Publications by authors named "Eleftheria Carinou"

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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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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The safe use of radiation sources presupposes the engagement of personnel adequately educated and trained on radiation protection and with the necessary safety culture. This is necessary in order to understand their responsibilities and perform their duties in the safest way for themselves, the public and the patients, where appropriate. The Greek Atomic Energy Commission (EEAE) provides education and training on radiation protection to scientists, technical personnel and members of emergency response teams as well as the recognition of the related programs.

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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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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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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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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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A questionnaire was developed by the members of WG12 of EURADOS in order to establish an overview of the current status of eye lens radiation dose monitoring in hospitals. The questionnaire was sent to medical physicists and radiation protection officers in hospitals across Europe. Specific topics were addressed in the questionnaire such as: knowledge of the proposed eye lens dose limit; monitoring and dosimetry issues; training and radiation protection measures.

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The use of a Monte Carlo code for the analysis and interpretation of whole body counting measurements is described. The sources of error are analysed and commented to show how a counting geometry can be improved by improving accuracy and precision in a measurement. The effects of body size, contamination distribution and counting geometry are also parameters which can be easily used to improve the quality of a body burden assessment.

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