Radiation exposure for intraoperative 3D scans in a hybrid operating room: how to reduce radiation exposure for the surgical team
Radiation exposure for intraoperative 3D scans in a hybrid operating room: how to reduce radiation exposure for the surgical team
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DOI：
10.1007/s11548-018-1747-1
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发表时间：
2018-08-01
影响因子：
3
通讯作者：
Richter, P. H.
中科院分区：
文献类型：
--
作者：
Schuetze, K.;Kraus, M.;Richter, P. H.
混合手术室被用于不同的手术领域。在骨科手术中，对困难解剖区域（脊柱、骨盆）进行3D扫描的可能性不仅在导航螺钉放置方面显示出有希望的结果。相关的辐射暴露引发了手术室人员和患者的潜在风险问题。本研究的重点是在混合手术室、相邻房间的三维扫描中散射辐射，以及减少辐射暴露的方法。材料与方法采用RaySafe (TM) i2剂量计测量混合手术室不同距离和高度下不同解剖区域的三维扫描散射辐射。3D扫描是通过具有3D扫描能力的地板式平板c型机械臂进行的（Artis Zeego，西门子，德国）。3D扫描是用一具人体尸体进行的。采用标准和剂量减少方案（DRP）进行3D扫描。结果三维扫描时，手术助理一侧骨盆散射辐射最高（1 m高度为39.5 Sv），而主刀一侧骨盆散射辐射最高（1 m高度为23 Sv）。在对其他解剖区域进行3D扫描时，对擦洗护士位置的散射辐射较少（1 m高度为6.8 Sv）。DRP组的辐射剂量约减少66%。在辐射防护墙后和相邻房间开着门的情况下测量了低散射辐射值。结论在进行扫描时，在手术室的各个部位都要测量散射辐射，尤其是在骨盆带的三维扫描中。因此，应尽可能使用剂量较低的设置。工作人员应站在辐射安全墙后，或离开手术室并关好门。本研究建立了六项避免混合手术室辐射的行为规则。
Background Hybrid operating rooms are used in different fields of surgery. In orthopedic surgery, the possibility of a 3D scan of difficult anatomical regions (spine, pelvis) showed promising results not only in navigated screw placement. The associated exposure to radiation raises questions regarding potential risks for the operating room personal and the patient. The present study focuses on scatter radiation during 3D scans in a hybrid operating room, the adjacent rooms, and methods to reduce radiation exposure.Material and Methods RaySafe (TM) i2 dosimeters were used to measure scatter radiation during 3D scans of different anatomical regions in different distances and heights in a hybrid operating room. The 3D scans were performed with a floor-based flat-panel robotic C-arm with 3D scan capability (Artis Zeego, Siemens; Germany). The 3D scans were performed using a human cadaver. The 3D scans were performed using a standard and a dose reduction protocol (DRP).Results The highest scatter radiation was measured during 3D scans of the pelvis on the side of the surgical assistant (39.5 Sv in height of 1 m) compared to the side of the main surgeon (23 Sv in height of 1 m). Scatter radiation was less on the position of the scrub nurse (6.8 Sv in height of 1 m) and during 3D scans of the other anatomical regions. The radiation dosage was about 66% less with the DRP. Low values of scatter radiation were measured behind a radiation protection wall and with open doors in the adjacent rooms.Conclusion While performing a scan scatter radiation was measured everywhere in the operating room especially during 3D scans of the pelvic girdle. Therefore, settings with lower dosage should be used whenever possible. Personnel should stand behind a radiation safety wall or leave the operating room and close the doors. For this study, six behavioral rules to avoid radiation in a hybrid operating room were established.