Background: Hysterosalpingography (HSG) is an indispensable tool for diagnosing infertility in females. The procedure exposes female reproductive organs to ionizing radiation as the genitals are irradiated during the process. Investigating patient absorbed dose during the procedures is essential for effective radiological protection of the patient. Objective: This study aims to investigate the radiation dose received by patient during HSG examination in the study environment in order to enhance optimization of procedures and the associated dose, thereby minimizing radiation risks. Material and Methods: The prospective pilot study, was conducted in four tertiary healthcare institutions in Southwest Nigeria. Thermoluminescence dosimeter (TLD 100) was used to determine the Entrance Surface Dose (ESD) of 80 patients presented for HSG investigation. The corresponding effective dose, ovary, uterus and urinary bladder doses were evaluated using PCXMC software. Results: The mean entrance surface doses (ESD) obtained from the four centers were 18.58±6.31 mGy, 15.18±2.27 mGy, 17.44±3.43 mGy and 34.24±11.98 mGy for SW1, SW2, SW3 and SW4 centers, respectively. The corresponding mean of effective doses were 1.54±0.63 mSv, 1.24±0.28 mSv, 1.41±0.30 mSv and 2.53±0.94 mSv for SW1, SW2, SW3 and SW4 centers, respectively. The resulting mean doses to the ovary, urinary bladder and uterus were also presented. Conclusion: The results obtained in general are comparable with international standards. It was, however, recommended that study centers with high doses should conduct dose audit in order to enhance patient safety. |
- Simpson Jr WL, Beitia LG, Mester J. Hysterosalpingography: a reemerging study. Radiographics. 2006;26:419-31. doi: 10.1148/rg.262055109. PubMed PMID: 16549607.
- Hernández J, Pineda R, editors. Hysterosalpingography: technique, findings and results from our experience. European Congress of Radiology; Vienna: ECR; 2014.
- Zafarani F, Ahmadi F, Shahrzad G. Hysterosalpingography in The Assessment of Congenital Cervical Anomalies. Int J Fertil Steril. 2017;11:71-8. doi: 10.22074/ijfs.2017.4716. PubMed PMID: 28670423. PubMed PMCID: PMC5347453.
- Gregan AC, Peach D, McHugo JM. Patient dosimetry in hysterosalpingography: a comparative study. Br J Radiol. 1998;71:1058-61. doi: 10.1259/bjr.71.850.10211066. PubMed PMID: 10211066.
- Yousef M, Tambul JY, Sulieman A. Radiation dose measurements during hysterosalpingography. Sudan Medical Monitor. 2014;9:15-18. doi:10.4103/1858-5000.144652.
- Sembuya R. Mother of nothing: the agony of infertility. Bulletin of the World Health Organization. 2010;88:881-2. doi: 10.2471/BLT.10.011210.
- Odewale BJ, OIadosun M, Amoo EO. Fertility desire and contraceptive use among women in Nigeria. 3rd International Conference on African Development Issues (CU-ICADI); Ota, Nigeria: Covenant University; 2016.
- Ikubor JE, Eze GU. Patterns of hysterosalpingographic findings in tertiary hospital, south-south Nigeria: A three year reviews. Afr J Tr Med Biomed Res. 2016;3:34-40.
- Olatunji A, Jagun O, Toyobo O, Ashaolu O, Adekoya O. Hysterosalpingogram findings among women with infertility in Ogun State, Nigeria. Annals of Health Research. 2017;3:75-81.
- Wong CS, Huang B, Sin HK, Wong WL, Yiu KL, Chu Yiu Ching T. A questionnaire study assessing local physicians, radiologists and interns’ knowledge and practice pertaining to radiation exposure related to radiological imaging. Eur J Radiol. 2012;81:e264-8. doi: 10.1016/j.ejrad.2011.02.022. PubMed PMID: 21439746.
- Bosanquet DC, Green G, Bosanquet AJ, Galland RB, Gower-Thomas K, Lewis MH. Doctors’ knowledge of radiation - a two-centre study and historical comparison. Clin Radiol. 2011;66:748-51. doi: 10.1016/j.crad.2011.03.009. PubMed PMID: 21546010.
- Calicchia A, Chiacchiararelli L, De Felice C, Gigliotti T, Indovina PL, Mazzei F, et al. [Assessment of radiation dose to patients in hysterosalpingography]. Radiol Med. 1998;95:93-7. PubMed PMID: 9636734.
- Okeji MC, Udoh BE, Chiaghanam NO. Evaluation of Absorbed dose during Hysterosalpingography in a Nigerian Hospital. European Journal of Scientific Research. 2011;67:137-9.
- Phillips J, Cochavi S, Silberzweig JE. Hysterosalpingography with use of mobile C-arm fluoroscopy. Fertil Steril. 2010;93:2065-8. doi: 10.1016/j.fertnstert.2008.12.135. PubMed PMID: 19200983.
- Karande VC, Pratt DE, Balin MS, Levrant SG, Morris RS, Gleicher N. What is the radiation exposure to patients during a gynecoradiologic procedure? Fertil Steril. 1997;67:401-3. doi: 10.1016/S0015-0282(97)81931-0. PubMed PMID: 9022623.
- Sulieman A, Theodorou K, Vlychou M, Topaltzikis T, Roundas C, Fezoulidis I, et al. Radiation dose optimisation and risk estimation to patients and staff during hysterosalpingography. Radiat Prot Dosimetry. 2008;128:217-26. doi: 10.1093/rpd/ncm324. PubMed PMID: 17584732.
- Perisinakis K, Damilakis J, Grammatikakis J, Theocharopoulos N, Gourtsoyiannis N. Radiogenic risks from hysterosalpingography. Eur Radiol. 2003;13:1522-8. doi: 10.1007/s00330-002-1809-0.
- Critchley HO, Bath LE, Wallace WH. Radiation damage to the uterus - review of the effects of treatment of childhood cancer. Hum Fertil (Camb). 2002;5:61-6. doi: 10.1080/1464727022000198942. PubMed PMID: 12082209.
- Kim SY, Kim SK, Lee JR, Woodruff TK. Ovary is necessary to the health of uterus. J Gynecol Oncol. 2016;27:e35. doi: 10.3802/jgo.2016.27.e35. PubMed PMID: 27029755. PubMed PMCID: PMC4823365.
- Alzimami K, Sulieman A, Babikir E, Alsafi K, Alkhorayef M, Omer H. Estimation of effective dose during hystrosalpingography procedures in certain hospitals in Sudan. Appl Radiat Isot. 2015;100:2-6. doi: 10.1016/j.apradiso.2015.02.009.
- Parry RA, Glaze SA, Archer BR. The AAPM/RSNA physics tutorial for residents. Typical patient radiation doses in diagnostic radiology. Radiographics. 1999;19:1289-302. doi: 10.1148/radiographics.19.5.g99se211289. PubMed PMID: 10489180.
- Hough DM, Fletcher JG, Grant KL, Fidler JL, Yu L, Geske JR, et al. Lowering kilovoltage to reduce radiation dose in contrast-enhanced abdominal CT: initial assessment of a prototype automated kilovoltage selection tool. AJR Am J Roentgenol. 2012;199:1070-7. doi: 10.2214/AJR.12.8637. PubMed PMID: 23096181.
- Achuka JA, Aweda MA, Usikalu MR, Aborisade CA. Cancer risks from chest radiography of young adults: A pilot study at a health facility in South West Nigeria. Data in Brief. 2018;19:1250-6. doi: 10.1016/j.dib.2018.05.123. PubMed PMID: 30229004. PubMed PMCID: PMC6140361.
- Achuka J, Aweda M, Usikalu M. Cancer risks from head radiography procedures. IOP Conference Series: Earth and Environmental Science; IOP Publishing; 2018:173:012038. doi: 1 0.1088/1755-1315/173/1/012038.
- Khoury HJ, Maia A, Oliveira M, Kramer R, Drexler G. Patient dosimetry in hysterosalpingography. International conference on radiological protection of patients in diagnostic and interventional radiology, nuclear medicine and radiotherapy; Malaga, Vienna: IAEA; 2001. P. 139-142.
- Plećaš DV, Živković MM, Ciraj-Bjelac OF. Radiation dose and risk assessment in hysterosalpingography. Nuclear Technology and Radiation Protection. 2010;25:217-21. doi:10.2298/NTRP103217P.
- Messaris GA, Abatzis I, Kagadis GC, Samartzis AP, Athanasopoulou P, Christeas N, et al. Hysterosalpingography using a flat panel unit: evaluation and optimization of ovarian radiation dose. Med Phys. 2012;39:4404-13. doi: 10.1118/1.4729715. PubMed PMID: 22830773.
- Gyekye PK, Emi-Reynolds G, Boadu M, Darko EO, Yeboah J, Inkoom S, et al. Cancer incidence risks to patients due to hysterosalpingography. J Med Phys. 2012;37:112-6. doi: 10.4103/0971-6203.94747. PubMed PMID: 22557802. PubMed PMCID: PMC3339143.
- International Atomic Energy Agency (IAEA). Applying Radiation Safety Standards in Diagnostic Radiology and Interventional Procedures Using X Ray. Safety Reports Series 39: International Atomic Energy Agency; Vienna: IAEA; 2006. p. 77.
- United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR). Sources and effects of ionizing radiation: sources. New York: United Nations Publications; 2008. p. 77.
|