Busoni S, Bruzzi M, Giomi S, Poggiali C, Quattrocchi M, Betti M, D'Urso D, Fedeli L, Mazzoni L N, Paolucci M, Rossi F, Taddeucci A, Bettarini S, Tortoli P, Belli G, Bernardi L, Gasperi C, Campanella F
Health Physics Unit, AOU Careggi (Firenze University Hospital), Italy.
Physics and Astronomy Department, University of Florence, Italy.
Phys Med. 2022 Dec;104:123-128. doi: 10.1016/j.ejmp.2022.11.002. Epub 2022 Nov 16.
This study investigated the radiation dose to surgeon eye lens for single procedure and normalised to exposure parameters for eight selected neuroradiology, cardiovascular and radiology interventional procedures.
The procedures investigated were diagnostic study, Arteriovenous Malformations treatment (AVM) and aneurysm embolization for neuroradiology procedures, Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (CA-PTCA), Pacemaker and Implantable Cardioverter-Defibrillator implantation (PM-ICD), Endovascular Aortic Repair (EVAR) and Fenestrated Endovascular Aortic Repair (FEVAR) for cardiovascular and electrophysiology procedures. CT-guided lung biopsy was also monitored. All procedures were performed with table-mounted and ceiling-suspended shields (0.5 mm lead equivalent thickness), except for FEVAR and PM-ICD where only a table mounted shield was present, and CT-guided lung biopsy where no shield was used. Dose assessment was performed using a dosemeter positioned close to the most exposed eye of the surgeon, outside the protective eyewear.
The surgeon most exposed eye lens median H(3) equivalent dose for a single procedure, without protective eyewear contribution, was 18 μSv for neuroradiology diagnostic study, 62 μSv for AVM, 38 μSv for aneurysm embolization, 33 μSv for CA-PTCA, 39 μSv for PM-ICD, 49 μSv for EVAR, 2500 μSv for FEVAR, 153 μSv for CT-guided lung biopsy.
In interventional procedures, the 20 mSv/year dose limit for surgeon eye lens exposure might be exceeded if shields or protective eyewear are not used. Surgeon eye lens doses, normalised to single procedures and to exposure parameters, are a valuable tool for determining appropriate radiation protection measures and dedicated eye lens dosemeter assignment.
本研究调查了单次手术中外科医生眼晶状体所受的辐射剂量，并针对八项选定的神经放射学、心血管和放射学介入手术，将其归一化至暴露参数。
所调查的手术包括神经放射学手术中的诊断性研究、动静脉畸形治疗（AVM）和动脉瘤栓塞，心血管和电生理手术中的冠状动脉造影和经皮冠状动脉腔内血管成形术（CA-PTCA）、起搏器和植入式心脏复律除颤器植入（PM-ICD）、血管腔内主动脉修复术（EVAR）和开窗血管腔内主动脉修复术（FEVAR）。还监测了CT引导下的肺活检。所有手术均使用安装在手术台上和天花板上的防护屏（铅当量厚度为0.5毫米）进行，除了FEVAR和PM-ICD仅使用了安装在手术台上的防护屏，以及CT引导下的肺活检未使用防护屏。剂量评估是通过将剂量计放置在外科医生最易受照射的眼睛附近、防护眼镜外部来进行的。
在不考虑防护眼镜影响的情况下，单次手术中外科医生最易受照射的眼晶状体的中位H(3)当量剂量，神经放射学诊断性研究为18微希沃特，AVM为62微希沃特，动脉瘤栓塞为38微希沃特，CA-PTCA为33微希沃特，PM-ICD为39微希沃特，EVAR为49微希沃特，FEVAR为2500微希沃特，CT引导下的肺活检为153微希沃特。
在介入手术中，如果不使用防护屏或防护眼镜，可能会超过外科医生眼晶状体每年20毫希沃特的剂量限值。将外科医生眼晶状体剂量归一化至单次手术和暴露参数，是确定适当辐射防护措施和专用眼晶状体剂量计分配的宝贵工具。
