ojrdrtОнкологический журнал: лучевая диагностика, лучевая терапияJournal of oncology: diagnostic radiology and radiotherapy2587-75932713-167XНЕКОММЕРЧЕСКОЕ ПАРТНЕРСТВО «ОБЩЕСТВО ИНТЕРВЕНЦИОННЫХ ОНКОРАДИОЛОГОВ»10.37174/2587-7593-2026-9-1-77-89ojrdrt-516Research ArticleРАДИАЦИОННАЯ БЕЗОПАСНОСТЬRADIATION SAFETYОценка дозовых нагрузок на медицинский персонал при проведении биопсии периферических образований лёгких под контролем компьютерной томографииAssessment of Staff Dose Loads During Computer Tomography-Guided Biopsyhttps://orcid.org/0000-0002-1129-7220ГармашА. А.GarmashA. A.

115409, Москва, Каширское шоссе, 31

31 Kashirskoye Highway, Moscow, 115409

https://orcid.org/0000-0002-0480-8467БуйденокЮ. В.BuydenokYu. V.

115409, Москва, Каширское шоссе, 31; 115478, Москва, Каширское шоссе, 24

31 Kashirskoye Highway, Moscow, 11540924 Kashirskoye Highway, Moscow, 115478

ВасюкЕ. Ю.VasyukE. Yu.

115409, Москва, Каширское шоссе, 31

31 Kashirskoye Highway, Moscow, 115409

https://orcid.org/0000-0003-0634-7841ЛебеденкоИ. М.LebedenkoI. M.

115409, Москва, Каширское шоссе, 31; 115478, Москва, Каширское шоссе, 24

31 Kashirskoye Highway, Moscow, 11540924 Kashirskoye Highway, Moscow, 115478

imlebedenko@mail.ruНайденовМ. Г.NaidenovM. G.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

https://orcid.org/0000-0001-7185-7165ДолгушинБ. И.DolgushinB. I.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

https://orcid.org/0000-0003-3931-1431ТюринИ. Е.TyurinI. E.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

БугаёвВ. Е.BugaevV. E.

115478, Москва, Каширское шоссе, 24; 119991 Москва, ул. Трубецкая, 8, с.2

24 Kashirskoye Highway, Moscow, 1154788-2. Trubetskaya str., Moscow, 119991

https://orcid.org/0000-0003-4744-6141КононецП. В.KononetsP. V.

115478, Москва, Каширское шоссе, 24; 119991 Москва, ул. Трубецкая, 8, с.2

24 Kashirskoye Highway, Moscow, 1154788-2. Trubetskaya str., Moscow, 119991

https://orcid.org/0000-0002-4006-3642ВиршкеЭ. Р.VirshkeE. R.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

https://orcid.org/0000-0002-2174-1399КозакЕ. Н.KozakE. N.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

https://orcid.org/0000-0001-7381-0942АхвердиеваГ. И.AkhverdievaG. I.

115409, Москва, Каширское шоссе, 31; 115478, Москва, Каширское шоссе, 24

31 Kashirskoye Highway, Moscow, 11540924 Kashirskoye Highway, Moscow, 115478

https://orcid.org/0000-0002-1295-4106ЛаптеваМ. Г.LaptevaM. G.

115478, Москва, Каширское шоссе, 24

24 Kashirskoye Highway, Moscow, 115478

ЗакурдаеваА. В.ZakurdaevaA. V.

115409, Москва, Каширское шоссе, 31

31 Kashirskoye Highway, Moscow, 115409

Национальный исследовательский ядерный университет МИФИРоссияNational Research Nuclear University MEPhI (Moscow Engineering Physics Institute)Russian FederationНациональный исследовательский ядерный университет МИФИ; Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РоссииРоссияNational Research Nuclear University MEPhI (Moscow Engineering Physics Institute); N.N. Blokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава РоссииРоссияN.N. Blokhin National Medical Research Center of OncologyRussian FederationНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России; ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияN.N. Blokhin National Medical Research Center of Oncology; Sechenov First Moscow State Medical UniversityRussian Federation202628032026917789Copyright © Гармаш А.А., Буйденок Ю.В., Васюк Е.Ю., Лебеденко И.М., Найденов М.Г., Долгушин Б.И., Тюрин И.Е., Бугаёв В.Е., Кононец П.В., Виршке Э.Р., Козак Е.Н., Ахвердиева Г.И., Лаптева М.Г., Закурдаева А.В., 20262026Гармаш А.А., Буйденок Ю.В., Васюк Е.Ю., Лебеденко И.М., Найденов М.Г., Долгушин Б.И., Тюрин И.Е., Бугаёв В.Е., Кононец П.В., Виршке Э.Р., Козак Е.Н., Ахвердиева Г.И., Лаптева М.Г., Закурдаева А.В.Garmash A.A., Buydenok Y.V., Vasyuk E.Y., Lebedenko I.M., Naidenov M.G., Dolgushin B.I., Tyurin I.E., Bugaev V.E., Kononets P.V., Virshke E.R., Kozak E.N., Akhverdieva G.I., Lapteva M.G., Zakurdaeva A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.oncoradjournal.ru/jour/article/view/516

Цель: Оценить дозовую нагрузку на медицинский персонал при проведении биопсии под контролем компьютерной томографии (КТ) у больных с периферическими образованиями легких и обосновать необходимость внедрения специальных технологий для снижения и предотвращения лучевой нагрузки на персонал. Материалы и методы: Измерения дозовой нагрузки излучения компьютерного томографа на кисти руки, область органов зрения и щитовидной железы хирурга для всех этапов взятия пункции без учета ослабления излучения средствами индивидуальной защиты хирурга и с учетом их проведены с использованием дозиметра RadiaScan-801M. Измерения эквивалентной дозы в области головы и шеи хирурга для всех этапов взятия биопсии с учетом фартука на пациенте и на антропоморфном фантоме AldersonRando проведены с использованием двух дозиметров — RadiaScan-801M и ДКС-АТ1123. Результаты: Показано, что максимальные значения эквивалентных доз, получаемых хирургом при взятии биопсии, приходятся на кисти рук, находящиеся в зоне сканирующего пучка. Существенному воздействию рассеянного рентгеновского излучения подвержены области головы и шеи. Средняя эквивалентная доза и средняя мощность дозы для всех этапов биопсии составили D = 1850 ± 874 мкЗв, Ḋ̅ = 21 ± 2 мкЗв/с. При этом, с учетом особенностей распространения рассеянного рентгеновского излучения при КТ, обусловленного вращением трубки, радиозащитные очки не могут полноценно выполнять свою функцию. Средняя эквивалентная доза в области головы и шеи и средняя мощность эквивалентной дозы составили D = 148,8 ± 116 мкЗв и Ḋ̅ = 1,5 ± 0,5 мкЗв/с соответственно. Предложен и обоснован дополнительный несложный способ снижения уровня рассеянного излучения, эффективность которого доказана в эксперименте на фантоме. Рассмотрены некоторые пути уменьшения лучевой нагрузки за счет автоматизации процесса. Заключение: Полученные результаты свидетельствуют о необходимости поиска мер более безопасного проведения процедур взятия биопсии под контролем КТ с максимально возможным уменьшением дозовых нагрузок на персонал.

Purpose: To assess the radiation exposure of personnel during biopsy of lung cancer patients under X-ray computed tomography control (CT) and to justify the need to implement specialized technologies to reduce and prevent radiation exposure to personnel. Materials and methods: Measurement of the radiation dose in the X-ray computed tomography beam on the surgeon’s hands, organs of vision and thyroid gland for all stages of puncture taking without taking into account the attenuation of radiation in the surgeon’s protective apron and taking it into account was carried out using a RadiaScan-801M dosimeter. The measurement of the equivalent dose in the surgeon’s head and neck area for all stages of biopsy taking, taking into account the apron on the patient and on the Alderson Rando anthropomorphic phantom, was carried out using two dosimeters: RadiaScan-801M and DKS-AT1123. Results: It has been shown that the maximum equivalent doses received by the surgeon during biopsy procedures were received by the hands, located within the scanning beam. The head and neck areas are significantly exposed to scattered X-ray radiation. The average equivalent dose and average dose rate for all biopsy stages were D = 1850 ± 874 μSv, Ḋ̅ = 21 ± 2 μSv/s. However, given the specific propagation of scattered X-rays during CT scanning due to tube rotation, radiation protective goggles cannot fully perform their function. The average equivalent dose in the head and neck area and average equivalent dose rate were D = 148.8 ± 116 μSv and Ḋ̅ = 1.5 ± 0.5 μSv/s, respectively. An additional simple method for reducing scattered radiation levels is proposed and validated, the effectiveness of which was demonstrated in a phantom experiment. Several ways to reduce radiation exposure through process automation are discussed. Conclusion: The obtained results indicate the need to find measures to make CT-guided biopsy procedures safer while minimizing radiation exposure to personnel

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The authors declare that there are no conflicts of interest present.