Radiation exposure to patients and radiologists during interventional procedures

Abstract

Patients who undergo interventional radiological examinations and the medical doctors who perform them receive a noticeable radiation dose. Twenty-six angiographies and six angioplasties were included in the present study. They were classified as examinations of lower limbs, abdominal aorta and aortic arch/carotid artery. Thermoluminescent dosemeters (TLDs) were placed underneath and over the lead apron of the doctors at all of the 32 examinations as well as next to the eyes and over the thyroid of 22 patients. Dose area product (DAP) values, time duration and other parameters were registered. Patients' effective dose (ED) and doses to the various organs were calculated with the aid of ODS-60 software. The EDs were normalised to DAP measured in each procedure. Based on TLD measurements, the Niklason method was applied for the calculation of doctors' ED. The calculated ED by ODS-60 were in the range of 0.00-1.46, 2.63-49.32 and 0.07-45.12 mSv for the three groups, respectively, while E/DAP indices were 0.023, 0.310 and 0.105 mSv Gy(-1) cm(-2). Very good correlation was found between TLD measurements of the eye and the thyroid of the patients and the relative values calculated by ODS-60. The ED for the radiologists ranged from 0.4 to 47.0 μSv for all the procedures. Taking into consideration the annual number of examinations performed in the department, the estimated dose to the radiologists' eyes is considerably high, so wearing leaded glasses is recommended for the optimisation of the procedure.

Review of air kerma‐area product, effective dose and dose conversion coefficients for non‐cardiac interventional fluoroscopy procedures

“…Among others, Peruzzo Cornetto et al tabulated data for 23 procedures in an Italian hospital, Compagnone et al published data from a different Italian hospital for nine interventional procedures, Dauer et al published P KA data for 43 interventional fluoroscopy procedures at a single U.S. institution, Bundy et al did the same for 12 procedures at a different U.S. medical center, Erskine et al published P KA data for 32 interventional fluoroscopy procedures in Australia, Étard et al’s report contains data from France for 15 procedures, Pitton et al published data for 17 interventional vascular procedures at a German hospital, Schmitz et al reported data on biliary interventions at 23 different facilities, and Ruiz‐Cruces et al reported data for seven interventional procedures performed at eight hospitals in Spain. Many other published studies were also consulted to estimate one or more of P KA , E , and DC E …”

“…Some of the literature uses very specific categories, based on the specific type and anatomic location of procedures, and sometimes on the indication for the procedure . Other literature uses more general categories . Some of the literature uses both specific and general categories, depending on the procedure .…”

“…E may be calculated for interventional fluoroscopy examinations in different ways . In some publications, E is determined by using the irradiation geometry for the clinical protocol and radiation dose data for clinical procedures as inputs into a Monte Carlo radiation transport simulation that uses computational models of human anatomy . In other publications, the irradiation geometry for the clinical protocol and radiation dose data for clinical procedures are used as parameters for irradiation of physical anthropomorphic phantoms containing dosimeters .…”

Comparison of Five Developed Algorithms to Estimate Staff Effective Dose in Interventional Cardiology: Are They Interchangeable?

“…[16][17][18][19][20][21][22] Collective doses and effective doses received by staff members working in fluoroscopic or interventional cardiology are increasing each year and occupational dosimetry is gaining more importance than before. There are several reasons for this trend.…”

DeGIR-Qualitätsreport 2011 - Bericht über die Behandlungsqualität minimalinvasiver Methoden

“…Sie sollte wie auch die übrigen Röntgenparameter (kV und Dosis pro Bild) dem Problem angepasst werden. Die aus den Datensätzen des DeGIR-QM-Systems ermittelten Dosiswerte und Durchleuchtungszeiten entsprechen sehr gut denen der rezenten Literatur: Molyvda-Athanasopoulou et al [13] geben für die untere Extremität DFP-Werte von 1348 -8276 cG×cm 2 und DL-Zeiten von 10,2 -13,8 min an, wobei einschränkend erwähnt werden muss, dass hier nur 2 Eingriffe aufgeführt sind und somit diese Werte wenig repräsentativ sein dürften. Majewska et al [14] haben dagegen das DFP und die DL-Zeiten bei insgesamt 473 Prozeduren gemessen.…”