Radiation safety and protection are a key component of fluoroscopy-guided interventions. We hypothesize that providing weekly personal dose feedback will increase radiation awareness and ultimately will lead to optimized behavior. Therefore, we designed and implemented a personalized feedback of procedure and personal doses for medical staff involved in fluoroscopy-guided interventions.
Medical staff (physicians and technicians, n = 27) involved in fluoroscopy-guided interventions were equipped with electronic personal dose meters (PDMs). Procedure dose data including the dose area product and effective doses from PDMs were prospectively monitored for each consecutive procedure over an 8-month period (n = 1082). A personalized feedback form was designed displaying for each staff individually the personal dose per procedure, as well as relative and cumulative doses. This study consisted of two phases: (1) 1–5th months: Staff did not receive feedback (n = 701) and (2) 6–8th months: Staff received weekly individual dose feedback (n = 381). An anonymous evaluation was performed on the feedback and occupational dose.
Personalized feedback was scored valuable by 76% of the staff and increased radiation dose awareness for 71%. 57 and 52% reported an increased feeling of occupational safety and changing their behavior because of personalized feedback, respectively. For technicians, the normalized dose was significantly lower in the feedback phase compared to the prefeedback phase: [median (IQR) normalized dose (phase 1) 0.12 (0.04–0.50) µSv/Gy cm2 versus (phase 2) 0.08 (0.02–0.24) µSv/Gy cm2, p = 0.002].
Personalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions.
International Commission On Radiological Protection. ICRP ref 4825-3093-1464. http://www.icrp.org/docs/icrp%20statement%20on%20tissue%20reactions.pdf. Accessed 2016.
Council NR. Health risks from exposure to low levels of ionizing radiation: BEIR VII Phase II. Washington: The National Academies; 2006.
Sutton DG, Williams JR. Radiation shielding for diagnostic radiology. London: British Institute of Radiology; 2012. p. 74–7.
Vano E, Fernandez JM, Sanchez R. Occupational dosimetry in real time. Benefits for interventional radiology. Radiat Measurements. 2011;46:1262–5. CrossRef
Bartal G, Roguin A, Paulo G. Call for implementing a radiation protection culture in fluoroscopically guided interventional procedures. Am J Roentgenol. 2016;206:1110–1. CrossRef
International Commissionon Radiological Protection. The 2007 recommendations of the International Commission on Radiological Protection. ICRP publication103.AnnICRP2007;37:1–332.
Basic safety standards for protection against the dangers arising from exposure to ionising radiation, Council Directive 2013/59/EURATOM (2013). https://ec.europa.eu/energy/sites/ener/files/documents/CELEX-32013L0059-EN-TXT.pdf Accessed Sept 21 2016.
ICRP Publication 74: conversion coefficients for use in radiological protection against external radiation. 1997Annals of the ICRP. vol 26(3). Elsevier, Oxford
International Commission On Radiological Protection. ICRP ref 4825-3093-1464. http://www.icrp.org/docs/icrp%20statement%20on%20tissue%20reactions.pdf Accessed 2016.
Rajaraman P1, Doody MM, Yu CL, Preston DL, Miller JS, Sigurdson AJ, Freedman DM, Alexander BH, Little MP, Miller DL, Linet MS. Cancer Risks in U.S. Radiologic Technologists Working With Fluoroscopically Guided Interventional Procedures, 1994–2008.
Mahmud E, Reeves R. The evidence supporting radiation safety methods-working towards zero operator exposure. J Imaging Interv Radiol. 2016;2:1–21.
Meisinger QC, Stahl CM, Andre MP, Kinney TB, Newton IG. Radiation protection for the fluoroscopy operator and staff. Am J Roentgenol. 2016;19:1–10.
Stahl CM, Meisinger QC, Andre MP, Kinney TB, Newton IG. Radiation risk to the fluoroscopy operator and staff. Am J Roentgenol. 2016;207:737–44. CrossRef
Domienik J, Brodecki M, Carinou E, Donadille L, Jankowski J, Koukorava C, Krim S, Nikodemova D, Ruiz-Lopez N, Sans-Mercé M, Struelens L, Vanhavere F. Extremity and eye lens doses in interventional radiology and cardiology procedures: first results of the ORAMED project. Radiat Prot Dosimetry. 2011;144:442–7. CrossRefPubMed
Vanhaverea F, Carinoub E, Domienikc J, Donadilled L, Ginjaumee M, Gualdrinif G, Koukoravab C, Krima S, Nikodemovag D, Ruiz-Lopezh N, Sans-Merceh M, Struelensa L. Measurements of eye lens doses in interventional radiology and cardiology: Final results of the ORAMED project. Radiat Measurements. 2011;46:1243–7. CrossRef
Sanchez R, Vano E, Fernandez JM, Gallego JJ. Staff radiation doses in a real-time display inside the angiography room. Cardiovasc Interv Radiol. 2010;33:1210–4. CrossRef
Mangiarotti M, D’Ercole L, Quaretti P, Moramarco L, Lafe E, Zappoli Thyrion F. Evaluation of an active personal dosimetry system in interventional radiology and neuroradiology: Preliminary results. Radiat Prot Dosimetry 2015 Dec 8. pii: ncv502.
Christopoulos G, Papayannis AC, Alomar M, et al. Effect of a real-time radiation monitoring device on operator radiation exposure during cardiac catheterization: the radiation reduction during cardiac catheterization using real-time monitoring study. Circ Cardiovasc Interv. 2014;7:744–5. CrossRefPubMed
- Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring
Anna M. Sailer
Willem H. van Zwam
Joachim E. Wildberger
Cécile R. L. P. N. Jeukens
- Springer US
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