TY - JOUR
T1 - Optimizing Staff Dose in Fluoroscopy-Guided Interventions by Comparing Clinical Data with Phantom Experiments
AU - Sailer, Anna M.
AU - Paulis, Leonie
AU - Vergoossen, Laura
AU - Wildberger, Joachim E.
AU - Jeukens, Cecile R. L. P. N.
N1 - Funding Information:
A.M.S. receives grants from Philips Healthcare (Best, the Netherlands). J.E.W. receives grants from Agfa (Morstel, Belgium), Bayer Healthcare (Berlin, Germany), GE (Chicago, Illinois), Philips Healthcare (Best, the Netherlands), Optimed, and Siemens Healthineers (Forcheim, Germany) and personal fees from Bayer Healthcare (Berlin, Germany) and Siemens Healthineers (Forcheim, Germany). None of the other authors have identified a conflict of interest. The authors thank E.C. Nijssen (Department of Radiology and Nuclear Medicine, Maastricht University Medical Center) for thorough reading and editing of the manuscript.
Publisher Copyright:
© 2018 SIR
PY - 2019/5
Y1 - 2019/5
N2 - Purpose: To evaluate conditions for minimizing staff dose in interventional radiology, and to provide an achievable level for radiation exposure reduction.Materials and. Methods: Comprehensive 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.Results: In 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%).Conclusions: Achievable 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.
AB - Purpose: To evaluate conditions for minimizing staff dose in interventional radiology, and to provide an achievable level for radiation exposure reduction.Materials and. Methods: Comprehensive 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.Results: In 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%).Conclusions: Achievable 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.
KW - RADIATION
KW - RADIOLOGY
KW - EXPOSURE
KW - OPERATOR
KW - PATIENT
KW - REDUCTION
U2 - 10.1016/j.jvir.2018.11.019
DO - 10.1016/j.jvir.2018.11.019
M3 - Article
C2 - 30952523
SN - 1051-0443
VL - 30
SP - 701-708.e1
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 5
ER -