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Published in: CardioVascular and Interventional Radiology 3/2017

Open Access 01-03-2017 | Clinical Investigation

Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice

Authors: Anna M. Sailer, Leonie Paulis, Laura Vergoossen, Axel O. Kovac, Geert Wijnhoven, Geert Willem H. Schurink, Barend Mees, Marco Das, Joachim E. Wildberger, Michiel W. de Haan, Cécile R. L. P. N. Jeukens

Published in: CardioVascular and Interventional Radiology | Issue 3/2017

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Abstract

Purpose

Knowledge of medical radiation exposure permits application of radiation protection principles. In our center, the first dedicated real-time, automated patient and staff dose monitoring system (DoseWise Portal, Philips Healthcare) was installed. Aim of this study was to obtain insight in the procedural and occupational doses.

Materials and Methods

All interventional radiologists, vascular surgeons, and technicians wore personal dose meters (PDMs, DoseAware, Philips Healthcare). The dose monitoring system simultaneously registered for each procedure dose-related data as the dose area product (DAP) and effective staff dose (E) from PDMs. Use and type of shielding were recorded separately. All procedures were analyzed according to procedure type; these included among others cerebral interventions (n = 112), iliac and/or caval venous recanalization procedures (n = 68), endovascular aortic repair procedures (n = 63), biliary duct interventions (n = 58), and percutaneous gastrostomy procedure (n = 28).

Results

Median (±IQR) DAP doses ranged from 2.0 (0.8–3.1) (percutaneous gastrostomy) to 84 (53–147) Gy cm2 (aortic repair procedures). Median (±IQR) first operator doses ranged from 1.6 (1.1–5.0) μSv to 33.4 (12.1–125.0) for these procedures, respectively. The relative exposure, determined as first operator dose normalized to procedural DAP, ranged from 1.9 in biliary interventions to 0.1 μSv/Gy cm2 in cerebral interventions, indicating large variation in staff dose per unit DAP among the procedure types.

Conclusion

Real-time dose monitoring was able to identify the types of interventions with either an absolute or relatively high staff dose, and may allow for specific optimization of radiation protection.
Literature
1.
go back to reference Bartal G, Vano E, Paulo G, Miller DL. Management of patient and staff radiation dose in interventional radiology: current concepts. Cardiovasc Interv Radiol. 2014;37:289–98.CrossRef Bartal G, Vano E, Paulo G, Miller DL. Management of patient and staff radiation dose in interventional radiology: current concepts. Cardiovasc Interv Radiol. 2014;37:289–98.CrossRef
2.
go back to reference Vano E, Fernandez JM, Sanchez R. Occupational dosimetry in real time. Benefits for interventional radiology. Radiat Meas. 2011;46:1262–5.CrossRef Vano E, Fernandez JM, Sanchez R. Occupational dosimetry in real time. Benefits for interventional radiology. Radiat Meas. 2011;46:1262–5.CrossRef
3.
go back to reference Rehani MM, Ciraj-Bjelac O, Vañó E, et al. ICRP publication 117: radiological protection in fluoroscopically guided procedures outside the imaging department. Ann ICRP. 2010;40:1–102.CrossRefPubMed Rehani MM, Ciraj-Bjelac O, Vañó E, et al. ICRP publication 117: radiological protection in fluoroscopically guided procedures outside the imaging department. Ann ICRP. 2010;40:1–102.CrossRefPubMed
4.
go back to reference Maccia C, Malchair F, Gobert I, Louvard Y, Lefevre T. Assessment of local dose reference values for recanalization of chronic total occlusions and other occlusions in a high-volume catheterization center. Am J Cardiol. 2015;116:1179–84.CrossRefPubMed Maccia C, Malchair F, Gobert I, Louvard Y, Lefevre T. Assessment of local dose reference values for recanalization of chronic total occlusions and other occlusions in a high-volume catheterization center. Am J Cardiol. 2015;116:1179–84.CrossRefPubMed
5.
go back to reference Sutton DG, Williams JR. Radiation shielding for diagnostic radiology. London: British Institute of Radiology; 2012. p. 74–7. Sutton DG, Williams JR. Radiation shielding for diagnostic radiology. London: British Institute of Radiology; 2012. p. 74–7.
6.
go back to reference Mahmud E, Reeves R. The evidence supporting radiation safety methods-working towards zero operator exposure. J Imaging Interv Radiol. 2016;2:1–21. Mahmud E, Reeves R. The evidence supporting radiation safety methods-working towards zero operator exposure. J Imaging Interv Radiol. 2016;2:1–21.
7.
go back to reference Sailer AM, Schurink GW, Bol ME, de Haan MW, van Zwam WH, Wildberger JE, Jeukens CR. Occupational radiation exposure during endovascular aortic repair. Cardiovasc Interv Radiol. 2015;38:827–32.CrossRef Sailer AM, Schurink GW, Bol ME, de Haan MW, van Zwam WH, Wildberger JE, Jeukens CR. Occupational radiation exposure during endovascular aortic repair. Cardiovasc Interv Radiol. 2015;38:827–32.CrossRef
8.
go back to reference Ingwersen M, Drabik A, Kulka U, Oestreicher U, Fricke S, Krankenberg H, Schwencke C, Mathey D. Physicians’ radiation exposure in the catheterization lab: does the type of procedure matter? JACC Cardiovasc Interv. 2013;6:1095–102.CrossRefPubMed Ingwersen M, Drabik A, Kulka U, Oestreicher U, Fricke S, Krankenberg H, Schwencke C, Mathey D. Physicians’ radiation exposure in the catheterization lab: does the type of procedure matter? JACC Cardiovasc Interv. 2013;6:1095–102.CrossRefPubMed
9.
go back to reference Sailer AM, Schurink GW, Wildberger JE, de Graaf R, van Zwam WH, de Haan MW, Kemerink GJ, Jeukens CR. Radiation exposure of abdominal cone beam computed tomography. Cardiovasc Interv Radiol. 2015;38:112–20.CrossRef Sailer AM, Schurink GW, Wildberger JE, de Graaf R, van Zwam WH, de Haan MW, Kemerink GJ, Jeukens CR. Radiation exposure of abdominal cone beam computed tomography. Cardiovasc Interv Radiol. 2015;38:112–20.CrossRef
10.
go back to reference Ozpelit ME, Ercan E, Ozpelit E, Pekel N, Tengiz I, Ozyurtlu F, Yilmaz A. Operator dependency of the radiation exposure in cardiac interventions: feasibility of ultra low dose levels. Radiat Prot Dosim. 2016. doi:10.1093/rpd/ncw028. Ozpelit ME, Ercan E, Ozpelit E, Pekel N, Tengiz I, Ozyurtlu F, Yilmaz A. Operator dependency of the radiation exposure in cardiac interventions: feasibility of ultra low dose levels. Radiat Prot Dosim. 2016. doi:10.​1093/​rpd/​ncw028.
11.
go back to reference ICRP Publication 74: conversion coefficients for use in radiological protection against external radiation. Annals of the ICRP, vol 26/3. Oxford: Elsevier; 1997 ICRP Publication 74: conversion coefficients for use in radiological protection against external radiation. Annals of the ICRP, vol 26/3. Oxford: Elsevier; 1997
13.
go back to reference Bartal G, Roguin A, Paulo G. Call for implementing a radiation protection culture in fluoroscopically guided interventional procedures. Am J Roentgenol. 2016;206:1110–1.CrossRef Bartal G, Roguin A, Paulo G. Call for implementing a radiation protection culture in fluoroscopically guided interventional procedures. Am J Roentgenol. 2016;206:1110–1.CrossRef
14.
go back to reference Haqqani OP, Agarwal PK, Halin NM, Iafrati MD. Defining the radiation “scatter cloud” in the interventional suite. J Vasc Surg. 2013;58:1339–45.CrossRefPubMed Haqqani OP, Agarwal PK, Halin NM, Iafrati MD. Defining the radiation “scatter cloud” in the interventional suite. J Vasc Surg. 2013;58:1339–45.CrossRefPubMed
15.
go back to reference Schueler BA, Vrieze TJ, Bjarnason H, Stanson AW. An investigation of operator exposure in interventional radiology. Radiographics. 2006;26:1533–41.CrossRefPubMed Schueler BA, Vrieze TJ, Bjarnason H, Stanson AW. An investigation of operator exposure in interventional radiology. Radiographics. 2006;26:1533–41.CrossRefPubMed
16.
go back to reference International Commissionon Radiological Protection. The 2007 recommendations of the international commission on radiological protection. ICRP publication 103. Ann ICRP 2007;37:1–332. International Commissionon Radiological Protection. The 2007 recommendations of the international commission on radiological protection. ICRP publication 103. Ann ICRP 2007;37:1–332.
17.
go back to reference Council NR. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase II. Washington, DC: The National Academics; 2006. Council NR. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase II. Washington, DC: The National Academics; 2006.
18.
go back to reference Rajaraman P, Doody MM, Yu CL, Preston DL, Miller JS, Sigurdson AJ, Freedman DM, Alexander BH, Little MP, Miller DL, Linet MS. Cancer risks in U.S. radiologic technologists working with fluoroscopically guided interventional procedures, 1994–2008. Am J Roentgenol. 2016;206:1101–8.CrossRef Rajaraman P, Doody MM, Yu CL, Preston DL, Miller JS, Sigurdson AJ, Freedman DM, Alexander BH, Little MP, Miller DL, Linet MS. Cancer risks in U.S. radiologic technologists working with fluoroscopically guided interventional procedures, 1994–2008. Am J Roentgenol. 2016;206:1101–8.CrossRef
19.
go back to reference de González BA, Ntowe E, Kitahara CM, Gilbert E, Miller DL, Kleinerman RA, Linet MS. Long-term mortality in 43 763 U.S. radiologists compared with 64 990 U.S. psychiatrists. Radiology. 2016;281:847–57.CrossRef de González BA, Ntowe E, Kitahara CM, Gilbert E, Miller DL, Kleinerman RA, Linet MS. Long-term mortality in 43 763 U.S. radiologists compared with 64 990 U.S. psychiatrists. Radiology. 2016;281:847–57.CrossRef
Metadata
Title
Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice
Authors
Anna M. Sailer
Leonie Paulis
Laura Vergoossen
Axel O. Kovac
Geert Wijnhoven
Geert Willem H. Schurink
Barend Mees
Marco Das
Joachim E. Wildberger
Michiel W. de Haan
Cécile R. L. P. N. Jeukens
Publication date
01-03-2017
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 3/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-016-1526-8

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