Occupational dose reduction in cardiac catheterisation laboratory: a randomised trial using a shield drape placed on the patient

Ordiales, J. M.; Nogales, J. M.; Vañó, Eliseo; López-Mínguez, José-Ramón; Álvarez, F. Javier; Ramos, João Gabriel Rosa; Martínez, G; Sánchez, R. Madrigal

doi:10.1093/rpd/ncw139

Cited by 2 publications

(2 citation statements)

References 30 publications

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Section: Discussionmentioning

confidence: 99%

“…That the occupational eye lens dose has been estimated as approximately 20% lower than the average radiation dose measured at chest level should be noted, but this factor depends on the position of the over-apron dosimeter and other geometric factors during the procedures. 15 The dose rate of the dose aware PDM ranges between 40 µSv/h and 500 mSv/h, and the badge response is angular and temperature-dependent, meaning that an additional variation in accuracy can be expected between 5% ± 30% at 50° of angulation, until within 180° of angulation of the badge in accordance with the C-arm source. From our prediction model, dose rates less than 40 µSv/h can also be expected.…”

Section: Figurementioning

confidence: 99%

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Radiation Awareness for Endovascular Abdominal Aortic Aneurysm Repair in the Hybrid Operating Room: An Instant Operator Risk Chart for Daily Practice

et al. 2021

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Introduction: While the operator radiation dose rates are correlated to patient radiation dose rates, discrepancies may exist in the effect size of each individual radiation dose predictors. An operator dose rate prediction model was developed, compared with the patient dose rate prediction model, and converted to an instant operator risk chart. Materials and Methods: The radiation dose rates (DRoperator for the operator and DRpatient for the patient) from 12,865 abdomen X-ray acquisitions were selected from 50 unique patients undergoing standard or complex endovascular aortic repair (EVAR) in the hybrid operating room with a fixed C-arm. The radiation dose rates were analyzed using a log-linear multivariable mixed model (with the patient as the random effect) and incorporated varying (patient and C-arm) radiation dose predictors combined with the vascular access site. The operator dose rate models were used to predict the expected radiation exposure duration until an operator may be at risk to reach the 20 mSv year dose limit. The dose rate prediction models were translated into an instant operator radiation risk chart. Results: In the multivariate patient and operator fluoroscopy dose rate models, lower DRoperator than DRpatient effect size was found for radiation protocol (2.06 for patient vs 1.4 for operator changing from low to medium protocol) and C-arm angulation. Comparable effect sizes for both DRoperator and DRpatient were found for body mass index (1.25 for patient and 1.27 for the operator) and irradiated field. A higher effect size for the DRoperator than DRpatient was found for C-arm rotation (1.24 for the patient vs 1.69 for the operator) and exchanging from femoral access site to brachial access (1.05 for patient vs 2.5 for the operator). Operators may reach their yearly 20 mSv year dose limit after 941 minutes from the femoral access vs 358 minutes of digital subtraction angiography radiation from the brachial access. Conclusion: The operator dose rates were correlated to patient dose rate; however, C-arm angulation and changing from femoral to brachial vascular access site may disproportionally increase the operator radiation risk compared with the patient radiation risk. An instant risk chart may improve operator dose awareness during EVAR.

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Section: Discussionmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%