = "826-834",
doi = "10.1002/ccd.22670"
}

Ciraj-Bjelac, O., Rehani, M. M., Sim, K. H., Liew, H. B., Vano, E.,& Kleiman, N. J.. (2010). Risk for Radiation-Induced Cataract for Staff in Interventional Cardiology: Is There Reason for Concern?. in Catheterization and Cardiovascular Interventions, 76(6), 826-834.
https://doi.org/10.1002/ccd.22670

Ciraj-Bjelac O, Rehani MM, Sim KH, Liew HB, Vano E, Kleiman NJ. Risk for Radiation-Induced Cataract for Staff in Interventional Cardiology: Is There Reason for Concern?. in Catheterization and Cardiovascular Interventions. 2010;76(6):826-834.
doi:10.1002/ccd.22670 .

Ciraj-Bjelac, Olivera, Rehani, Madan M., Sim, Kui Hian, Liew, Houng Bang, Vano, Eliseo, Kleiman, Norman J., "Risk for Radiation-Induced Cataract for Staff in Interventional Cardiology: Is There Reason for Concern?" in Catheterization and Cardiovascular Interventions, 76, no. 6 (2010):826-834,
https://doi.org/10.1002/ccd.22670 . .