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Organ Dose Assessment in Radiological Central Venous Port Procedures: An Experimental Phantom-Based Study.

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Fluoroscopy-guided central venous port placement delivers significant radiation to thoracic organs like the lungs and thyroid. This study quantifies these doses using an anthropomorphic phantom to improve patient safety during interventional procedures.

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Area of Science:

  • Medical Physics
  • Radiology
  • Interventional Cardiology

Background:

  • Fluoroscopy-guided central venous port (CVP) catheter placement is a common interventional procedure.
  • Assessing radiation dose to organs at risk is crucial for patient safety.

Purpose of the Study:

  • To quantitatively evaluate radiation doses to radiosensitive thoracic and cervical organs during fluoroscopy-guided CVP placement.
  • To identify the most exposed anatomical regions during this procedure.

Main Methods:

  • An Alderson Rando anthropomorphic phantom was used, simulating a CVP fluoroscopic procedure.
  • Thermoluminescent dosimeters (TLDs) measured absorbed doses in 14 organ sites.
  • A Siemens Artis Zee C-arm fluoroscopy system was used with an 8-minute active exposure time.

Main Results:

  • Highest radiation doses were observed in thoracic organs: right middle lung (7.84 mGy), thoracic spinal cord (5.23 mGy), and right lung apex (3.91 mGy).
  • The thyroid received moderate exposure: right lobe (1.48 mGy) and left lobe (1.41 mGy).
  • Distant organs like the pituitary gland and ethmoid sinus had negligible absorbed doses (< 0.03 mGy).

Conclusions:

  • Fluoroscopic CVP placement results in substantial localized radiation exposure, particularly to the lungs and thyroid.
  • Quantitative organ dose mapping using anthropomorphic phantoms is valuable for optimizing patient safety protocols.
  • Minimizing radiation exposure during interventional procedures is essential.