Physician scatter dose in interventional CT fluoroscopy

Abstract

PurposeTo quantify operator dose in interventional CT fluoroscopy (CTF) procedures and compare to catheterization laboratory and interventional radiology procedures.MethodsFifteen studies quantifying operator scatter dose for c‐arm fluoroscopy and CTF were reviewed from a literature survey. The dose provided in each study was normalized to skin entrance air kerma and air kerma rate including backscatter. The average air kerma rate and exposure duration were calculated and compared between c‐arm fluoroscopy and CTF. To enable operator scatter dose calculations in CTF procedures, a model was created which scaled the dose from a reference condition.ResultsOur literature survey indicated that for CTF relative to c‐arm fluoroscopy: (1) the mean air kerma rate is 3.5 times higher, while (2) the mean exposure duration is 31.6 times lower. On average, a physician would have to perform 9.1 times (i.e., 31.6/3.5) more CTF procedures relative to c‐arm fluoroscopy procedure to receive equal operator scatter doses. Our own experimental measurements provided scaling factors allowing physician scatter dose to be obtained at any rotation time, tube current, beam collimation, or beam energy.ConclusionOur results shed light onto a currently mis‐understood issue in radiology. Namely, that physicians receive more dose from CT relative to c‐arm fluoroscopy motivating them to retreat from the room during interventional exposures. Our literature review and experimental measurements indicate the opposite it true; interventional CT produces on average nine times less physician dose relative to c‐arm procedures. Our method allows for prospective/retrospective determination of an individual's dose.