A Study of Operator's Hand and Finger Exposure Dose Reduction During Angiographic Procedures

Abstract

The number of examinations using interventional radiology (IVR) has increased recently. Because of the more advanced and more complex procedures for IVR, longer treatment time is required. Therefore, it is important to determine exposure doses. We measured operator exposure dose during IVR using a thermoluminescence dosimeter. The results revealed the dose equivalent to the operator's hands and fingers to be higher than that of other parts, although the effective dose for the operator was low. Moreover, we looked into the factors that affected exposure dose to the operator's fingers, and examined ways to reduce the dose. In regard to the exposed dose to the operator's fingers, dose reduction was possible as a result of a geometric arrangement of the fluoroscopic unit, the radiation field size, using a radiation protective device and deliberation to exposure dose reduction of the operator. It is possible to carry out IVR more safely using the method of exposure dose reduction to the operator's fingers.

JCS 2021 Guideline on Radiation Safety in Cardiology

“…However, we should pay more attention to specific clinical situations where primary X-rays are given directly to the fingers; for example, during cardiac catheter intervention or other interventional radiology. 23 The 3 principles apply to occupational exposure: justification, optimization of protection, and dose limits. Although dose limits for occupational exposure in Japan (Table 3) incorporate ICRP Publication 60 (1990 Recommendations), 19,24 the equivalent dose limit for eye lenses has been drastically reduced from 150 mSv/year to 100 mSv/5 years and 50 mSv/year, based on ICRP Publication 118 (2012 Recommendations), from April 2021, and thus measurement of radiation dose and protection of lenses has become more important.…”

“…The standards established by the Japan Medical Imaging and Radiological Systems Industries Association stipulate maintenance and inspection standards for the performance and safety of nuclear medicine diagnostic equipment and its accessories and devices used in routine diagnostics. 61 In this case, a personal dosimeter should be worn inside the protective apron (chest for men and abdomen for women of childbearing potential), with an additional dosimeter in the area of the trunk most likely to be exposed to radiation (usually the head and neck), or at the extremities in cases where the extremities are most likely to be exposed (fingers in IVR procedures 23 ). However, if the exposure dose at the extremities is less than that of the trunk, a private dosimeter at the extremities is not required.…”

Personal Radiation Protection and Corresponding Dosimetry in Interventional Radiology: An Overview and Future Developments

“…The dose limit for the hands is 500 mSv per year (directive 2013/ 59/Euratom). Since the hands are unprotected and are thus directly exposed to scatter radiation, the radiation exposure is very high here [47]. In addition, there is a risk of the hands entering the primary beam.…”

Monitoring and Protection against Radiation Dose to Eyes of Operators Performing Neuroendovascular Procedures: A Nationwide Study in Japan

“…8) Specialized skills are required to safely perform neuroendovascular procedures, leading the radiation risk to increase to some particular operators. 9) In 2011, the International Commission on Radiation Protection (ICRP) recommended reducing the dose limit for the eye lens from 150 to 20 mSv per year, averaged over five years, with no annual dose in a single year exceeding 50 mSv. 10) The reduction has had a significant impact on healthcare professionals in many aspects.…”