Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values

Abstract

The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm(2); personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures.

Taller staff occupationally exposed to less radiation to the temple in cardiac procedures, but risk higher doses during vascular cases

“…In contrast, the heads of taller scrub nurses may extend above the lead glass, especially when the doctor may position it lower, allowing for scattered radiation to project above the shield and impinge on the cranium of the scrub nurse. It has been demonstrated that doses during endovascular procedures may be higher than that of coronary 32,33 and this may explain why there is a marked difference between both the height-dose relationship when comparing coronary procedures to vascular (Fig. 4), but again fails to account for the positive height-dose relationship for scrub and scout nurses during procedures imaging the chest, which largely constitutes cardiac procedures.…”

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 …”

“…Many other published studies were also consulted to estimate one or more of P KA , E, and DC E . 7,11,12,14,15,[17][18][19]21,[24][25][26][27][29][30][31][32][33][34][35][36][37][38][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] Published values of P KA are included in Table I. Table II provides data for E and Table III provides data for DC E .…”

Assessment of eye doses to staff involved in interventional cardiology procedures in Kuwait

“…For example, it has been shown that typically 1 Gy • cm 2 of KAP to the patient results in an estimated average dose to the lens of the eye of 10 μSv due to scatter dose at a C-arm (Leyton et al 2016). By applying radiation protection measures, the eye dose due to scattered radiation can be reduced by up to 6%, at a C-arm (Vano et al 2016). Variations in fluoroscopy time and KAP were observed (Table 2), which were probably due to the complexity of the procedure and the experience of the cardiologist, because similar systems were used for all measurements.…”

“…The key components of the implemented training actions were radiation protection, optimizing of work practice, eye lens doses monitoring and reduction. Training in radiation protection is the most desirable and successful action to reduce occupational doses (Vano et al 2016). Additionally, for clinicians who were not interested in any technical details a simplified version of the training material was developed as a mobile app that provides a higher level of outreach than more detailed training material.…”