Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring

Abstract

PurposeRadiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions.Materials and MethodsMedical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs). Procedure dose data including the dose area product and effective doses from PDMs were prospectively monitored for each consecutive procedure over an 8-month period (n = 1082). A personalized feedback form was designed displaying for each staff individually the personal dose per procedure, as well as relative and cumulative doses. This study consisted of two phases: (1) 1–5th months: Staff did not receive feedback (n = 701) and (2) 6–8th months: Staff received weekly individual dose feedback (n = 381). An anonymous evaluation was performed on the feedback and occupational dose.ResultsPersonalized feedback was scored valuable by 76% of the staff and increased radiation dose awareness for 71%. 57 and 52% reported an increased feeling of occupational safety and changing their behavior because of personalized feedback, respectively. For technicians, the normalized dose was significantly lower in the feedback phase compared to the prefeedback phase: [median (IQR) normalized dose (phase 1) 0.12 (0.04–0.50) µSv/Gy cm2 versus (phase 2) 0.08 (0.02–0.24) µSv/Gy cm2, p = 0.002].ConclusionPersonalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions.

Procedure and step-based analysis of the occupational radiation dose during endovascular aneurysm repair in the hybrid operating room

“…Personalized dose feedback has been shown to be an effective method to reduce staff exposure dose. 13 The DoseAware PDM badges have an accuracy of <0.001 mSv. During the stepwise analysis, most steps corresponded to a cumulative dose <0.001 for supporting staff members.…”

Personal Radiation Protection and Corresponding Dosimetry in Interventional Radiology: An Overview and Future Developments

“…The advantage of this system is that every person in the examination room is measured in real time and immediate action can be take in the case of increased radiation exposure [57,58]. Sailer et al were able to show in a current study that this not only increases the feeling of safety of medical personnel but also results in a significant reduction in the personal dose for technical personnel (from 0.12 µSv/ Gy cm 2 to 0.08 µSv/Gy cm 2 ) [59].…”

Performance indicators for radiation protection management: suggestions from the European Society of Radiology

“…Individualised observation and documentation of workflows are therefore useful in order to promptly recognise any influences on the individual radiation exposure of equipment users. This can be done, for example, by real-time measuring systems, thus enabling personalised feedback [ 22 ].…”