Sailer Anna M, Vergoossen Laura, Paulis Leonie, van Zwam Willem H, Das Marco, Wildberger Joachim E, Jeukens Cécile R L P N
Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94303, USA.
Cardiovasc Intervent Radiol. 2017 Nov;40(11):1756-1762. doi: 10.1007/s00270-017-1690-5. Epub 2017 May 12.
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 cm versus (phase 2) 0.08 (0.02-0.24) µSv/Gy cm, p = 0.002].
Personalized dose feedback increases radiation awareness and safety and can be provided to staff involved in fluoroscopy-guided interventions.
辐射安全与防护是透视引导介入操作的关键组成部分。我们假设每周提供个人剂量反馈将提高辐射意识，并最终导致行为优化。因此，我们为参与透视引导介入操作的医务人员设计并实施了操作剂量和个人剂量的个性化反馈。
参与透视引导介入操作的医务人员（医生和技术人员，n = 27）配备了电子个人剂量计（PDM）。在8个月的时间里（n = 1082），对每个连续操作的包括剂量面积乘积和来自PDM的有效剂量在内的操作剂量数据进行前瞻性监测。设计了一份个性化反馈表，分别为每位工作人员显示每次操作的个人剂量以及相对剂量和累积剂量。本研究包括两个阶段：（1）第1 - 5个月：工作人员未收到反馈（n = 701）；（2）第6 - 8个月：工作人员收到每周的个人剂量反馈（n = 381）。对反馈和职业剂量进行了匿名评估。
76%的工作人员认为个性化反馈很有价值，71%的工作人员辐射剂量意识有所提高。分别有57%和52%的人报告称，由于个性化反馈，职业安全感增强且行为发生了改变。对于技术人员而言，反馈阶段的标准化剂量显著低于反馈前阶段：[中位数（四分位间距）标准化剂量（第1阶段）0.12（0.04 - 0.50）µSv/Gy cm 对比（第2阶段）0.08（0.02 - 0.24）µSv/Gy cm，p = 0.002]。
个性化剂量反馈可提高辐射意识和安全性，可为参与透视引导介入操作的工作人员提供。
