Perisinakis Kostas, Solomou Georgia, Stratakis John, Damilakis John
Department of Medical Physics, Medical School, University of Crete, P.O. Box 2208, Heraklion 71003, Crete, Greece; Department of Medical Physics, University Hospital of Heraklion, P.O. Box 1352, Heraklion 71110, Crete, Greece.
Department of Medical Physics, Medical School, University of Crete, P.O. Box 2208, Heraklion 71003, Crete, Greece.
Phys Med. 2016 Feb;32(2):386-92. doi: 10.1016/j.ejmp.2016.02.006. Epub 2016 Mar 2.
To provide normalized scatter exposure data and methods for reliable estimation of cumulative effective dose and eye-lens equivalent dose to personnel involved in fluoroscopically guided cardiac catheterization (FGCC) procedures.
An anthropomorphic phantom was placed supine on the table of a modern digital C-arm angiographic system and 17 different fluoroscopic projections commonly employed during FGCC procedures were represented. Scatter exposure rates at the waist and eye level were measured for varying exposure parameters and position in the operating room. The effect of beam field size, patient size, use of radioprotective garments and small variations in projection angulation and table height on scatter radiation was investigated.
Apart from the position and use of radio-protective garments, radiation burden to operators during fluoroscopic guidance was found to remarkably depend beam field size (>45% reduction if a 10 × 10 cm(2) instead of 15 × 15 cm(2) fluoroscopy beam is used) and patient size (>25% increased scatter for obese patients). In contrast, the variation of measured scatter exposure from a given projection was found to be <10% when the source to skin distance was altered by ±10 cm or beam angulation of a specific projection was altered by ±10°.
Presented scatter exposure data charts and methods allow for prospective and retrospective estimation of effective dose and eye-lens equivalent dose to personnel involved in any FGCC procedure. Projection specific maps of scatter exposure produced may enhance familiarization of involved medical staff to good radiation protection practice and optimization of working habits in the cardiac catheterization lab.
提供标准化的散射剂量数据及方法，用于可靠估算在荧光透视引导下的心脏导管插入术（FGCC）过程中工作人员的累积有效剂量和眼晶状体当量剂量。
将一个人体模型仰卧放置在现代数字C形臂血管造影系统的检查台上，模拟FGCC过程中常用的17种不同的荧光透视投照。针对不同的曝光参数和手术室中的位置，测量腰部和眼睛高度处的散射剂量率。研究了射野大小、患者体型、使用辐射防护衣以及投照角度和检查台高度的微小变化对散射辐射的影响。
除了辐射防护衣的位置和使用情况外，发现荧光透视引导期间操作人员所受的辐射负担显著取决于射野大小（如果使用10×10 cm²而不是15×15 cm²的透视射野，辐射负担降低>45%）和患者体型（肥胖患者的散射剂量增加>25%）。相比之下，当源皮距离改变±10 cm或特定投照的射束角度改变±10°时，给定投照下测得的散射剂量变化<10%。
所呈现的散射剂量数据图表和方法可用于前瞻性和回顾性估算参与任何FGCC过程的人员的有效剂量和眼晶状体当量剂量。生成的特定投照散射剂量图可增强相关医务人员对良好辐射防护实践的熟悉程度，并优化心导管实验室的工作习惯。
