Interventional radiology and cardiology are widespread employed techniques for diagnosis and treatment of several pathologies because they avoid the majority of the side-effects associated with surgical treatments, but are known to increase the radiation exposure to patient and operators. In recent years many studies treated the exposure of the operators performing cardiological procedures. The aim of this work is to study the exposure condition of the medical staff in some selected interventional radiology procedures. The Monte Carlo simulations have been employed with anthropomorphic mathematical phantoms reproducing the irradiation scenario of the medical staff with two operators and the patient. A personal dosemeter, put on apron, was modelled for comparison with measurements performed in hospitals, done with electronic dosemeters, in a reduced number of interventional radiology practices. Within the limits associated to the use of numerical anthropomorphic models to mimic a complex interventional procedure, the personal dose equivalent, Hp(10), was evaluated and normalised to the simulated Kerma-Area Product, KAP, value, indeed the effective dose has been calculated. The Hp(10)/KAPvalue of the first operator is about 10 μSv/Gy.cm2, when ceiling shielding is not used. This value is calculated on the trunk and it varies of +/−30% moving the dosemeter to the waist or to the neck. The effective dose, normalised to the KAP value, varies between 0.03 and 0.4 μSv/Gy.cm2. Considering all the unavoidable approximation of this kind of investigations, the comparisons with hospital measurement and literature data showed a good agreement allowing to use of the present results for dosimetric characterisation of interventional radiology procedures.
Interventional radiology and cardiology guarantee high benefits for patients, but are known to be associated with a high level of radiation exposure of medical staff. The recently suggested decrease of the annual dose limit for the eye lens, from 150 to 20 mSv, caused a need for a reconsideration of practices ensuring sufficient protection for the lens of the eyes of medical staff. In such context the study of the scattered radiation around the operator's head could help in finding the best solutions to be adopted for the ceiling-suspended shield and lead glasses in the most common situations in interventional practices. MCNPX Monte Carlo code was employed with anthropomorphic mathematical phantoms to simulate interventional practice projections. For each projection the effect of changing selected parameters on the evaluated scattered radiation towards the operator's head has been calculated. The variety of modelled situations provides plentiful material regarding the spatial distribution of the scattered radiation, useful to improve eye lens radiation protection, such as the following: (a) Glasses, which provide shielding from both lateral and bottom-up scattered radiation, can reduce by ten times the exposure to the most exposed eyes; (b) The ceiling-suspended shield offers valuable protection, but such effectiveness can diminish by 90% if the shielding is not correctly positioned; (c) The transition from femoral to radial access usually intensifies the scattered radiation toward the operator head (a factor of 1.5 for AP projection), but for RAO projections, a reduction of the order by two to three times, in the case of radial access, can be seen, due to the protection provided by the image receptor. The detailed fluence outcomes show that there is a preferential direction of the impinging scattered radiation that should be considered when radiation protection options are evaluated or when a dedicated eye lens dosemeter is used for monitoring.
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