A Study of Radiation Doses to the Patient and Medical Team at Embolization Procedures

Abstract

Background: This study aimed to estimate occupational doses and patient peak skin doses (PSDs) during interventional radiology procedures. Materials and Methods: We examined data from brain embolization (n = 30), hepatic chemoembolization (n = 50), and uterine embolization (n = 12). The PSDs were measured using radiochromic film around the patient' s head (group 1) or abdominal/pelvic region (group 2). Acquisition technical data and kerma-area products (KAP) were also recorded. Occupational doses were measured using Instadose TM dosimeters near the left eye region (LER), chest, and left ankle. Results and Discussion: The third quartile (median) KAP values were 408.1 (235.3) Gy• cm 2 for group 1 and 584.4 (449.4) Gy• cm 2 for group 2. The average PSDs were greatest during vascular procedures, reaching 1,004.4 (786.4) mGy, and the highest PSD was 2,352.6 mGy (during hepatic chemoembolization). The third quartile (median) occupational doses were 0.35 (0.21) mSv at the LER, 0.25 (0.15) mSv at the chest, and 1.47 (0.64) mSv at the left ankle. Occupational doses at the LER were higher than at the chest, which highlights the importance of protective glasses and suspended shields. The occupational doses at the ankle region were also high, which highlights the importance of using a lead-lined curtain attached to the table. Conclusion: The results indicate that physicians can reach, for eye region, the weekly occupational dose limit after around 15 procedures, even when using proper protection. The average PSD values were below the threshold for tissue reactions, although the complexity of these procedures emphasises the importance of considering related risks.

Radiation Exposure during Prostatic Artery Embolization: A Single Institution Review

“…The International Commission on Radiological Protection (ICRP) classifies radiation effects as deterministic effects (tissue reactions) affected by radiation doses and assessed by air kerma values (Castilho et al 2019; Harrison et al 2021) and stochastic effects (cancers and inheritable diseases) (Harrison et al 2021). Air kerma can be used to estimate radiation dose at the patient’s skin, predicting the risk of radiation dermatitis, the most common deterministic effect from fluoroscopically guided interventions (FGIs) (Panick et al 2018).…”

“…Several studies reporting a significant increase in radiation-associated cataracts among interventional physicians have been published, leading the ICRP to recommend an annual limit for the equivalent dose for lenses of eyes to 20 mSv averaged over 5 y with a dose in any year not exceeding 50 mSv (Andrade et al 2017; Harrison et al 2021). Healthcare professionals can receive an annual effective dose of 20 mSv, and physicians can reach the weekly dose limit for the eye region after 15 procedures, regardless of proper protection (Castilho et al 2019).…”

“…A major concern for health team members is the deterministic effects of radiation on the eye. Fluoroscopy-guided interventional procedures are associated with eye lens damage (Castilho et al 2019). Several studies reporting a significant increase in radiation-associated cataracts among interventional physicians have been published, leading the ICRP to recommend an annual limit for the equivalent dose for lenses of eyes to 20 mSv averaged over 5 y with a dose in any year not exceeding 50 mSv (Andrade et al 2017; Harrison et al 2021).…”

“…Other examples of tissue reactions include posterior cataract development of the lens of the eye, cardiovascular disease, and cerebrovascular diseases (Harrison et al 2021). In addition, the International Atomic Energy Agency (IAEA) recommends that the patient's peak skin dose (PSD) should be kept below 2 Gy in order to avoid tissue reactions that include alopecia, erythema, and necrosis (Castilho et al 2019). This study's fluoroscopy time and air kerma were compared to published values (Table 3).…”