Abstract
Purpose
The purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.
Materials and Methods
In one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.
Results
A total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).
Conclusion
A real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter.
Similar content being viewed by others
References
Sanchez R, Vano E, Fernandez JM, Gallego JJ (2010) Staff radiation doses in a real-time display inside the angiography room. Cardiovasc Intervent Radiol 33(6):1210–1214. doi:10.1007/s00270-010-9945-4
Vano E, Gonzalez L, Guibelalde E, Fernandez JM, Ten JI (1998) Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 71(849):954–960. doi:10.1259/bjr.71.849.10195011
Bartal G, Vano E, Paulo G, Miller DL (2014) Management of patient and staff radiation dose in interventional radiology: current concepts. Cardiovasc Intervent Radiol 37(2):289–298. doi:10.1007/s00270-013-0685-0
Kim KP, Miller DL, Balter S, Kleinerman RA, Linet MS, Kwon D et al (2008) Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys 94(3):211–227. doi:10.1097/01.HP.0000290614.76386.35
Jensen K, Zangani L, Martinsen AC, Sandbaek G (2011) Changes in dose-area product, entrance surface dose, and lens dose to the radiologist in a vascular interventional laboratory when an old X-ray system is exchanged with a new system. Cardiovasc Intervent Radiol 34(4):717–722. doi:10.1007/s00270-010-0017-6
Le Heron J, Padovani R, Smith I, Czarwinski R (2010) Radiation protection of medical staff. Eur J Radiol 76(1):20–23. doi:10.1016/j.ejrad.2010.06.034
Miller DL, Vano E, Bartal G, Balter S, Dixon R, Padovani R et al (2010) Occupational radiation protection in interventional radiology: a joint guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology. J Vasc Interv Radiol 21(5):607–615. doi:10.1016/j.jvir.2010.01.007
Cuaron JJ, Hirsch AE, Medich DC, Hirsch JA, Rosenstein BS (2011) Introduction to radiation safety and monitoring. J Am Coll Radiol 8(4):259–264. doi:10.1016/j.jacr.2010.08.020
Vano E, Gonzalez L, Fernandez JM, Haskal ZJ (2008) Eye lens exposure to radiation in interventional suites: caution is warranted. Radiology 248(3):945–953. doi:10.1148/radiol.2482071800
External Dosimetry: Operational Quantities and their Measurement, 11th International Congress of the International Radiation Protection Association (IRPA) Sess. (May, 2004)
Williams J (2004) Is there a benefit in promoting the concept of radiation risk? Br J Radiol 77(919):545–546
Racadio J, Nachabe R, Carelsen B, Racadio J, Hilvert N, Johnson N et al (2014) Effect of real-time radiation dose feedback on pediatric interventional radiology staff radiation exposure. J Vascul Interv Radiol 25(1):119–126. doi:10.1016/j.jvir.2013.08.015
Conflict of interest
Frederic Baumann: no conflict of interest. Barry T. Katzen: member of Advisory Board for Philips. Bart Carelsen: employee of Philips Healthcare who distributes the DoseAware technology. Nicolas Diehm: no conflict of interest. James Benenati: no conflict of interest. Constantino Peña: no conflict of interest.
Statement of Informed Consent
This study focused on the review of data acquired during the quality assessment process. IRB permission for the retrospective use of this HIPAA compliant data was obtained and informed consent was waived.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Baumann, F., Katzen, B.T., Carelsen, B. et al. The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting. Cardiovasc Intervent Radiol 38, 1105–1111 (2015). https://doi.org/10.1007/s00270-015-1075-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-015-1075-6