Evaluation of equivalent and effective dose by KAP for patient and orthopedic surgeon in vertebral compression fracture surgery. (March 2017)

• Record Type: Journal Article
• Authors: Santos, Felipe A.; Galeano, Diego C.; Santos, William S.; Silva, Ademir X.; Souza, Susana O.; Carvalho Júnior, Albérico B.
• Is Part Of: Radiation physics and chemistry. Volume 132(2017)
• Page Start: 30
• Page End: 40
• Publication Date: 2017-03
• Subjects: Vertebra compression fracture -- HT/KAP and E/KAP Kyphoplasty -- Virtual Phantoms -- MCNPX; Radiation chemistry -- Periodicals; Radiometry -- Periodicals; Radiation -- Periodicals; Chimie sous rayonnement -- Périodiques; 539.2
• DOI: 10.1016/j.radphyschem.2016.11.011
• Languages: English
• ISSNs: 0969-806X

Abstract

Abstract: Clinical scenarios were virtually modeled to estimate both the equivalent and effective doses normalized by KAP (K ermaA reaP roduct) to vertebra compression fracture surgery in patient and surgeon. This surgery is known as kyphoplasty and involves the use of X-ray equipment, the C-arm, which provides real-time images to assist the surgeon in conducting instruments inserted into the patient and in the delivery of surgical cement into the fractured vertebra. The radiation transport code used was MCNPX (M onteC arloN -P article eX tended) and a pair of UFHADM (U niversity ofF loridaH ybridAD ultM ale) virtual phantoms. The developed scenarios allowed us to calculate a set of equivalent dose (HT ) and effective dose (E) for patients and surgeons. In additional, the same scenario was calculated KAP in the tube output and was used for calculating conversion coefficients (E/KAP and HT /KAP). From the knowledge of the experimental values of KAP and the results presented in this study, it is possible to estimate absolute values of effective doses for different exposure conditions. In this work, we developed scenarios with and without the surgical table with the purpose of comparison with the existing data in the literature. The absence of the bed in the scenario promoted a percentage absolute difference of 56% in the patient effective doses in relation to scenarios calculated with a bed. Regarding the surgeon, the use of the personal protective equipment (PPE) reduces between 75% and 79% the effective dose and the use of the under table shield (UTS) reduces the effective dose of between 3% and 7%. All these variations emphasize the importance of the elaboration of virtual scenarios that approach the actual clinical conditions generating E/KAP and HT /KAP closer to the actual values. Highlights: Virtual scenarios of vertebra compression fracture surgery. MC simulations using virtual anthropomorphic phantoms and surgical setups. Estimation of E/KAP and HT /KAP in VCF surgeries. Results allow evaluation of effective doses to patients and surgeon.