The influence of operator position, height and body orientation on eye lens dose in interventional radiology and cardiology: Monte Carlo simulations versus realistic clinical measurements

Principi, Sara; Farah, Jad; Ferrari, P.; Carinou, E.; Clairand, I.; Ginjaume, M.

doi:10.1016/j.ejmp.2016.08.010

Cited by 45 publications

(35 citation statements)

References 15 publications

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“…Based on the MIRD phantom, the project Optimization of Radiation Protection for Medical Staff (ORAMED) conducted a simulation campaign to investigate various parameters that contribute to eye lens dose in IR . Koukorava and Principi also examined similar parameters using the MIRD phantom . However, phantoms used in these studies are not able to accurately represent the anatomical structure of the human body, especially small features such as the eye lens.…”

Section: Introductionmentioning

confidence: 99%

“…[13][14][15] Koukorava and Principi also examined similar parameters using the MIRD phantom. 16,17 However, phantoms used in these studies are not able to accurately represent the anatomical structure of the human body, especially small features such as the eye lens. The commonly used MIRD phantom is a stylized phantom based on quadratic equations.…”

Section: Introductionmentioning

confidence: 99%

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Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Mao

Caracappa

et al. 2019

Medical Physics

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Purpose To quantify the effects of operator head posture and different types of protective eyewear on the eye lens dose to operators in interventional radiology (IR). Methods A deformable computational human phantom, Rensselaer Polytechnic Institute (RPI) Adult Male, consisting of a high‐resolution eye model, was used to simulate a radiologist who is performing an interventional radiology procedure. The radiologist phantom was deformed to a set of different head postures. Three different protective eyewear models were incorporated into the posture‐deformed radiologist phantom. The eye lens dose of the radiologist was calculated using the Monte Carlo code, MCNP. Effects of the radiologist's head posture and different types of protective eyewear on eye lens doses were studied. The relationship between efficacy of protective eyewear and the radiologist's head posture was investigated. Effects of other parameters on efficacy of protective eyewear were also studied, including the angular position of the radiologist, the gap between the eyewear and the face of the radiologist, and the lead equivalent thickness. Results The dose to both lenses decreased by 80% as the head posture moved from looking downward to looking upward. Sports wrap glasses were found to reduce doses further than the other two studied models. The efficacy of eyewear was found to be related to radiologist's head posture as well. When the radiologist was looking up, the protective eyewear almost provided no protection to both lenses. Other factors such as the face‐to‐eyewear distance and the lead equivalent thickness were also found to have an impact on the efficacy of protective eyewear. The dose reduction factor (DRF), defined as the ratio of the dose to the lens without protection to that with protection, decreased from 4.25 to 1.07 as the face‐to‐eyewear distance increased. The DRF almost doubled when the lead equivalent thickness increased from 0.07 to 0.35 mm. However, further increase in lead equivalent thickness showed little improvement in dose reduction. Conclusion The radiologist's head posture has a significant influence on the eye lens dose in IR. Sports wrap protective eyewear which conforms to the curve of the face is essential for the radiation protection of the eye lens. However, the radiologist's head posture and other exposure parameters should be considered when evaluating the protection of the radiologist's eyes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Mao

Caracappa

et al. 2019

Medical Physics

View full text Add to dashboard Cite

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“…It has been reported that staff height may also influence occupational dose as the taller the staff member is, the further away their head is from the source of scattered radiation (Principi et al, ). This study did not find a significant correlation between the heights of nursing staff and head dose which reflects the findings by Antic et al, (), but contradicts clinical and phantom studies which found that dosimeters worn at chest level detected higher levels of radiation in short staff members than in their taller colleagues (Omar, Marteinsdottir, Kadesjo, & Fransson, ; Rigatelli et al, ).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography

Wilson‐Stewart

Härtel

Fontanarosa

2019

Journal of Advanced Nursing

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Aims This study aimed to compare the head dose of a cardiologist to scrub and scout nurses during cardiac angiography. Design A correlational longitudinal quantitative design was used to examine the relationship between the variable of occupational dose to the medical operator when compared with the dose to the scrub and scout nurses. Methods A quantitative analysis was performed on data collected during coronary angiograms (N = 612) for one cardiologist and 22 nurses performing either the scrub or scout role between May 2015 and February 2017. Analysis was based on log‐transformed dose levels and reported as geometric means and associated 95% confidence intervals. Results It was found that scrub nurses received on average 41% more head dose than the cardiologist during diagnostic procedures and 52% higher doses during interventional cases. Conclusion Nurses working in fluoroscopic cardiovascular procedures should be provided with appropriate training and protective equipment, notably lead skull caps, to minimize their occupational radiation exposure. Impact There is a notable lack of research evaluating the occupational head and eye exposure to nurses involved in fluoroscopic procedures. This study found that during diagnostic coronary angiograms, the scrub nurses received 41% more occupational head dose than the cardiologist and 52% higher head doses during interventional cases. Radial access resulted in higher doses to scrub nurses than femoral artery access. It is advisable that staff wear protective lead glasses and skull caps and use appropriately positioned ceiling mounted lead shields to minimize the risk of adverse effects of occupational exposure to ionizing radiation.

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“…It is known that at this position the clinician will be exposed to the least amount of radiation, due to a shielding effect caused by the flat panel detector. 20 The height of the head phantom was 168.5 cm, determined by the mean average height of both a male and female British person. 21 Accumulated dose rates to the clinician's eye lenses from five 10-second exposures at 75 kV 25.2 mAs with a focal spot size of 1 mm and a tantalum filter were recorded for different angles of gaze to decrease random error, therefore promoting higher levels of accuracy.…”

Section: Methodsmentioning

confidence: 99%

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

et al. 2019

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Introduction: Smart glasses can be adapted to display radiographic images to allow clinician's gaze not to be directionally fixed or predetermined by computer monitor location. This study presents an analysis of eye lens dose during interventional fluoroscopy guided procedures, comparing fixed monitor positions against the use of smart glasses.Methods: Using a head phantom (simulating the clinician), thermoluminescent dosimeters and lead shielded glasses, the dose to the eye was measured for different head 'rotations and tilts' for: gaze directed towards the main scattering source (patient / primary beam) to represent potential gaze direction if smart glasses are used; gaze directed to a range of potential computer monitor positions. An anthropomorphic pelvis phantom was utilised to simulate the patient. Accumulated dose rates (µGy.sˉ¹) from five 10-second exposures at 75 kV 25.2 mAs were recorded.Results: An average DAP reading of 758.84 cGy.cm 2 was measured during each 10 second exposure. Whilst wearing lead shielded glasses a 6.10fold reduction in dose rate to the lens is possible (p<0.05). Influence of the direction of gaze by the clinician demonstrated a wide range of dose rate reduction from 3.13% (p=0.16) to 143.69% (p<0.05) when the clinician's gaze was towards the main scattering source. Increased dose rate to the clinician's eyes was received despite wearing lead shielded glasses, as the angle of gaze moved 45º and 90º from 0º.Conclusion: If the clinician's gaze is directed towards the main scattering source a potential exists for reducing eye lens dose compared with fixed location computer monitors. Introduction of lead lined smart glasses into interventional radiology may lead to improvements in patient care, reducing the need for the clinician to look away from the patient to observe a radiographic image.

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The influence of operator position, height and body orientation on eye lens dose in interventional radiology and cardiology: Monte Carlo simulations versus realistic clinical measurements

Cited by 45 publications

References 15 publications

Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Influences of operator head posture and protective eyewear on eye lens doses in interventional radiology: A Monte Carlo Study

Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography

Radiation protection value to the operator from augmented reality smart glasses in interventional fluoroscopy procedures using phantoms

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