Department of Medical Physics, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa.
Health Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa.
Radiography (Lond). 2023 May;29(3):539-545. doi: 10.1016/j.radi.2023.02.024. Epub 2023 Mar 14.
During fluoroscopic examinations, radiation dose reduction gloves (RRGs) protect the hands of the interventionalist against ionising scattered radiation from the patient. Some fluoroscopic procedures may require the hands of the interventionalist in the path of the primary X-ray beam. This study investigates the influence of RRGs in the field of view (FOV) on exposure parameters, entrance dose rates and eye doses of interventionalists during mobile C-arm fluoroscopic procedures.
Polymethylmethacrylate (PMMA) slabs were stacked on each other to simulate patient thicknesses. The abdomen protocol of the unit was selected for the study. The entrance dose rates to the surface of the PMMA slabs and the scattered radiation were measured for an undercouch configuration with and without RRGs in the FOV. The exposure parameters were noted. The scattered radiation for an overcouch configuration was measured.
The entrance dose rate increases as the FOV decreases for a fixed thickness of PMMA. The presence of RRGs in the FOV increases the exposure parameters, entrance dose rates and the scattered radiation to the eyes of the interventionalist. For the first level of RRG coverage, percentage increases in entrance dose rates and eye doses for the 23 cm FOV for all thicknesses of PMMA slabs ranged from 1.0% to 17.0% and 20.0%-30.0%, respectively; for the second level of RRG coverage, the entrance dose rates ranged from 17.0% to 45.0% and the eye doses from 50.0% to 60.0%. Percentage increases depend on the FOV, the patient's thickness, and the size and orientation of the RRGs in the FOV. Scattered radiation to the eyes of the interventionalist increases with an overcouch configuration compared to an undercouch configuration.
Sterile RRGs protects the hands of the interventionalist against scattered radiation. But in the FOV, they increase the scattered radiation to the personnel and the patient entrance dose rate.
For best practice in C-arm fluoroscopy-guided procedures, appropriate FOV and C-arm orientation should be selected, whilst RRGs should not be in the path of the primary beam unless necessary.
在透视检查过程中，辐射防护手套（RRG）可保护介入医生的手部免受来自患者的电离散射辐射。在某些透视过程中，介入医生的手部可能会处于主 X 射线束的路径中。本研究旨在探讨 RRG 在视野（FOV）内对介入医生在移动式 C 臂透视过程中曝光参数、入射剂量率和眼部剂量的影响。
将聚甲基丙烯酸甲酯（PMMA）板相互堆叠以模拟患者的厚度。选择该设备的腹部方案进行研究。在 FOV 内有无 RRG 的情况下，测量 PMMA 板表面的入射剂量率和散射辐射。记录曝光参数。测量过顶配置的散射辐射。
对于固定的 PMMA 厚度，FOV 减小，入射剂量率增大。FOV 内存在 RRG 会增加介入医生的曝光参数、入射剂量率和散射辐射到眼部。对于第一级 RRG 覆盖，所有 PMMA 板厚度的 23cm FOV 的入射剂量率和眼部剂量的百分比增加分别为 1.0%至 17.0%和 20.0%至 30.0%；对于第二级 RRG 覆盖，入射剂量率范围为 17.0%至 45.0%，眼部剂量率范围为 50.0%至 60.0%。百分比的增加取决于 FOV、患者的厚度以及 FOV 内 RRG 的大小和方向。与过顶配置相比，介入医生眼部的散射辐射随过顶配置而增加。
无菌 RRG 可保护介入医生的手部免受散射辐射。但在 FOV 内，它们会增加人员和患者入射剂量率的散射辐射。
在 C 臂透视引导下的操作中，应选择合适的 FOV 和 C 臂方位，除非必要，否则 RRG 不应处于主射线束的路径中。
