Occupational and patient doses for interventional radiology integrated into a dose management system

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.

Optimization of Radiation Protection in Pediatric Interventional Radiology in Latin America and the Caribbean: Development, Advancements, Challenges and Achievements of the OPRIPALC Program

“…uta.cl (accessed on 1 September 2023), which was installed on a server at the University of Tarapacá (Arica, Chile) for possible connections of some of the hospitals involved in OPRIPALC to receive and process structured dose reports and generate alerts for potential optimization actions [30]. It is foreseen, as a challenge, the possibility of additionally managing occupational doses in some of the centers that could have personal electronic dosimeters as it is already being performed at the San Carlos Hospital in Madrid [29]. Currently, the Roberto del Rio Hospital in Chile is already connected with a sample of 223 procedures, and during the year 2023, it is expected that it will be also installed at the Italian Hospital in Buenos Aires, Argentina.…”

“…Examples of the latter are systematic communications via email, virtual meetings or a WhatsApp group. A web page has been created and continuously updated, which has basic information about the program, the list of participating centers, the number of procedures collected, a section with relevant bibliography and supporting resources [28][29][30]. To gather technical and scientific information from each center, five surveys have been performed so far.…”

“…Initially, the collection of patient dose values was carried out manually by each participating center and collected by the University of Tarapaca (Chile) for safekeeping and analysis. As of 2021, an automatic dose management system was used thanks to the support of the Medical Physics service of the San Carlos hospital in Madrid [29,30].…”

Improving a regional project on diagnostic reference levels for interventional procedures (OPRIPALC) with the support of a dose management system for the protection of patients and staff

“…If hospitals have electronic dosimeters to obtain data on occupational doses, the DOLQA system allows the integration of these doses into the system and the comparison of occupational dose values with patient doses and other geometrical and technical data (such as C-arm angulation, collimation, x-ray beam filtration, etc) [7]. This option is particularly relevant in paediatric procedures where interventionists are in close proximity to the patients, and it is not always possible to use the ceiling-suspended screen for occupational protection.…”

“…In 2022, the OPRIPALC board decided to incorporate support for a dose management system (DMS) into the programme, and it was agreed with the San Carlos University Hospital in Madrid to use the DOLQA (Dose On Line for Quality Assurance) system, a software created in the Hospital by the Medical Physics Service, and currently in use in several hospitals in Spain [6,7].…”