Patient and staff dosimetry in neuroradiological procedures

Published on May 1, 1995in British Journal of Radiology3.039
· DOI :10.1259/0007-1285-68-809-495
Nicholas W. Marshall23
Estimated H-index: 23
,
J Noble1
Estimated H-index: 1
,
Keith Faulkner26
Estimated H-index: 26
Sources
Abstract
Cerebral angiography provides valuable information for use in the clinical management of patients but can result in relatively high radiation doses to patients and staff due to the extended fluoroscopy time and number of images acquired during an examination. In this study, extremity doses to radiologists and scrub nurses working in a neuroradiological centre were monitored during a 3 month period using thermoluminescent dosemeters (TLDs). Electronic personal dosemeters were also used to monitor doses above the lead apron at chest height to the radiologists, radiographers and the scrub nurses. Patient doses were recorded using a dose-area product meter whilst patient thyroid dose was measured using TLDs. Two types of examination were studied: cerebral angiography and arterial embolization. It was deduced from the results of the study that the radiologist may expect to receive a mean dose above the lead apron at chest height of 11 uSv and 25 uSv per examination when performing cerebral angiography and arterial embolization, respectively. A radiologist mean hand dose of 19.3 uSv per examination was found, whilst the average eye dose for both radiologist and scrub nurse was 13.4 uSv per examination. The patient dosimetry results revealed a mean thyroid dose of 1.7 mSv and a dose-area product of 48.5 Gy cm 2 for cerebral angiography. Average dose-area product for arterial embolization was 122.2 Gy cm 2 along with a mean patient thyroid dose of 3.3 mSv. More detailed patient dosimetry was also performed using a Rando anthropomorphic phantom loaded with TLDs to measure organ doses and hence estimate effective dose. A typical four vessel angiogram was found to result in a patient effective dose of 3.6 mSv. In the main, occupationally exposed individuals working in radiology departments receive radiation doses which are very low. However, certain small groups of staff who have to stand adjacent to the patient couch during fluoroscopy receive higher doses. The radiation dose to staff performing barium studies are minimized by using dedicated equipment which either has lead curtains suspended from the image intensifier housing or can be operated remotely from behind the protective barrier at the equipment console. Additional radiation protection problems occur in the case of interventional radiology, as fluoroscopy times tend to be longer and the nature of the procedures performed preclude the use of lead protection attached to the image intensifier. Moreover, it is likely that other clinical specialists may also be present in the room during the interventional procedure. A recent review of staff doses in fluoroscopy [1] has indicated that, for high workloads and for some interventional radiology procedures, certain individuals could receive a radiation dose close to the level at which they would need to become a classified radiation worker. It was also apparent that few staff dosimetry studies had been performed
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References16
Newest
#1D Hart (National Radiological Protection Board)H-Index: 7
#2B F WallH-Index: 1
Abstract The International Commission on Radiological Protection has recommended the use of a new dose quantity “effective dose”. The doses to 22 organs of the human body are required for a formal calculation of this quantity. This paper shows that a quick estimate of the effective dose received by a patient from a barium meal or a barium enema can be made by multiplying the measured dose–area product for the complete examination by an appropriate conversion coefficient. Despite the varied techn...
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#1D. HartH-Index: 2
#2D. G. JonesH-Index: 2
Last. B. F. WallH-Index: 2
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The exposure of staff during fluoroscopic procedures was simulated for overcouch x-ray tube/undercouch image intensifer and undercouch x-ray tube/overcouch image intensifier geometries. A Rando phantom with film badge dosimeters attached to the skin surface at seven commonly used monitoring sites and loaded with lithium fluoride thermoluminescent dosimeters was irradiated for an extended period in the vicinity of a patient couch. Scattered radiation generated from the irradiation of an anthropom...
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Digital subtraction angiography (DSA) is based on digital image processing with logarithmic subtraction and edge enhancement. It is used increasingly for the visualization of blood vessels throughout the body. The bulk of the workload in the angiography suite at the Queen Elizabeth Hospital, Birmingham involves carotid and femoral angiograms with other examinations, including hepatic and renal angiograms, being carried out less frequently. A typical DSA examination involves both fluoroscopy and ...
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In general the radiation dose received by staff in diagnostic radiology is usually a small fraction of the average dose to a typical member of the population from all sources in a year. However, the introduction of interventional radiology procedures involving extended fluoroscopy times has led to higher staff doses. A review of radiation dose levels to staff for various fluoroscopy and interventional radiology procedures is presented, together with an assessment of the implications for personal...
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Relationships between effective dose and each of entrance surface dose, entrance air kerma and dose-area product were studied for common radiographic projections using the organ dose data from Monte Carlo modelling. Dose-area product proved to be the best quantity for estimating effective dose and these data are presented. For typical peak generating potentials, estimates of effective dose can be made from dose-area product using a small number of conversion coefficients. For cervical spine, che...
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#1Keith FaulknerH-Index: 26
#2H.P. BuschH-Index: 5
Last. D.J. RawlingsH-Index: 1
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#1Vladimir M. Feygelman (UF: University of Florida)H-Index: 5
#2Walter Huda (UF: University of Florida)H-Index: 19
Last. Keith R. Peters (UF: University of Florida)H-Index: 18
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PURPOSE To determine values of the effective dose equivalent, HE, for patients undergoing diagnostic cerebral angiography and compare these values with radiation doses received by patients undergoing other diagnostic examinations of the head. METHODS The radiographic techniques for ten patients undergoing cerebral angiography were recorded and used to obtain the product of the entrance skin dose and the x-ray beam cross-sectional area. These measured dose-area product data were converted into ef...
The measurement and prediction of scattered radiation dose to staff in diagnostic radiology is particularly important, owing to the increased use and complexity of interventional radiology. The air kerma-area product and scattered radiation dose in the vicinity of the patient couch, for both overcouch and undercouch X-ray tube geometries, were simultaneously monitored. The scattered radiation distribution at the couchside was deduced at a range of tube potentials for both overcouch and undercouc...
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Radiation scattered throughout the room during fluoroscopy-guided interventional (FGI) procedures was quantified at different locations using nanoDot optically stimulated luminescence dosemeters. All the tube angulation imaging shows that the radiation spectrum resembled a single peak distribution. The left anterior oblique 90 degrees shows the highest single peak distribution (28.65 mSv/h). The single peak distribution for standard anteroposterior, left anterior oblique 45 degrees and right ant...
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: The present work reports data of the radiation exposure to the patient in various diagnostic and therapeutic interventional radiological (IR) procedures. The study includes 260 diagnostic and 195 therapeutic exposure data in 455 IR procedures. All the IR procedures were performed on a biplane angiographic machine in a tertiary care hospital. The radiation exposure was estimated from dose-area product (DAP), fluoroscopy time (FT), number of fluoroscopic runs, number of images and cumulative dos...
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Digital subtraction angiography (DSA) is a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. The use of DSA procedures has been increased quite significantly in the Radiology departments in various cities in Indonesia. Various reports showed that both patients and medical staff received a noticeable radiation dose during the course of this procedure. A study had been carried out to measure these doses amo...
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Currently, there exists no standardised method for monitoring radiation doses to the eye lens. This investigation aimed to determine the optimum method for monitoring the eye doses for interventional radiologists. Three interventional radiologists were issued with a series of dosimeters to wear during their routine work. These dosimeters were worn at defined positions on the body and the absorbed dose to each position was measured. It was confirmed that the dose received to the thyroid collar fo...
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This work suggests a classification of interventional radiology and cardiology procedures based on statistical analysis of operators’ finger doses measured in routine clinical conditions. In total, 346 finger doses were measured and the observed mean finger dose per class of procedure ranged from 0.03 mSv to 1.56 mSv for Cerebral, and Bone and Joint procedures, respectively. The statistical analysis showed that the finger dose in Cerebral procedures is significantly lower than in Cardiac procedu...
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Coronary angiography (CA), percutaneous coronary intervention (PCI), catheter-based structural heart intervention, electrophysiological studies, and arrhythmia ablation are procedures that help cardiologists ensure better clinical diagnosis and treatment (Dawkins et al. 2005). During these procedures, catheters, guide wires, and other devices are visualized and guided by using real-time fluoroscopy. Therefore, operators are inevitably exposed to radiation (Kim and Miller 2009). Compared to other...
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