Wunderle Kevin A, Chung Mina K, Rayadurgam Sripriya, Miller Mark A, Obuchowski Nancy A, Lindsay Bruce D
Department of Radiology, Cleveland Clinic, 25900 Science Park Dr., AC211, Beachwood, OH, 44122, USA.
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
J Interv Card Electrophysiol. 2019 Nov;56(2):183-190. doi: 10.1007/s10840-018-0462-8. Epub 2018 Oct 2.
Technological advancements have greatly expanded the field of cardiac electrophysiology, requiring greater demands on imaging systems and potentially delivering higher radiation doses to patients and operators. With little contemporary research on occupational and patient radiation risk in the electrophysiology laboratory, the aim of this study was to analyze radiation doses, including occupational fetal doses, over approximately the last decade. We benchmarked the occupational data to our patient radiation dose data to allow for comparison and to put into perspective the associated radiation risks.
Occupational radiation dosimetry analyzed included data from an 11-year period for physicians, a 7-year period for nurses, and a 9-year period for fetal doses. Patient-related dose metrics over an 8-year period were also analyzed.
In the physician and nursing groups, there was a nearly 70% decrease in the average occupational radiation doses over the given periods. Within the electrophysiology department, the average fetal occupational doses were very low, close to 0 μSv. The average reference point air kerma per patient for all electrophysiology procedures decreased from nearly 600 mGy/procedure in 2010 to just over 100 mGy/procedure in 2017.
Patient and occupational radiation doses in our laboratories significantly decreased over the periods analyzed as a result of clinical and technical staff efforts as well as advances in imaging technology. The radiation-related risk to individuals working in our electrophysiology laboratories, including pregnant women, is very low. Data reported herein could be used by other institutions to evaluate their occupational and patient radiation safety practices.
技术进步极大地扩展了心脏电生理学领域，对成像系统的要求更高，可能会给患者和操作人员带来更高的辐射剂量。由于目前关于电生理实验室中职业和患者辐射风险的研究较少，本研究的目的是分析过去大约十年的辐射剂量，包括职业胎儿剂量。我们将职业数据与患者辐射剂量数据进行了对比，以便进行比较并正确看待相关的辐射风险。
分析的职业辐射剂量测定数据包括医生11年的数据、护士7年的数据以及胎儿剂量9年的数据。还分析了8年期间与患者相关的剂量指标。
在医生和护士组中，给定时期内的平均职业辐射剂量下降了近70%。在电生理科内，平均胎儿职业剂量非常低，接近0微希沃特。所有电生理手术的每位患者平均参考点空气比释动能从2010年的近600毫戈瑞/手术降至2017年的略高于100毫戈瑞/手术。
由于临床和技术人员的努力以及成像技术的进步，我们实验室中患者和职业辐射剂量在分析期间显著下降。在我们的电生理实验室工作的人员，包括孕妇，与辐射相关的风险非常低。本文报告的数据可供其他机构用于评估其职业和患者辐射安全实践。
