Department of Radiology, Division of Pediatric Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229.
Interventional X-ray Department, Philips Healthcare, Best, The Netherlands.
J Vasc Interv Radiol. 2014 Jan;25(1):119-26. doi: 10.1016/j.jvir.2013.08.015. Epub 2013 Oct 1.
To measure and compare individual staff radiation dose levels during interventional radiologic (IR) procedures with and without real-time feedback to evaluate whether it has any impact on staff radiation dose.
A prospective trial was performed in which individuals filling five different staff roles wore radiation dosimeters during all IR procedures during two phases: a 12-week "closed" phase (measurements recorded but display was off, so no feedback was provided) and a 17-week "open" phase (display was on and provided real-time feedback). Radiation dose rates were recorded and compared by Mann-Whitney U test.
There was no significant difference in median procedure time, fluoroscopy time, or patient dose (dose-area product normalized to fluoroscopy time) between the two phases. Overall, the median staff dose was lower in the open phase (0.56 µSv/min of fluoroscopy time) than in the closed phase (3.01 µSv/min; P < .05). The IR attending physician dose decreased significantly for procedures for which the physicians were close to the patient, but not for ones for which they were far away.
A radiation dose monitoring system that provides real-time feedback to the interventional staff can significantly reduce radiation exposure to the primary operator, most likely by increasing staff compliance with use of radiation protection equipment and dose reduction techniques.
通过测量并比较有实时反馈和无实时反馈两种情况下介入放射学(IR)操作中各工作人员的辐射剂量水平,评估实时反馈是否会对工作人员的辐射剂量产生影响。
本研究采用前瞻性试验设计,在两个阶段中,5 名不同岗位的工作人员在所有 IR 操作中均佩戴辐射剂量计:12 周的“封闭”阶段(记录测量值但显示屏关闭,因此未提供反馈)和 17 周的“开放”阶段(显示屏开启并提供实时反馈)。采用 Mann-Whitney U 检验比较辐射剂量率。
两个阶段的中位操作时间、透视时间和患者剂量(剂量面积乘积除以透视时间)均无显著差异。总体而言,开放阶段(透视时间中位数为 0.56 µSv/min)的工作人员剂量中位数明显低于封闭阶段(3.01 µSv/min;P <.05)。对于靠近患者的手术,介入放射医师的剂量显著降低,但对于远离患者的手术则没有显著降低。
为介入放射工作人员提供实时反馈的辐射剂量监测系统可显著降低主要操作人员的辐射暴露,这很可能是通过提高工作人员对辐射防护设备和剂量减少技术的使用依从性实现的。