L. Donadille

Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay, Île-de-France, France

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Publications (96)123.24 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Monte Carlo calculations were used to investigate the efficiency of radiation protection equipment in reducing eye and whole body doses during fluoroscopically guided interventional procedures. Eye lens doses were determined considering different models of eyewear with various shapes, sizes and lead thickness. The origin of scattered radiation reaching the eyes was also assessed to explain the variation in the protection efficiency of the different eyewear models with exposure conditions. The work also investigates the variation of eye and whole body doses with ceiling-suspended shields of various shapes and positioning. For all simulations, a broad spectrum of configurations typical for most interventional procedures was considered. Calculations showed that 'wrap around' glasses are the most efficient eyewear models reducing, on average, the dose by 74% and 21% for the left and right eyes respectively. The air gap between the glasses and the eyes was found to be the primary source of scattered radiation reaching the eyes. The ceiling-suspended screens were more efficient when positioned close to the patient's skin and to the x-ray field. With the use of such shields, the Hp(10) values recorded at the collar, chest and waist level and the Hp(3) values for both eyes were reduced on average by 47%, 37%, 20% and 56% respectively. Finally, simulations proved that beam quality and lead thickness have little influence on eye dose while beam projection, the position and head orientation of the operator as well as the distance between the image detector and the patient are key parameters affecting eye and whole body doses.
    Journal of Radiological Protection 06/2014; 34(3):509. DOI:10.1088/0952-4746/34/3/509 · 1.70 Impact Factor
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    ABSTRACT: Purpose: Test and validation of analytical models predicting leakage neutron exposure in passively scattered proton therapy.
    Medical Physics 06/2014; 41(6):336-337. DOI:10.1118/1.4888812 · 2.64 Impact Factor
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    ABSTRACT: The aim of this study was to assess the long term pre-clinical effects of low-dose radiation on the micro-vascular structure among interventional physicians whose hands are exposed to ionising radiation in their daily practice.
    Occupational and Environmental Medicine 06/2014; 71 Suppl 1:A60. DOI:10.1136/oemed-2014-102362.187 · 3.27 Impact Factor
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    ABSTRACT: Purpose: Measure stray radiation inside a passive scattering proton therapy facility, compare values to Monte Carlo (MC) simulations and identify the actual needs and challenges.
    Medical Physics 06/2014; 41(6):363-364. DOI:10.1118/1.4888927 · 2.64 Impact Factor
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    ABSTRACT: Monte Carlo calculations are increasingly used to assess stray radiation dose to healthy organs of proton therapy patients and estimate the risk of secondary cancer. Among the secondary particles, neutrons are of primary concern due to their high relative biological effectiveness. The validation of Monte Carlo simulations for out-of-field neutron doses remains however a major challenge to the community. Therefore this work focused on developing a global experimental approach to test the reliability of the MCNPX models of two proton therapy installations operating at 75 and 178 MeV for ocular and intracranial tumor treatments, respectively. The method consists of comparing Monte Carlo calculations against experimental measurements of: (a) neutron spectrometry inside the treatment room, (b) neutron ambient dose equivalent at several points within the treatment room, (c) secondary organ-specific neutron doses inside the Rando–Alderson anthropomorphic phantom. Results have proven that Monte Carlo models correctly reproduce secondary neutrons within the two proton therapy treatment rooms. Sensitive differences between experimental measurements and simulations were nonetheless observed especially with the highest beam energy. The study demonstrated the need for improved measurement tools, especially at the high neutron energy range, and more accurate physical models and cross sections within the Monte Carlo code to correctly assess secondary neutron doses in proton therapy applications.
    Physics in Medicine and Biology 05/2014; 59(11):2747. DOI:10.1088/0031-9155/59/11/2747 · 2.76 Impact Factor
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    ABSTRACT: This paper's goal is to assess secondary neutron doses received by paediatric patients treated for intracranial tumours using a 178 MeV proton beam. The MCNPX Monte Carlo model of the proton therapy facility, previously validated through experimental measurements for both proton and neutron dosimetry, was used. First, absorbed dose was calculated for organs located outside the clinical target volume using a series of hybrid computational phantoms for different ages and considering a realistic treatment plan. In general, secondary neutron dose was found to decrease as the distance to the treatment field increases and as the patient age increases. In addition, secondary neutron doses were studied as a function of the beam incidence. Next, neutron equivalent dose was assessed using organ-specific energy-dependent radiation weighting factors determined from Monte Carlo simulations of neutron spectra at each organ. The equivalent dose was found to reach a maximum value of ~155 mSv at the level of the breasts for a delivery of 49 proton Gy to an intracranial tumour of a one-year-old female patient. Finally, a thorough comparison of the calculation results with published data demonstrated the dependence of neutron dose on the treatment configuration and proved the need for facility-specific and treatment-dependent neutron dose calculations.
    Journal of Radiological Protection 04/2014; 34(2):279. DOI:10.1088/0952-4746/34/2/279 · 1.70 Impact Factor
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    ABSTRACT: This work suggests a classification of interventional radiology and cardiology procedures based on statistical analysis of operators’ finger doses measured in routine clinical conditions. In total, 346 finger doses were measured and the observed mean finger dose per class of procedure ranged from 0.03 mSv to 1.56 mSv for Cerebral, and Bone and Joint procedures, respectively. The statistical analysis showed that the finger dose in Cerebral procedures is significantly lower than in Cardiac procedures, which was significantly lower than the rest. Furthermore, finger doses in therapeutic procedures and in close ones were significantly greater than in diagnostic procedures and in distal ones. This work also studied the statistical relation between the use of ceiling-suspended shields or leaded gloves and the extremity dose. From the set of collected and analyzed data, a finger dose classification was proposed for different criteria: procedure type (diagnostics/therapeutic), proximity (close/distal), procedure class and access route.
    Radioprotection 01/2014; eFirst(1):1-9. DOI:10.1051/radiopro/2013087 · 0.54 Impact Factor
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    ABSTRACT: Monte Carlo simulations were used to assess secondary neutron doses received by patients treated with proton therapy for ocular melanoma and craniopharyngioma. MCNPX calculations of out-of-field doses were done for ∼20 different organs considering realistic treatment plans and using computational phantoms representative of an adult male individual. Simulations showed higher secondary neutron doses for intracranial treatments, ∼14 mGy to the salivary glands, when compared with ocular treatments, ∼0.6 mGy to the non-treated eye. This secondary dose increase is mainly due to the higher proton beam energy (178 vs. 75 MeV) as well as to the impact of the different beam parameters (modulation, collimation, field size etc.). Moreover, when compared with published data, the assessed secondary neutron doses showed similar trends, but sometimes with sensitive differences. This confirms secondary neutrons to be directly dependent on beam energy, modulation technique, treatment configuration and methodology.
    Radiation Protection Dosimetry 11/2013; 161(1-4). DOI:10.1093/rpd/nct283 · 0.91 Impact Factor
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    ABSTRACT: This paper presents the dosimetry part of the European ELDO project, funded by the DoReMi Network of Excellence, in which a method was developed to estimate cumulative eye lens doses for past practices based on personal dose equivalent values, Hp(10), measured above the lead apron at several positions at the collar, chest and waist levels. Measurement campaigns on anthropomorphic phantoms were carried out in typical interventional settings considering different tube projections and configurations, beam energies and filtration, operator positions and access routes and using both mono-tube and biplane X-ray systems. Measurements showed that eye lens dose correlates best with Hp(10) measured on the left side of the phantom at the level of the collar, although this correlation implicates high spreads (41 %). Nonetheless, for retrospective dose assessment, Hp(10) records are often the only option for eye dose estimates and the typically used chest left whole-body dose measurement remains useful.
    Radiation Protection Dosimetry 07/2013; 157(4). DOI:10.1093/rpd/nct180 · 0.91 Impact Factor
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    ABSTRACT: A radiation transport code based on a Monte Carlo tool is used to simulate a proton therapy beamline designed to treat paediatric patients with intracranial tumours. The treatments are performed using the IBA gantry at the Proton Therapy Centre of the Institut Curie. The treatment is undertaken at 178.16 MeV using the double scattering technique. The aim of this study is to present the Monte Carlo model of the transported proton beam, beamline and treatment room, as well as the experimental validation of the proton dose distributions calculated by this model. The beamline components and the treatment room are accurately modelled using the Monte Carlo code MCNPX. The proton source at the beamline entrance is defined on the basis of IBA data, measurements and calculations. Measured and calculated relative proton dose distributions in a water phantom are compared for the validation. Depth dose profiles, including pristine Bragg peaks and a spread out Bragg peak, and lateral dose profiles are studied. A general good agreement was found between calculated and measured distributions with discrepancies of less than 2 mm. Relative proton dose distributions are therefore considered to be correctly described by our simulated geometry and proton source parameters. The Monte Carlo simulation will be used subsequently for radiation protection purposes: calculation of secondary neutron doses received by treated patients of different ages.
    Radioprotection 07/2013; 48(3):317-339. DOI:10.1051/radiopro/2012054 · 0.54 Impact Factor
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    ABSTRACT: Radiation dose to the eye lens is a crucial issue for interventional cardiologists (ICs) who are exposed during the procedures they perform. This paper presents a retrospective assessment of the cumulative eye lens doses of ICs enrolled in the O'CLOC study for Occupational Cataracts and Lens Opacities in interventional Cardiology. Information on the workload in the catheterisation laboratory, radiation protection equipment, eye lens dose per procedure and dose reduction factors associated with eye-protective equipment were considered. For the 129 ICs at an average age of 51 who had worked for an average period of 22 years, the estimated cumulative eye lens dose ranged from 25 mSv to more than 1600 mSv; the mean±SD was 423±359 mSv. After several years of practice, without eye protection, ICs may exceed the new ICRP lifetime eye dose threshold of 500 mSv and be at high risk of developing early radiation-induced cataracts. Radiation protection equipment can reduce these doses and should be used routinely.
    Radiation Protection Dosimetry 07/2012; 153(3). DOI:10.1093/rpd/ncs116 · 0.91 Impact Factor

  • Physica Medica 06/2012; 28:S8. DOI:10.1016/j.ejmp.2012.08.032 · 2.40 Impact Factor

  • Archives des Maladies Professionnelles et de l Environnement 06/2012; 73(3):551-552. DOI:10.1016/j.admp.2012.03.333 · 0.09 Impact Factor
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    ABSTRACT: This article expresses the current view of the European Society of Gastrointestinal Endoscopy (ESGE) about radiation protection for endoscopic procedures, in particular endoscopic retrograde cholangiopancreatography (ERCP). Particular cases, including pregnant women and pediatric patients, are also discussed. This Guideline was developed by a group of endoscopists and medical physicists to ensure that all aspects of radiation protection are adequately dealt with. A two-page executive summary of evidence statements and recommendations is provided. The target readership for this Guideline mostly includes endoscopists, anesthesiologists, and endoscopy assistants who may be exposed to X-rays during endoscopic procedures.
    Endoscopy 04/2012; 44(4):408-21. DOI:10.1055/s-0031-1291791 · 5.05 Impact Factor
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    ABSTRACT: Depth–dose curves in LiF detectors of different effective thicknesses, together with their responses, were calculated for typical nuclear medicine radiation fields with 99mTc, 18F and 90Y sources. Responses were analysed in function of the radionuclide, detector effective thickness and irradiation geometry. On the other hand the results of the nuclear medicine measurement campaign of the ORAMED project were presented focussing on the dose distribution across the hand and on the appropriate position to wear the dosimeter.According to the results, thin LiF detectors provide better responses in all cases. Its use is essential for 18F, since thick dosimeters can underestimate Hp(0.07) up to a 50% because of the very inhomogeneous dose deposition on the active layer. The preliminary results of the measurement campaign showed that the index tip of the non-dominant hand is usually the most exposed position among the 22 monitored positions. It was also found that, in average, wrist dosimeters are likely to underestimate the maximum skin dose by a factor of the order of 20. This factor is reduced to around 6 for a ring dosimeter worn on the base of the index of the non-dominant hand. Thus, for typical nuclear medicine procedures, the base of the index of the non-dominant hand is recommended as the best monitoring option.
    Radiation Measurements 12/2011; 46(12). DOI:10.1016/j.radmeas.2011.06.047 · 1.21 Impact Factor
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    ABSTRACT: The main aim of the Work Package 1 (WP1) of the ORAMED project, Collaborative Project (2008–2011), supported by the European Commission within its 7th Framework Programme, was to obtain a set of standardized data on extremity and eye lens doses for staff in interventional radiology and cardiology (IR/IC) workplaces and to recommend a series of guidelines on radiation protection in order to both guarantee and optimize staff protection. Within the project, coordinated measurements were performed in 34 hospitals in 6 European countries. Furthermore, simulations of the most representative workplaces in IR and IC were performed to determine the main parameters that influence the extremity and eye lens doses. The work presented in this paper shows the recommendations that were formulated by the results obtained from both measurements and simulations. The presented guidelines are directed to operators, assistant personnel, radiation protection officers and medical physics experts. They concern radiation protection issues, such as the use of room protective equipment, as well as the positioning of the extremity and eye lens dosemeters for routine monitoring.
    Radiation Measurements 11/2011; 46(11):1324-1329. DOI:10.1016/j.radmeas.2011.05.027 · 1.21 Impact Factor
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    ABSTRACT: Within the ORAMED project a coordinated measurement program for occupationally exposed medical staff was performed in different hospitals in Europe. The main objectives of ORAMED were to obtain a set of standardized data on doses for staff in interventional cardiology and radiology and to optimize staff protection. Doses were measured with thermoluminescent dosemeters on the ring finger and wrist of both hands, on legs and at the level of the eyes of the main operator performing interventional procedures. In this paper an overview of the doses per procedure measured during 646 interventional cardiology procedures is given for cardiac angiographies and angioplasties (CA/PTCA), radiofrequency ablations (RFA) and pacemaker and defibrillator implantations (PM/ICD). 31% of the monitored procedures were associated with no collective protective equipment, whereas 44% involved a ceiling screen and a table curtain. Although associated with the smallest air kerma – area product (KAP), PM/ICD procedures led to the highest doses. As expected, KAP and doses values exhibited a very large variability. The left side of the operator, most frequently the closest to the X-ray scattering region, was more exposed than his right side. An analysis of the effect of parameters influencing the doses, namely collective protective equipment, X-ray tube configuration and catheter access route, was performed on the doses normalized to KAP. Ceiling screen and table curtain were observed to reduce normalized doses by atmost a factor 4, much smaller than theoretical attenuation factors typical for such protections, i.e. from 10 to 100. This observation was understood as their inappropriate use by the operators and their non-optimized design. Configurations with tube above the patient led to higher normalized doses to the operator than tube below, but the effect of using a biplane X-ray suite was more complex to analyze. For CA/PTCA procedures, the upper part of the operator’s body received higher normalized doses for radial than for femoral catheter access, by atmost a factor 5. This could be seen for cases with no collective protection. The eyes were observed to receive the maximum fraction of the annual dose limit almost as frequently as legs and hands, and clearly the most frequently, if the former 150 mSv and new 20 mSv recommended limits for the lens of the eye are considered, respectively.
    Radiation Measurements 11/2011; 46(11):1203-1209. DOI:10.1016/j.radmeas.2011.06.034 · 1.21 Impact Factor
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    ABSTRACT: 90Y-labelled radiopharmaceuticals offer promising prospects for radionuclide therapies of tumours, e.g. radioimmunotherapies (RIT), (EANM, 2007), peptide receptor radiotherapies (PRRT), (Otte et al., 1998), and selective internal radiotherapies (SIRT), (Salem and Thurston, 2006). 90Y, an almost pure high-energy beta radiation emitter (Eβ,max = 2.28 MeV), is a favourable radionuclide for therapeutic purposes. However, when preparing and performing these therapies, high activities of 90Y (>1 GBq) are to be manipulated and technicians, physicians and nurses may receive high skin exposures to the hands. If radiation protection standards are low, the exposure of staff can exceed the annual skin dose limit of 500 mSv. Within a particular work package (WP4) of the ORAMED project, comprehensive measurements in nuclear medicine departments of several hospitals in 6 European countries were carried out. The study focussed on 90Y-labelled substances such as Zevalin® and DOTATOC to achieve a representative database on staff exposure. This paper summarises the most important results and conclusions for individual monitoring of skin exposure of staff.
    Radiation Measurements 11/2011; 46(11):1283-1286. DOI:10.1016/j.radmeas.2011.05.068 · 1.21 Impact Factor
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    ABSTRACT: The introduction of interventional radiology (IR) procedures in the 20th century has demonstrated significant advantages over surgery procedures. As a result, their number is continuously rising in diagnostic, as well as, in therapy field and is connected with progress in highly sophisticated equipment used for these purposes. Nowadays, in the European countries more than 400 fluoroscopically guided IR procedures were identified with a 10–12% increase in the number of IR examinations every year (UNSCEAR, 2010). Depending on the complexity of the different types of the interventions large differences in the radiation doses of the staff are observed.The staff that carries out IR procedures is likely to receive relatively high radiation doses, because IR procedures require the operator to remain close to the patient and close to the primary radiation beam. In spite of the fact that the operator is shielded by protective apron, the hands, eyes and legs remain practically unshielded. For this reason, one of the aims of the ORAMED project was to provide a set of standardized data on extremity doses for the personnel that are involved in IR procedures and to optimize their protection by evaluating the various factors that affect the doses. In the framework of work package 1 of the ORAMED project the impact of protective equipment, tube configuration and access routes were analyzed for the selected IR procedures. The position of maximum dose measured is also investigated. The results of the extremity doses in IR workplaces are presented in this study together with the influence of the above mentioned parameters on the doses.
    Radiation Measurements 11/2011; 46(11):1210-1215. DOI:10.1016/j.radmeas.2011.07.038 · 1.21 Impact Factor

Publication Stats

754 Citations
123.24 Total Impact Points


  • 2005-2014
    • Institut de Radioprotection et de Sûreté Nucléaire (IRSN)
      • LEPID - Laboratory of Epidemiology
      Fontenay, Île-de-France, France
    • DSM Biomedical
      Exton, Pennsylvania, United States
  • 2007
    • University Joseph Fourier - Grenoble 1
      Grenoble, Rhône-Alpes, France
  • 1999-2005
    • University of Birmingham
      • School of Physics and Astronomy
      Birmingham, ENG, United Kingdom