No abstract

Objectives: The International Commission on Radiological Protection recommends managing patient and occupational doses as an integrated approach, for the optimisation of interventional procedures. The conventional passive personal dosimeters only allow one to know the accumulated occupational doses during a certain period of time. This information is not enough to identify if there is a lack of occupational radiation protection during some procedures. This paper describes the use of a dose management system (DMS) allowing patient and occupational doses for individual procedures to be audited. Methods: The DMS manages patient and occupational doses measured by electronic personal dosimeters. One dosemeter located at the C-arm is used as a reference for scatter radiation. Data has been collected from five interventional rooms. Dosimetry data can be managed for the whole procedure and the different radiation events. Optimisation is done through auditing different sets of parameters for individual procedures: patient dose indicators, occupational dose values, the ratio between occupational doses and the doses measured by the reference dosemeter at the C-arm, and the ratio between occupational and patient dose values. Results: The managed data correspond to the year 2021, with around 4500 procedures, and 8000 records on occupational exposures. Patient and staff dose data (for 11 cardiologists, 7 radiologists and eight nurses) were available for 3043 procedures. The DMS allows alerts for patient dose indicators and occupational exposures to be set. Conclusions.: The main advantage of this integrated approach is the capacity to improve radiation safety for patients and workers together, auditing alerts for individual procedures. Advances in knowledge: The management of patient and occupational doses together (measured with electronic personal dosimeters) for individual interventional procedures, using dose management systems, allows alerting optimisation on high dose values for patients and staff.

Even if this collective radiation dose may seem moderate, at an individual level this medical practice delivers the greatest doses and, therefore, optimisation remains of paramount importance.