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Organ-based estimation and minimization of clinician’s X-ray dose

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Hybrid surgeries, allowing real-time visualization of patient inner anatomy, are possible through the use of intraoperative X-ray imaging. However, the intensive use of X-rays can have undesired consequences for the clinicians or the patient in the operating room (OR).

Methods

In this paper, we provide a tool to visualize the X-rays and to optimally place protective shields in the hybrid operating room to reduce the clinician’s dose according to their most sensitive body parts. We first acquire measurements in a hybrid operating room with dosimeters placed at different locations on a mannequin simulating a clinician. We demonstrate that a small displacement of a protective shield has significant consequences on the dose received by a clinician. Then, we reproduce the scene virtually and use Monte Carlo simulations to estimate the dose received by the clinician. Finally, we optimally place protective shields with a Nelder–Mead-based numerical optimization algorithm.

Results

The results show a high sensitivity of the clinician’s dose to protective shield placement. Numerical optimization of the shields’ placement can help to reduce the dose and show a decrease between 79 and 89% of the exposition when comparing no external shield protection and our optimal external shield position.

Conclusion

Our work can help to raise awareness of the risks induced by X-rays during intraoperative surgery and reduce the dose received by the clinicians. In future work, our approach can be linked with human pose estimation algorithms to trace surgeons’ moves, estimate dynamically the dose and summarize it in a surgical report, giving the dose for important organs.

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Funding

This work was carried out within the framework of the ANR project Optimix (ANR-19-CE45-0011). This work was supported by French state funds managed within the “Plan Investissements d’Avenir” and by the ANR (reference ANR-10-IAHU-02).

Author information

Authors and Affiliations

  1. ICube, CNRS, University of Strasbourg, Strasbourg, France

    Alexandre Krebs, Jean-Paul Mazellier, Cindy Rolland & Nicolas Padoy

  2. IHU, Strasbourg, France

    Jean-Paul Mazellier, Juan Verde & Nicolas Padoy

  3. LaTIM, INSERM UMR1101, Univ Brest, Brest, France

    Julien Bert

Authors
  1. Alexandre Krebs
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  2. Jean-Paul Mazellier
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  3. Juan Verde
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  4. Cindy Rolland
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  5. Julien Bert
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  6. Nicolas Padoy
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Correspondence to Alexandre Krebs.

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Krebs, A., Mazellier, JP., Verde, J. et al. Organ-based estimation and minimization of clinician’s X-ray dose. Int J CARS 17, 2357–2364 (2022). https://doi.org/10.1007/s11548-022-02710-3

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  • DOI: https://doi.org/10.1007/s11548-022-02710-3

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