Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Department of Neuroradiology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52076 Aachen, Germany.
Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Eur J Radiol. 2023 Jul;164:110882. doi: 10.1016/j.ejrad.2023.110882. Epub 2023 May 13.
Radiological neuro-interventions, especially endovascular stroke treatment (EST), are increasing in case numbers worldwide with increasing occupational radiation exposure. Aim of this study was to define the radiation exposure of neurointerventionalists (NI) during EST and to compare the accumulated dose reaching the left arm with the left temple.
This is a prospective observational study in a tertiary stroke center conducted between 11/2021 and 07/2022. Radiation exposure was measured using real time dosimetry with dosimeters being carried by the NI during EST simultaneously at the left temple and left arm. The effective dose [µSV] per dose area product (DAP) and potential influencing factors were compared in univariate analysis between the two dosimeter positions.
In total, 82 ESTs were analyzed with a median DAP of 6179 µGym (IQR 3271 µGym-11720 µGy*m). The accumulated dose at the left arm and left temple correlated with the DAP and fluoroscopy time of the EST (DAP and arm: p = 0.01, DAP and temple: p = 0.006). The radiation exposure (RE) showed a wide range and did not differ between the two dosimeter positions (median, IQR arm 7 µSV, IQR 3.1-16.9 µSV, min. 0.3 µSV max. 64.5 µSV) vs. head 7 µSv, IQR 3.2-17.4 µSV, min. 0.38 µSV, max. 48.6 µSV, p = 0.94). Occupational RE depends on the number of thrombectomy attempts, but not the target vessel occlusion location or the NI's body height.
Neurointerventionalists experience a generally low but very variable radiation exposure during EST, which depends on the intervention's fluoroscopy time and dose area product as well as thrombectomy attempts but does not differ between left temple and left arm.
放射神经介入治疗，特别是血管内卒中治疗（EST），在全球范围内的病例数量不断增加，同时职业辐射暴露也在增加。本研究的目的是确定神经介入医师（NI）在 EST 期间的辐射暴露情况，并比较累积剂量达到左手臂与左太阳穴的情况。
这是一项在三级卒中中心进行的前瞻性观察研究，于 2021 年 11 月至 2022 年 7 月进行。在 EST 期间，NI 同时佩戴实时剂量仪在左太阳穴和左手臂处进行实时剂量测量。在单变量分析中，比较了两个剂量仪位置之间的每剂量面积产物（DAP）的有效剂量[µSV]和潜在影响因素。
共分析了 82 例 EST，DAP 的中位数为 6179µGym（IQR 3271µGym-11720µGy*m）。左手臂和左太阳穴的累积剂量与 EST 的 DAP 和透视时间相关（DAP 和手臂：p=0.01，DAP 和太阳穴：p=0.006）。辐射暴露（RE）范围很广，且两个剂量仪位置之间无差异（中位数，IQR 手臂 7µSV，IQR 3.1-16.9µSV，最小 0.3µSV，最大 64.5µSV）与头部 7µSv，IQR 3.2-17.4µSV，最小 0.38µSV，最大 48.6µSV，p=0.94）。职业性 RE 取决于取栓尝试的次数，但与目标血管闭塞位置或 NI 的身高无关。
神经介入医师在 EST 期间的辐射暴露总体较低，但差异较大，这取决于介入的透视时间和剂量面积产物以及取栓尝试次数，但与左太阳穴和左手臂之间无差异。
