Radiology Department, Faculty of Medicine. Complutense University, E-28040 Madrid, Spain.
IdISSC and Medical Physics Service, Hospital Clínico San Carlos, Martin Lagos s.n., E-28040 Madrid, Spain.
J Radiol Prot. 2020 Nov 11;40(4). doi: 10.1088/1361-6498/abc325.
Occupational protection is still a challenge for interventional cardiology. One of the main problems is the occasional improper use of the ceiling suspended screen. We present a methodology to audit the correct use of the shielding using active electronic dosimeters. To improve the protection, we suggest the use of an alert based on the ratio between the occupational dose per procedure, measured by a personal electronic dosimeter over the lead apron, and the dose measured by an unshielded dosimeter, located at the C-arm. The new electronic dosimeters and the automatic dose management systems allow processing the dosimetric data for individual procedures and for the radiation events, sending the values (wireless) to a central database. We selected six interventional cardiologists and analysed 385 interventional procedures involving about 30 000 radiation events. Our results suggest that for individual procedures, standard values of the ratio between operator dose and the C-arm reference dose, should be between 1%-2% for a proper use of the shielding. Percentage values ≥5%-10% for individual procedures, require an analysis of the different radiation events to identify the lack of occupational protection and suggest corrective actions. In our sample, half of the operators should improve the use of the shielding in around 20% of the procedures. Using this ratio as an alert to operators allows optimising occupational radiation protection and discriminating between high occupational doses derived from complex procedures and high doses due to the improper use of the protective screen.
职业防护仍然是介入心脏病学面临的挑战之一。其中一个主要问题是偶尔会不当使用天花板悬挂式防护屏。我们提出了一种使用有源电子剂量仪来审核防护屏正确使用的方法。为了改善防护，我们建议使用基于个人电子剂量仪测量的每个程序的职业剂量与未屏蔽剂量仪（位于 C 臂）测量的剂量之间的比值的警报。新型电子剂量仪和自动剂量管理系统允许对单个程序和辐射事件的剂量数据进行处理，并将值（无线）发送到中央数据库。我们选择了六名介入心脏病专家，分析了涉及约 30000 次辐射事件的 385 次介入程序。我们的结果表明，对于单个程序，操作人员剂量与 C 臂参考剂量之间的比值的标准值应为 1%-2%，以正确使用防护屏。对于个体程序，比值≥5%-10%，需要分析不同的辐射事件，以确定职业防护是否缺失，并提出纠正措施。在我们的样本中，大约一半的操作人员应该在大约 20%的程序中改进防护屏的使用。将该比值用作操作人员的警报，可以优化职业辐射防护，并区分复杂程序引起的高职业剂量和因防护屏不当使用而导致的高剂量。
