Influence of standing positions and beam projections on effective dose and eye lens dose of anaesthetists in interventional procedures

BackgroundProtection of the head and eyes of the neurointerventional radiologist is a growing concern, especially after recent reports on the incidence of brain cancer among these personnel, and the revision of dose limits to the eye lens. The goal of this study was to determine typical occupational dose levels and to evaluate the efficiency of non-routine radiation protective gear (protective eyewear and cap). Experimental correlations between the dosimetric records of each measurement point and kerma area product (KAP), and between whole body doses and eye lens doses were investigated.MethodsMeasurements were taken using thermoluminescent dosimeters placed in plastic bags and worn by the staff at different places. To evaluate the effective dose, whole body dosimeters (over and under the lead apron) were used.ResultsThe mean annual effective dose was estimated at 0.4 mSv. Annual eye lens exposure was estimated at 17 mSv when using a ceiling shield but without protective glasses. The protective glasses reduced the eye lens dose by a factor of 2.73. The mean annual dose to the brain was 12 mSv; no major reduction was observed when using the cap. The higher correlation coefficients with KAP were found for the dosimeters positioned between the eyes (R2=0.84) and above the apron, and between the eye lens (R2=0.85) and the whole body.ConclusionsUnder the specific conditions of this study, the limits currently applicable were respected. If a new eye lens dose limit is introduced, our results indicate it could be difficult to comply with, without introducing additional protective eyewear.

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OCCUPATIONAL EYE LENS DOSE ESTIMATED USING WHOLE-BODY DOSEMETER IN INTERVENTIONAL CARDIOLOGY AND RADIOLOGY: A MONTE CARLO STUDY

Radiation Protection Dosimetry ◽

10.1093/rpd/ncy283 ◽

2019 ◽

Vol 185 (2) ◽

pp. 135-142 ◽

Cited By ~ 2

Author(s):

Predrag Božović ◽

Olivera Ciraj-Bjelac ◽

Jelena Stanković Petrović

Keyword(s):

Interventional Procedures ◽

Monte Carlo Study ◽

Interventional Cardiology ◽

Medical Personnel ◽

Whole Body ◽

Eye Lens ◽

Protective Equipment ◽

Eye Lens Dose ◽

Center Position ◽

High Doses

Abstract Medical personnel performing interventional procedures in cardiology and radiology is considered to be a professional group exposed to high doses of ionizing radiation. Reduction of the eye lens dose limit made its assessment in the interventional procedures one of the most challenging topics. The objective of this work is to assess eye lens doses based on the whole-body doses using methods of computational dosimetry. Assessment included different C-arm orientations (PA, LAO and RAO), tube voltages (80 –110 kV) and efficiency of different combinations of protective equipment used in interventional procedures. Center position at the height of the thyroid gives best estimate of eye lens dose, with spreads of 11% (13%), 13% (17%) and 14% (13%) for the left (right) eye lens. The conversion factors of 1.03 (0.83), 1.28 (1.06) and 1.36 (1.06) to convert whole body to eye lens dose were derived for positions of first operator, nurse and radiographer, respectively. The eye lens dose reduction factors for different combinations of applied protective equipment are 178, 5 and 6, respectively.

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Estimation of patient eye-lens dose during neuro-interventional procedures using a dense neural network (DNN)

Medical Imaging 2021: Physics of Medical Imaging ◽

10.1117/12.2580723 ◽

2021 ◽

Author(s):

Jacob Collins ◽

Sheng-Hsuan Sun ◽

Chao Guo ◽

Alexander R. Podgorsak ◽

Stephen Rudin ◽

...

Keyword(s):

Neural Network ◽

Interventional Procedures ◽

Eye Lens ◽

Eye Lens Dose

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HOW TO ESTABLISH AN ADEQUATE SYSTEM FOR EYE LENS DOSE MONITORING: A PROPOSAL FOR TYPICAL WORKPLACES

Radiation Protection Dosimetry ◽

10.1093/rpd/ncz009 ◽

2019 ◽

Author(s):

R P Kollaard ◽

E Carinou ◽

M Ginjaume ◽

L Struelens

Keyword(s):

Eye Lens ◽

Eye Lens Dose ◽

Dose Monitoring

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Surgeon eye lens dose monitoring in catheterization lab: A multi-center survey

Physica Medica ◽

10.1016/j.ejmp.2019.03.027 ◽

2019 ◽

Vol 60 ◽

pp. 127-131 ◽

Cited By ~ 4

Author(s):

Margherita Betti ◽

Lorenzo Nicola Mazzoni ◽

Giacomo Belli ◽

Luca Bernardi ◽

Sara Bicchi ◽

...

Keyword(s):

Eye Lens ◽

Eye Lens Dose ◽

Dose Monitoring

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Eye protection in interventional procedures

British Journal of Radiology ◽

10.1259/bjr.20210436 ◽

2021 ◽

Vol 94 (1126) ◽

pp. 20210436 ◽

Cited By ~ 1

Author(s):

Beth A. Schueler ◽

Kenneth A Fetterly

Keyword(s):

Interventional Procedures ◽

Eye Lens ◽

Radiation Doses ◽

Radiation Induced ◽

Individual Actions ◽

Dose Measurements ◽

Dose Levels ◽

Patient Radiation Dose ◽

Low Radiation Doses

Data suggest that radiation-induced cataracts may form without a threshold and at low-radiation doses. Staff involved in interventional radiology and cardiology fluoroscopy-guided procedures have the potential to be exposed to radiation levels that may lead to eye lens injury and the occurrence of opacifications have been reported. Estimates of lens dose for various fluoroscopy procedures and predicted annual dosages have been provided in numerous publications. Available tools for eye lens radiation protection include accessory shields, drapes and glasses. While some tools are valuable, others provide limited protection to the eye. Reducing patient radiation dose will also reduce occupational exposure. Significant variability in reported dose measurements indicate dose levels are highly dependent on individual actions and exposure reduction is possible. Further follow-up studies of staff lens opacification are recommended along with eye lens dose measurements under current clinical practice conditions.

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