Medical Physics Service and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Radiology Department, Medicine Faculty of the Universidad Complutense de Madrid, Madrid, Spain.
Br J Radiol. 2021 Jan 1;94(1117):20200774. doi: 10.1259/bjr.20200774. Epub 2020 Nov 24.
In fluoroscopy-guided interventional practices, new dose reduction systems have proved to be efficient in the reduction of patient doses. However, it is not clear whether this reduction in patient dose is proportionally transferred to operators' doses. This work investigates the secondary radiation fields produced by two kinds of interventional cardiology units from the same manufacturer with and without dose reduction systems.Data collected from a large sample of clinical procedures over a 2-year period (more than 5000 procedures and 340,000 radiation events) and the DICOM radiation dose structured reports were analysed.
The average cumulative (10) per procedure measured at the C-arm was similar for the standard and the dose reduction systems (452 476 μSv respectively). The events analysis showed that the ratio (10)/KAP at the C-arm was (mean ± SD) 5 ± 2, 10 ± 4, 14 ± 4 and 14 ± 6 μSv·Gy·cm for the beams with no added filtration, 0.1, 0.4 and 0.9 mm Cu respectively and suggested that the main cause for the increment of the ratio (10)/KAP the "standard system" is the use of higher beam filtration in the "dose reduction" system.
Dose reduction systems are beneficial to reduce KAP in patients and their use should be encouraged, but they may not be equally effective to reduce occupational doses. Interventionalists should not overlook their own personal protection when using new technologies with dose reduction systems.
Dose reduction technology in interventional systems may increase scatter dose for operators. Personal protection should not be overlooked with dose reduction systems.
在透视引导的介入操作中,新的剂量减少系统已被证明能有效地降低患者剂量。然而,目前尚不清楚患者剂量的减少是否会成比例地转移到操作人员的剂量上。本研究调查了同一家制造商的两种介入心脏病学设备在有和没有剂量减少系统的情况下产生的次级辐射场。
从一个为期 2 年的大量临床操作(超过 5000 例操作和 34 万次辐射事件)中收集数据,并对 DICOM 辐射剂量结构化报告进行了分析。
在 C 臂处测量的每例操作的累积(10)剂量,标准系统和剂量减少系统相似(分别为 452 476 μSv)。事件分析表明,C 臂处的比值(10)/KAP 分别为(平均值±标准差)5±2、10±4、14±4 和 14±6 μSv·Gy·cm,无附加过滤、0.1、0.4 和 0.9 毫米 Cu 过滤的射线束分别为,这表明比值(10)/KAP 在“标准系统”中增加的主要原因是“剂量减少系统”中使用了更高的射线束过滤。
剂量减少系统有利于减少患者的 KAP,应鼓励其使用,但它们可能对降低职业剂量的效果并不相同。介入医生在使用具有剂量减少系统的新技术时,不应忽视自身的个人防护。
介入系统中的剂量减少技术可能会增加操作人员的散射剂量。在使用剂量减少系统时,不应忽视个人防护。