Evaluation of patient doses and lens radiation doses to interventional cardiologists in a nationwide survey in Chile

Abstract

The objective of this study was to perform a nationwide survey in Chile to determine dose levels to patients and staff in four risk scenarios during cardiac catheterisation procedures. Different phantom thicknesses of polymethyl methacrylate (PMMA) were used to simulate adult patients. Scenario 1: 10-min fluoroscopy and 800 cine frames for 20 cm of PMMA; Scenario 2: 10-min fluoroscopy and 800 cine frames for 28 cm of PMMA; Scenario 3: 30-min fluoroscopy and 2400 cine frames for 20 cm of PMMA; Scenario 4: 30-min fluoroscopy and 2400 cine frames for 28 cm of PMMA. The average values regarding dose-area product and scattered doses at the cardiologist eye lens achieved for the four scenarios were 94, 249, 281, 747 Gy cm(2) and 0.3, 0.8, 0.9 and 2.5 mSv, respectively. Large variations in radiation doses received by both patients and staff for the same type of procedure suggest that optimising procedure protocols and using the most effective types of protective devices may substantially reduce the dose values found here.

Occupational Exposure of the Eye Lens in Interventional Procedures: How to Assess and Manage Radiation Dose

“…Unprotected eye lens dose values vary up to 250-fold for different fluoroscopic views [43] and reported eye lens dose values per procedure range from less than 0.1 to 1100 µSv [44]. Multiple acquisition modes are used in clinical conditions [45,46] in which dose rate at the level of operator's eye ranges from 1-22 mSv/h (fluoroscopy) to 12-235 mSv/h (DSA-digital subtraction angiography). Eye lens doses for seven interventional radiology systems were measured using phantoms simulating patients 16-28 cm in thickness undergoing low-, medium and high-mode fluoroscopy, cine cardiac imaging and DSA [47].…”

First results of an eye lens dosimetry survey in an interventional cardiology department

“…Those data are similar to the lower boundary of our evaluations. On the other side, Kim et al [21] reported values ranging from 0.17 and 0.44 mSv and Ubeda et al [22] in a case of no operator shielding, estimated eye lens doses of the order of 0.3 ÷ 2.5 mSv per procedure. Therefore the published data confirm, at least as a first guess, the reliability of the range of doses calculated in this study.…”

Medical staff dose estimation during pediatric cardiac interventional procedures

“…On the other hand, several papers [18][19][20][21] reporting scattered doses or dose rates at the eyes of the staff by measurements performed using defined technique factors and phantoms to simulate the patient. Nevertheless, studies on real medical personnel who perform paediatric cardiological interventional procedures are scarce [18][19][20][21].…”

“…On the other hand, several papers [18][19][20][21] reporting scattered doses or dose rates at the eyes of the staff by measurements performed using defined technique factors and phantoms to simulate the patient. Nevertheless, studies on real medical personnel who perform paediatric cardiological interventional procedures are scarce [18][19][20][21]. Therefore, due to a paucity of literature addressing occupational exposures associated with paediatric cardiac interventional procedures, the aim of this study was to evaluate the occupational doses (eye lens, extremity, and whole body) in paediatric cardiac interventional and diagnostic catheterization procedures performed in a paediatric reference hospital.…”