Scatter radiation dose at the height of the operator's eye in interventional cardiology

Leyton, Fernando; Nogueira, Maria do Socorro; Saad, Jamil Abdalla; Santos, Jorge A. dos; Vañó, Eliseo; Oliveira, Marina Amaral de; Ubeda, Carlos

doi:10.1016/j.radmeas.2014.07.015

Cited by 12 publications

(6 citation statements)

References 26 publications

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“…It is noted however that moving the C arm would have an impact on the results. 17,33 This study supports further research for glasses use and testing within the clinical setting. Further research is recommended into how changing the C arm angle affects dose rate to the clinician's eye lenses.…”

Section: Discussionsupporting

confidence: 73%

“…Further research is recommended into how changing the C arm angle affects dose rate to the clinician's eye lenses. Additionally, the distance between the patient table and operators eyes 20,33 , the size of the irradiated volume 34 along with the exposure parameters 34,35 can affect the dose to the operator and these have remained constant in this study. Future work could also include the testing of lead line smart glasses within an actual interventional procedure, to establish the impact of clinician's gaze.…”

Section: Discussionmentioning

confidence: 99%

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Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

et al. 2019

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Introduction: Smart glasses can be adapted to display radiographic images to allow clinician's gaze not to be directionally fixed or predetermined by computer monitor location. This study presents an analysis of eye lens dose during interventional fluoroscopy guided procedures, comparing fixed monitor positions against the use of smart glasses.Methods: Using a head phantom (simulating the clinician), thermoluminescent dosimeters and lead shielded glasses, the dose to the eye was measured for different head 'rotations and tilts' for: gaze directed towards the main scattering source (patient / primary beam) to represent potential gaze direction if smart glasses are used; gaze directed to a range of potential computer monitor positions. An anthropomorphic pelvis phantom was utilised to simulate the patient. Accumulated dose rates (µGy.sˉ¹) from five 10-second exposures at 75 kV 25.2 mAs were recorded.Results: An average DAP reading of 758.84 cGy.cm 2 was measured during each 10 second exposure. Whilst wearing lead shielded glasses a 6.10fold reduction in dose rate to the lens is possible (p<0.05). Influence of the direction of gaze by the clinician demonstrated a wide range of dose rate reduction from 3.13% (p=0.16) to 143.69% (p<0.05) when the clinician's gaze was towards the main scattering source. Increased dose rate to the clinician's eyes was received despite wearing lead shielded glasses, as the angle of gaze moved 45º and 90º from 0º.Conclusion: If the clinician's gaze is directed towards the main scattering source a potential exists for reducing eye lens dose compared with fixed location computer monitors. Introduction of lead lined smart glasses into interventional radiology may lead to improvements in patient care, reducing the need for the clinician to look away from the patient to observe a radiographic image.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

et al. 2019

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“…The increasing complexity of interventional cardiology procedures, however, require longer fluoroscopic duration, leading to increased exposure time to ionizing radiation for the patient, and also for the medical staff since they need to remain close to the patient throughout the procedure. The scattered radiation from the patient and from elements of the X-ray equipment is the main sources of exposure to the medical staff that received via unshielded parts of their bodies [5].…”

Section: Introduction mentioning

confidence: 99%

Occupational and Patient Doses in Interventional Cardiology in Indonesia: A Preliminary Result

Hiswara

Sofyan

et al. 2019

Atom Indo.

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Interventional cardiology is a branch of cardiology that manages the catheter based treatment of structural heart illnesses. These minimally invasive procedures involve inserting catheters and other devices through superficial arterial and venous access sites. Due to increased reliability and advancing technology, the number and complexity of interventional cardiology procedures haves increased in recent years. The increasing complexity of the procedures, however, require longer fluoroscopic duration, leading to increased exposure time to ionizing radiation for the patient and also for the medical staff since they need to remain close to the patient throughout the procedure. This study attempts to investigate the occupational and patient doses during the course of several interventional cardiology procedures in Indonesia, i.e. CA, PCI, cathscan, PA, PTCA, TACE, PAC and peripheral vascular. Occupational doses were measured by using individually packed three chips of TLD-100 placed in over-and under-thyroid shield used by medical staff, over-and under-apron in waist position, inside a special 'eye-D' holder, and inside a ring holder, while patient doses were estimated by using individually packed three TLD-100 chips attached in the x-ray tube. All TLDs were calibrated in the Secondary Standard Dosimetry Laboratory (SSDL) Jakarta. The study was performed in three big hospitals in the cities of Jakarta, Yogyakarta and Semarang. The results show that PCI procedure was the most performed one during the course of this study and gave the highest radiation doses to the staff for all type of doses calculated and measured. The maximum effective doses, eye lens doses, extremity doses, thyroid doses and gonad/ovary doses were 0.098 mSv, 0.1967 mSv, 0.7604 mSv, 0.1760 mSv and 0.0990 mSv, respectively. In the case of patient doses, the mean value of DAP for PTCA procedure of 776.76 Gy cm 2 was the highest compared with those for other procedures. The results of measurement for occupational doses were in general similar to those reported by other authors, but not for patient doses that was found to be 4-5 times higher. Due to the involving of various parameters during the course of interventional cardiology procedures, it was difficult to establish a correlation between the doses received by medical staff and by the patients.

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“…Other European centres have aimed to establish links between eye doses and patient exposure levels (Antic et al 2013, Ciraj-Bjelac et al 2016. Extensive studies of exposure of interventional staff have also been undertaken in the Far East (Yokoyama et al 2017a, 2017b, 2019, Suzuki et al 2018, Kato et al 2019, South America (Leyton et al 2014, Khoury et al 2015 and Australasia (Mclean et al 2016), including comparisons between results from dosemeters worn at the collar and adjacent to the eye (Haga et al 2017). Studies in nuclear medicine have demonstrated that body dosemeters give an indication of eye dose, but there may be some underestimation (Kubo and Mauricio 2014).…”

Section: Q2mentioning

confidence: 99%

Report of IRPA task group on issues and actions taken in response to the change in eye lens dose limit

et al. 2020

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In 2018, the International Radiation Protection Association (IRPA) established its third task group (TG) on the implementation of the eye lens dose limit. To contribute to sharing experience and raising awareness within the radiation protection community about protection of workers in exposure of the lens of the eye, the TG conducted a questionnaire survey and analysed the responses. This paper provides an overview of the results of the questionnaire.

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Scatter radiation dose at the height of the operator's eye in interventional cardiology

Cited by 12 publications

References 26 publications

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

Occupational and Patient Doses in Interventional Cardiology in Indonesia: A Preliminary Result

Report of IRPA task group on issues and actions taken in response to the change in eye lens dose limit

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