Morcillo Ana Belén, Alejo Luis, Huerga Carlos, Bayón José, Marín Alberto, Corredoira Eva, Novo Joan Ricardo, Hernández Teresa, Ponce María Dolores, Garzón Gonzalo, Vañó Eliseo, Guibelalde Eduardo
Medical Physics Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain.
Vascular and Interventional Radiology Department, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28046, Spain.
Med Phys. 2021 Apr;48(4):1956-1966. doi: 10.1002/mp.14753. Epub 2021 Mar 4.
To assess occupational lens exposure in a mixed interventional radiology department, comparing pediatric and adult procedures. To analyze the correlation between the lens dose and the doses measured at the chest and collar level and the kerma-area product (P ).
For 17 months, three radiologists performing both pediatric and adult interventions were monitored by means of 14 dosimeters per worker: 12 single-point optically stimulated luminescent (OSL) dosimeters calibrated in terms of H (0.07) were placed on the inside and outside of two pairs of lead glasses, one for pediatric procedures and one for adult interventions; another whole-body OSL dosimeter calibrated in terms of H (10) was placed over the thyroid shield; finally, an additional active solid-state dosimeter, also calibrated for H (10), was worn on the chest, over the apron. Furthermore, a database was created to register the demographic and dosimetric data of the procedures, as well as the name of the radiologist acting as first operator.
For the three radiologists, who performed 276-338 procedures/year (20% pediatric), cumulative annual doses to the left bare eye exceeded 20 mSv (21-61 mSv). Considering the glasses' protection, annual doses exceeded 6 mSv (13-48 mSv) for both eyes. No important differences were observed in lens dose per procedure between pediatric and adult interventions (0.16 vs 0.18, 0.12 vs 0.09, and 0.07 vs 0.07 mSv), although lens dose per P was 4.1-4.5 times higher in pediatrics (5.8 vs 1.3, 3.3 vs 0.8, and 2.6 vs 0.6 µSv/Gy·cm ) despite a similar use of the ceiling-suspended screen. Lens doses were highly correlated with collar readings (with Pearson coefficients [r] ranging from 0.86 to 0.98) and with chest readings (with r ranging from 0.75 to 0.93). However, slopes of the linear regressions varied greatly among radiologists.
There is real risk of exceeding the occupational dose limit to the eye lens in mixed interventional radiology rooms if radiation protection tools are not used properly. Regular monitoring of the lens dose is recommended, given lens exposure might easily exceed 6 mSv/yr. Using a collar dosimeter for this purpose might be suitable if it is preceded by an individualized regression analysis. The same radiation protection measures should be applied to interventional radiologists regardless of whether they are treating pediatric or adult patients.
评估混合介入放射科的职业性晶状体照射情况，比较儿科和成人手术。分析晶状体剂量与胸部和领口水平测量的剂量以及比释动能面积乘积（P）之间的相关性。
在17个月的时间里，对三名既进行儿科手术又进行成人手术的放射科医生进行监测，每位工作人员使用14个剂量计：12个单点光激励发光（OSL）剂量计，根据H（0.07）进行校准，分别放置在两副铅眼镜的内侧和外侧，一副用于儿科手术，一副用于成人手术；另一个根据H（10）校准的全身OSL剂量计放置在甲状腺防护装置上方；最后，在胸部围裙上方佩戴一个同样根据H（10）校准的有源固态剂量计。此外，创建了一个数据库，用于记录手术的人口统计学和剂量学数据，以及担任第一操作者的放射科医生的姓名。
对于这三名每年进行276 - 338例手术（20%为儿科手术）的放射科医生，每年左侧裸眼的累积剂量超过20 mSv（21 - 61 mSv）。考虑到眼镜的防护作用，双眼的年剂量超过6 mSv（13 - 48 mSv）。儿科和成人手术之间每例手术的晶状体剂量没有观察到重要差异（0.16对0.18、0.12对0.09以及0.07对0.07 mSv），尽管尽管儿科手术中每单位比释动能面积乘积的晶状体剂量高4.1 - 4.5倍（5.8对1.3、3.3对0.8以及2.6对0.6 μSv/Gy·cm），但天花板悬挂式防护屏的使用情况相似。晶状体剂量与领口读数高度相关（皮尔逊系数[r]范围为0.86至0.98），与胸部读数也高度相关（r范围为0.75至0.93）。然而，放射科医生之间线性回归的斜率差异很大。
在混合介入放射科，如果辐射防护工具使用不当，存在超过职业性晶状体剂量限值的实际风险。鉴于晶状体照射可能很容易超过每年6 mSv，建议定期监测晶状体剂量。如果在此之前进行个体化回归分析，使用领口剂量计可能是合适的。无论介入放射科医生治疗的是儿科患者还是成人患者，都应采取相同的辐射防护措施。
