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

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 have 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 8 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.

[1]  E. Vañó,et al.  Managing occupational doses with smartphones in interventional radiology , 2021, Medical physics.

[2]  E. Vañó,et al.  Get Protected! Recommendations for Staff in IR , 2021, CardioVascular and Interventional Radiology.

[3]  O. Ciraj-Bjelac,et al.  Vendor‐independent skin dose mapping application for interventional radiology and cardiology , 2021, Journal of applied clinical medical physics.

[4]  E. Vañó,et al.  Challenges in Occupational Dosimetry for Interventional Radiologists , 2021, CardioVascular and Interventional Radiology.

[5]  E. Vañó,et al.  Helping to know if you are properly protected while working in interventional cardiology , 2020, Journal of radiological protection : official journal of the Society for Radiological Protection.

[6]  S. Schindera,et al.  Radiation dose management systems—requirements and recommendations for users from the ESR EuroSafe Imaging initiative , 2020, European Radiology.

[7]  E. Vañó,et al.  Dose‐reducing fluoroscopic system decreases patient but not occupational radiation exposure in chronic total occlusion intervention , 2020, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[8]  Colin J. Martin,et al.  Unintended and Accidental Exposures, Significant Dose Events and Trigger Levels in Interventional Radiology , 2020, CardioVascular and Interventional Radiology.

[9]  G. Cayla,et al.  Clinical evaluation of a dose management system-integrated 3D skin dose map by comparison with radiochromic films , 2020, European Radiology.

[10]  E. Vañó,et al.  Strategies to optimise occupational radiation protection in interventional cardiology using simultaneous registration of patient and staff doses , 2018, Journal of radiological protection : official journal of the Society for Radiological Protection.

[11]  L. Dauer,et al.  ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures , 2018, Annals of the ICRP.

[12]  C J Martin,et al.  ICRP Publication 135: Diagnostic Reference Levels in Medical Imaging , 2017, Annals of the ICRP.

[13]  J. Wildberger,et al.  Personalized Feedback on Staff Dose in Fluoroscopy-Guided Interventions: A New Era in Radiation Dose Monitoring , 2017, CardioVascular and Interventional Radiology.

[14]  C. Clement,et al.  Diagnostic reference levels in medical imaging , 2017 .

[15]  Marco Das,et al.  Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice , 2016, CardioVascular and Interventional Radiology.

[16]  C. Cagnon,et al.  Radiation-Induced Cataractogenesis: A Critical Literature Review for the Interventional Radiologist , 2016, CardioVascular and Interventional Radiology.

[17]  J. I. Ten,et al.  Benefits of an automatic patient dose registry system for interventional radiology and cardiology at five hospitals of the Madrid area. , 2015, Radiation protection dosimetry.

[18]  Sophie Jacob,et al.  Interventional cardiologists and risk of radiation-induced cataract: results of a French multicenter observational study. , 2013, International journal of cardiology.

[19]  J. I. Ten,et al.  Experience with patient dosimetry and quality control online for diagnostic and interventional radiology using DICOM services. , 2013, AJR. American journal of roentgenology.

[20]  Madan M Rehani,et al.  Radiation-associated lens opacities in catheterization personnel: results of a survey and direct assessments. , 2013, Journal of vascular and interventional radiology : JVIR.

[21]  K. Sim,et al.  Radiation-Induced Eye Lens Changes and Risk for Cataract in Interventional Cardiology , 2012, Cardiology.

[22]  Stephen Balter,et al.  Occupational Radiation Doses to Operators Performing Fluoroscopically-Guided Procedures , 2012, Health physics.

[23]  J I Ten,et al.  Automatic management system for dose parameters in interventional radiology and cardiology. , 2011, Radiation protection dosimetry.

[24]  Madan M Rehani,et al.  Risk for radiation‐induced cataract for staff in interventional cardiology: Is there reason for concern? , 2010, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[25]  Gabriel Bartal,et al.  Guidelines for patient radiation dose management. , 2009, Journal of vascular and interventional radiology : JVIR.

[26]  Jack Valentin,et al.  Managing patient dose in digital radiology , 2004 .