student profile: Mr Don Nocum


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Thesis work

Thesis title: Minimising radiation exposure to female patients undergoing uterine artery embolisation in the angiography suite

Supervisors: John ROBINSON , Michelle MOSCOVA, Warren REED , Nadine THOMPSON

Thesis abstract:

�p�«p»«p»The objective of this thesis is to investigate the predictors of radiation effective dose in digital subtraction angiography (DSA) which are contributing to patient radiation dose exposure during uterine artery embolisation (UAE). This interventional procedure is a less invasive and non-surgical alternative to hysterectomy or myomectomy, for the treatment of symptomatic fibroids and/or adenomyosis. The problem statement relies on understanding what factors contribute to the total radiation effective dose exposure to the patient. In order to comply with these objectives, research was performed on the multiple variables that may contribute to radiation dose during UAE, including: patient demographic factors, angiography machine parameters and exposures, and embolisation end-points.«/p» «p» «/p» «p»Since interventional angiography uses ionising radiation with relatively high doses compared to other x-ray imaging modalities, the attention to dose and exposures are of clinical importance to UAE procedures as the presenting patients are usually of child-bearing age. This study will aim to identify the dose predictors such that dose optimisation and dose reduction techniques can be implemented in the future, particularly for the controllable variables. Application of the ALARA principle (“as low as reasonably achievable”) in practice during UAEs can reduce the potential deterministic and stochastic risks to the patient.«/p» «p» «/p» «p»The single-radiologist in this single-centre hospital setting performs the most UAE procedures in New South Wales, Australia. With a ≥90% success rate on the treatment of uterine fibroids and/or adenomyosis and <5% recurrence rate, there is substantial evidence to support the clinical viability of UAE over hysterectomy or myomectomy. This study exists to provide foundation data on the radiation doses attributed by UAE for the patients being treated. The results can be compared to the UAE radiation doses observed and measured in previous literature from Europe, Asia and the United States. Minimising the total radiation effective dose will compliment the treatment of the presenting uterine pathology, and thus addresses a holistic approach to the care of the patient.«/p» «p» «/p» «p»The thesis is structured in five main chapters: (1) Introduction, referring to the aim, scope and methodology; (2) Literature Review, addressing the academic background for the radiation dose attributed by UAE; (3) Materials and Methods, used to perform a prospective study on radiation dose on UAE patients in a single-centre interventional catheter lab; (4) Results found on the statistical analysis of data collected from the UAE patients and procedures; and (5) Conclusions, Limitations and Future Research, discussing the significance of dose optimisation and dose reduction to minimise the radiation effective dose of patients undergoing UAE.«/p»«/p»�/p�

Selected publications

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Journals

  • Reed, W., Nocum, D., Huang, R., Brennan, P. (2014). Naive observer performance and prevalence expectations. Radiography, 20(2), 174-174. [More Information]
  • Nocum, D., Brennan, P., Huang, R., Reed, W. (2013). The effect of abnormality-prevalence expectation on naive observer performance and visual search. Radiography, 19(3), 196-199. [More Information]

2014

  • Reed, W., Nocum, D., Huang, R., Brennan, P. (2014). Naive observer performance and prevalence expectations. Radiography, 20(2), 174-174. [More Information]

2013

  • Nocum, D., Brennan, P., Huang, R., Reed, W. (2013). The effect of abnormality-prevalence expectation on naive observer performance and visual search. Radiography, 19(3), 196-199. [More Information]

Note: This profile is for a student at the University of Sydney. Views presented here are not necessarily those of the University.