Optimizing Staff Dose in Fluoroscopy-Guided Interventions by Comparing Clinical Data with Phantom Experiments |
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Authors: | Anna M. Sailer Leonie Paulis Laura Vergoossen Joachim E. Wildberger Cécile R.L.P.N. Jeukens |
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Affiliation: | 1. Department of Radiology and Nuclear Medicine, School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands;2. Cardiovascular Research Institute Maastricht, School for Cardiovascular Diseases, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands;3. Department of Radiology, Stanford University School of Medicine, Stanford, California |
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Abstract: | PurposeTo evaluate conditions for minimizing staff dose in interventional radiology, and to provide an achievable level for radiation exposure reduction.Materials and MethodsComprehensive phantom experiments were performed in an angiography suite to evaluate the effects of several parameters on operator dose, such as patient body part, radiation shielding, x-ray tube angulation, and acquisition type. Phantom data were compared with operator dose data from clinical procedures (n = 281), which were prospectively acquired with the use of electronic real-time personal dosimeters (PDMs) combined with an automatic dose-tracking system (DoseWise Portal; Philips, Best, The Netherlands). A reference PDM was installed on the C-arm to measure scattered radiation. Operator exposure was calculated relative to this scatter dose.ResultsIn phantom experiments and clinical procedures, median operator dose relative to the dose-area product (DAP) was reduced by 81% and 79% in cerebral procedures and abdominal procedures, respectively. The use of radiation shielding decreased operator exposure up to 97% in phantom experiments; however, operator dose data show that this reduction was not fully achieved in clinical practice. Both phantom experiments and clinical procedures showed that the largest contribution to relative operator dose originated from left-anterior-oblique C-arm angulations (59%–75% of clinical operator exposure). Of the various x-ray acquisition types used, fluoroscopy was the main contributor to procedural DAP (49%) and operator dose in clinical procedures (82%).ConclusionsAchievable levels for radiation exposure reduction were determined and compared with real-life clinical practice. This generated evidence-based advice on the conditions required for optimal radiation safety. |
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Keywords: | DAP dose-area product PDM personal dosimeter |
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