Evaluation of the impact of a system for real-time visualisation of occupational radiation dose rate during fluoroscopically guided procedures

Abstract

Optimisation of radiological protection for operators working with fluoroscopically guided procedures has to be performed during the procedure, under varying and difficult conditions. The aim of the present study was to evaluate the impact of a system for real-time visualisation of radiation dose rate on optimisation of occupational radiological protection in fluoroscopically guided procedures. Individual radiation dose measurements, using a system for real-time visualisation, were performed in a cardiology laboratory for three cardiologists and ten assisting nurses. Radiation doses collected when the radiation dose rates were not displayed to the staff were compared to radiation doses collected when the radiation dose rates were displayed. When the radiation dose rates were displayed to the staff, one cardiologist and the assisting nurses (as a group) significantly reduced their personal radiation doses. The median radiation dose (Hp(10)) per procedure decreased from 68 to 28 μSv (p = 0.003) for this cardiologist and from 4.3 to 2.5 μSv (p = 0.001) for the assisting nurses. The results of the present study indicate that a system for real-time visualisation of radiation dose rate may have a positive impact on optimisation of occupational radiological protection. In particular, this may affect the behaviour of staff members practising inadequate personal radiological protection.

Combined Use of a Patient Dose Monitoring System and a Real-Time Occupational Dose Monitoring System for Fluoroscopically Guided Interventions

“…The system consisted of four individual personal dosimeters (PDMs), placed above the lead apron at chest level. The PDMs estimated the user's dose, equivalent to the dose in tissue at a depth of d ¼ 10 mm (Hp(10)) (14). Within the scope of the present study, the PDMs of the two main operators were analyzed.…”

“…As a consequence, a proactive approach is now feasible, and the operator can immediately adapt technical settings or adjust use of protective devices (9). Although patient dose monitoring systems and realtime occupational dose monitoring systems proved to be effective in routine clinical situations (11)(12)(13)(14)(15)(16)(17), implications of the combined use of the two systems were not evaluated. The purpose of the present study was to determine the effect on patient radiation exposure of the combined use of a patient dose monitoring system and a real-time occupational dose monitoring system.…”

Coaching Reduced the Radiation Dose of Pain Physicians by Half during Interventional Procedures

“…A method to optimize radiation protection during fluoroscopy is knowledge of radiation dose levels and of basic strategies to minimize these levels . Awareness of dose levels can be provided to specialists using a system that gives real‐time information about the received dose . The Dose Aware system (Philips Healthcare, Best, the Netherlands) contains personal dosimeters for real‐time visualization of the received dose on a monitor.…”

“…They concluded that the system can help to optimize staff members’ radiation protection during fluoroscopy. Recently, the Dose Aware system was used by Sandblom et al . to evaluate its impact on the dose rate of cardiologists during fluoroscopically guided procedures.…”

“…to evaluate its impact on the dose rate of cardiologists during fluoroscopically guided procedures. They found that real‐time visualization of radiation dose rate may have a positive impact on optimization of occupational radiological protection for cardiac interventions …”