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
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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