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Abstract: 133-1

133-1

Monte Carlo evaluation of occupational doses during uterine artery embolization procedures according to patient’s BMI

Authors:
Samara Pavan Souza (PPGEB/FEELT/UFU - Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia) ; Tainara Gabrieli Zandoná (PPGEB/FEELT/UFU - Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia) ; William de Souza Santos (PPGEB/FEELT/UFU - Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, UFS - Departamento de Física, Universidade de Sergipe) ; Lucio Pereira Neves (PPGEB/FEELT/UFU - Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, INFIS - UFU - Instituto de Física, Universidade Federal de Uberlândia,) ; Ana Paula Perini (PPGEB/FEELT/UFU - Programa de Pós-Graduação em Engenharia Biomédica, Faculdade de Engenharia Elétrica, Universidade Federal de Uberlândia, INFIS - UFU - Instituto de Física, Universidade Federal de Uberlândia,)

Abstract:

Currently, approximately 40% of women of childbearing age are affected by uterine fibroids, which are considered benign tumors that are in the uterus. Among the different treatment methods available, Uterine Artery Embolization (UAE) [1] stands out. This minimally invasive interventional procedure aims to embolize the arteries supplying the fibroids, thereby ceasing their blood supply, and reducing their size and symptoms. The goal of this technique is to preserve the patient's reproductive system, as it is a minimally invasive procedure, leading to faster recovery and shorter hospitalization time [2]. Despite the benefits, the procedure is guided by X-rays to allow the physician to visualize the arteries supplying the tumor. This raises concerns about the radiological protection of all professionals involved. Interventional radiology is one of the medical specialties that exposes staff to the highest occupational doses, as they remain close to the patient, who is the primary source of scattered radiation in these situations.  The objective of this study was to evaluate the equivalent and effective doses of professionals involved in UAE procedures performed on patients with different body mass indexes (BMI). The evaluation was carried out using the MCNPX code [3], and virtual anthropomorphic phantoms with different BMI. Common UAE procedure scenarios were constructed, containing fluoroscopy equipment and personal and collective protective equipment typical of the hemodynamics environment. Radiation fields of different sizes were used, that is 20 × 20, 25 × 25, 32 × 32 cm², tube voltages of 60, 70, 80, 90, 100 and 110 kV, and beam projections were LAO45, RAO45 and PA. The patient was represented by three different female phantoms with BMIs of 20.1, 22.7, and 31.7 kg/m2. The results showed that both equivalent and effective occupational doses increased with the patient's BMI. This is due to the need for higher voltage and larger field size when treating a larger patient. The highest doses were recorded with the LAO45 projection, using a field size of 32 × 32 cm², a tube voltage of 110 kV, and a patient's BMI of 31.7 kg/m². The results are consistent with literature findings that indicate larger fields and higher tube voltages lead to increased amounts of scattered radiation in interventional radiology procedures [4]. It is important to emphasize that the appropriate selection of technical parameters, such as field size and tube voltage tailored to the individual patient's needs, can help minimize radiation doses to healthcare professionals. Additionally, the correct use of personal and collective protective equipment is essential.

Acknowledgements

The authors would like to thank Dr. Richard Kramer for kindly providing the virtual anthropomorphic phantoms used in this work, and the  Brazilian agencies CNPq (Grants 312160/2023-2 (L.P.N), 312124/2021-0 (A.P.P), 309675/2021-9 (W.S.S) and 406303/2022-3) and FAPEMIG (Grants  APQ-04215-22, APQ-01254-23 and APQ-04348-23). S.P.S. receive a FAPEMIG scholarship.

Keywords:
 Radiation Protection, Uterine Artery Embolization, Monte Carlo simulation, Scattered radiation, Dosimetry