Publications by authors named "Carinou E"

The escalating use of Computed Tomography (CT) imaging necessitates establishment and periodic revision of Diagnostic Reference Levels (DRLs) to ensure patient protection optimization. This paper presents the outcomes of a national survey conducted from 2019 to 2022, focusing on revising DRLs for adult CT examinations. Dosimetric data from 127 scanners in 120 medical facilities, representing 25% of the country's CT scanners, were collected, emphasizing geographic distribution and technology representation.

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The goal of this work was to develop a methodology for risk assessment in case of an accident originating from a nuclear power plant, and consequently, to improve the relevant radiation monitoring network. In specific, the study involved risk estimation in Greece from a transboundary nuclear power plant accident. The tool employed was JRODOS (Java-based Real-time Decision Support), which is a system for off-site emergency management of radioactive material in the environment.

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This paper presents the approach, assumptions, and computational analysis of the preliminary safety assessment, regarding the post-closure period for the disposal of radioactive waste in Greece. The assessment was implemented in the context of the National Program for the disposal of radioactive waste in the country, which is currently in the early stage for the investigation of facility siting. The basis scenario selected for this investigation was the leaching of radionuclides and the exposure in a residence offsite.

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Article Synopsis
  • Estimating radiation exposure for workers in interventional procedures is tough, especially because these procedures can expose them to high doses of radiation.
  • To protect themselves, workers are required to wear protective garments, prompting the need for accurate measurement techniques for doses received, particularly to the lens of the eye.
  • The study examines data from four European dosimetry services to create practical guidelines for using personal dosimeters in such settings, also discussing the pros and cons of using one versus two dosimeters.
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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.

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License applicants are often faced with the need to perform a radiological impact assessment study for the liquid discharges in public sewers, even for practices with short-lived isotopes used in medical, educational or research laboratories. The present paper addresses the regulatory management challenges in performing such assessments and provides a practical calculation toolbox that enables more realistic derivation of doses to critical members, based on a simple calculation means. The proposed methodology is validated through comparisons with results from other models.

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The aim of the study was to measure and evaluate the radiation dose to the eye lens and forehead of interventional radiologists (IRs). The study included 96 procedures (lower-limb percutaneous transluminal angioplasties, embolisations/chemoembolisations and vertebroplasties) performed by 6 IRs. A set of seven thermoluminescence dosemeters was allocated to each physician.

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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.

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For years, the dose limit of 150 mSv for occupational exposure of the lens of the eye to ionising radiation was rarely exceeded, and the dose to the eye was only monitored occasionally. With the national implementation of the European Basic Safety Standards in 2018, this dose limit was reduced to 20 mSv and the Member States are expected to implement an adequate system for the monitoring of category A workers. Where the system for monitoring the whole body dose is settled in most countries, this is not the situation for the lens of the eye.

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In the context of a new annual eye lens dose limit for occupational exposure equal to 20 mSv, European Radiation Dosimetry Group (EURADOS) organized an intercomparison dedicated to eye lens dosemeters, including photon and beta radiations. The objective was to complete the first intercomparison recently organized by EURADOS for photons and to update the overview of eye lens dosemeters available in Europe. The dosemeters provided by the 22 participants coming from 12 countries were all composed of thermoluminescent detectors.

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Following the proposal of the ICRP for the reduction of the dose limit for the lens of the eye, which has been adopted by the International Atomic Energy Agency and the European Council, concerns have been raised about the implementation of proper dose monitoring methods as defined in national regulations, and about the harmonisation between European countries. The European Radiation Dosimetry Group organised a survey at the end of 2017, through a web questionnaire, regarding national dose monitoring regulations. The questions were related to: double dosimetry, algorithms for the estimation of the effective dose, methodology for the determination of the equivalent dose to the lens of the eye and structure of the national dose registry.

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In fluoroscopy guided interventional procedures, workers use protective garments and often two personal dosemeters, the readings of which are used for the estimation of the effective dose; whereas the dosemeter above the protection can be used for the estimation of the equivalent dose of the lens of the eye. When a protective apron is worn the scattered field that reaches the dosemeter is different from the case where no protection is used; this study analyses the changes in the response of seven passive and eight active personal dosemeters (APDs) when they are placed above a lead or lead equivalent garment for S-Cs and x-ray diagnostic qualities. Monte Carlo simulations are used to support the experimental results.

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A regulatory authority for radiation safety should continuously evaluate and improve the national safety framework, in line with current requirements and standards. In this context, the Greek Atomic Energy Commission initiated a series of concerted actions. The radiation dose to the population due to public and medical exposures was assessed.

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Considering that occupational exposure in medicine is a matter of growing concern, active personal dosimeters (APDs) are also increasingly being used in different fields of application of ionising radiation in medicine. An extensive survey to collect relevant information regarding the use of APDs in medical imaging applications of ionising radiation was organised by the EURADOS (European Radiation Dosimetry Group) Working Group 12. The objective was to collect data about the use of APDs and to identify the basic problems in the use of APDs in hospitals.

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Article Synopsis
  • The study aimed to establish generic dose alert levels for monitoring skin injuries during high-dose interventional procedures across nine European countries.
  • Various measurement methods (Gafchromic films and TLDs) were utilized to assess Maximum Skin Dose (MSD), with correlations found between certain dose indicators and MSD to set alert levels at 2 Gy and 5 Gy.
  • Results showed that while a significant percentage of MSD values exceeded 2 Gy in procedures like TACE, hospital-specific alert levels are recommended for greater accuracy, despite the feasibility of generic levels as initial guidelines.
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This study describes the retrospective lens dose calculation methods developed and applied within the European epidemiological study on radiation-induced lens opacities among interventional cardiologists. While one approach focuses on self-reported data regarding working practice in combination with available procedure-specific eye lens dose values, the second approach focuses on the conversion of the individual whole-body dose to eye lens dose. In contrast with usual dose reconstruction methods within an epidemiological study, a protocol is applied resulting in an individual distribution of possible cumulative lens doses for each recruited cardiologist, rather than a single dose estimate.

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Pediatric brain computed tomography (CT) is identified as the most frequent CT examination in children. The aim of the study is the direct measurement of skin, eye lens and thyroid dose in pediatric patients during brain CT examinations. The study included 35 pediatric patients who underwent brain CT examinations.

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The lens of the eye is one of the radiosensitive tissues of the human body; if exposed to ionizing radiation can develop radiation-induced cataract at early ages. This study was held in Greece and included 44 Interventional Cardiologists (ICs) and an unexposed to radiation control group of 22 persons. Of the note, 26 ICs and the unexposed individuals underwent special eye examinations.

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Interventional radiology and cardiology guarantee high benefits for patients, but are known to be associated with a high level of radiation exposure of medical staff. The recently suggested decrease of the annual dose limit for the eye lens, from 150 to 20 mSv, caused a need for a reconsideration of practices ensuring sufficient protection for the lens of the eyes of medical staff. In such context the study of the scattered radiation around the operator's head could help in finding the best solutions to be adopted for the ceiling-suspended shield and lead glasses in the most common situations in interventional practices.

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Occupational exposure from interventional x-ray procedures is one of the areas in which increased eye lens exposure may occur. Accurate dosimetry is an important element to investigate the correlation of observed radiation effects with radiation dose, to verify the compliance with regulatory dose limits, and to optimize radiation protection practice. The objective of this work is to review eye lens dose levels in clinical practice that may occur from the use of ionizing radiation.

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Objective: This paper aims to provide some practical recommendations to reduce eye lens dose for workers exposed to X-rays in interventional cardiology and radiology and also to propose an eye lens correction factor when lead glasses are used.

Methods: Monte Carlo simulations are used to study the variation of eye lens exposure with operator position, height and body orientation with respect to the patient and the X-ray tube. The paper also looks into the efficiency of wraparound lead glasses using simulations.

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A thorough literature review about the current situation on the implementation of eye lens monitoring has been performed in order to provide recommendations regarding dosemeter types, calibration procedures and practical aspects of eye lens monitoring for interventional radiology personnel. Most relevant data and recommendations from about 100 papers have been analysed and classified in the following topics: challenges of today in eye lens monitoring; conversion coefficients, phantoms and calibration procedures for eye lens dose evaluation; correction factors and dosemeters for eye lens dose measurements; dosemeter position and influence of protective devices. The major findings of the review can be summarised as follows: the recommended operational quantity for the eye lens monitoring is H p (3).

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In the context of the decrease in the eye lens dose limit for occupational exposure to 20 mSv per year stated by the recent revision of the European Basic Safety Standards Directive 2013/59/EURATOM, the European Radiation Dosimetry Group (EURADOS) has organised in 2014, for the first time, an intercomparison exercise for eye lens dosemeters. The main objective was to assess the capabilities of the passive eye lens dosemeters currently in use in Europe for occupational monitoring in medical fields. A total of 20 European individual monitoring services from 15 different countries have participated.

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The new developed thermoluminescence (TL) glow-peak expressions derived from the one trap-one recombination (OTOR) level model were used to analyze the TL glow-curves recorded with linear and exponential heating function profiles under various experimental conditions. The results showed that these expressions can, accurately, analyze the TL glow-curves even with the overlapped glow-peaks. Low values of R=A/A were reported for glow-peaks in different TL materials.

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