Mottareale Rocco, Manna Francesco, Carmosino Patrizio Antonio, Fiore Francesco, Correra Marco, Stilo Salvatore, Tarotto Luca, Pugliese Mariagabriella
Department of Physics "E. Pancini", Federico II University, 80126 Naples, Italy.
Centro Servizi Metrologici e Tecnologici Avanzati, Federico II University, 80146 Naples, Italy.
Sensors (Basel). 2025 Jun 11;25(12):3666. doi: 10.3390/s25123666.
Interventional radiology offers minimally invasive procedures guided by real-time imaging, reducing surgical risks and enhancing patient recovery. While beneficial to patients, these advancements increase occupational hazards for physicians due to chronic exposure to ionizing radiation. This exposure raises health risks like radiation-induced cataracts, cardiovascular disease, and cancer. Despite regulations like the European Council Directive 2013/59/EURATOM, which sets limits on whole-body and eye lens doses, no dose limits exist for the brain and meninges, since the brain has traditionally been considered a radioresistant organ. Recent studies, however, have highlighted radiation-induced brain damage, suggesting that meningeal exposure in interventional radiology may be underestimated. This study evaluates the entrance air Cumulative mean annual entrance air kerma to the skullull during interventional radiology procedures, using thermoluminescent dosimeters and controlled exposure simulations. Data were collected by varying the exposure time and analyzing the contribution to the entrance air kerma on each side of the head. The results indicate that, considering the attenuation of the cranial bone, the absorbed dose to the brain, obtained by averaging the head entrance air kerma for the right, front, and left sides of the operator's head, could represent 0.81% to 2.18% of the annual regulatory limit in Italy of 20 mSv for the average annual effective dose of exposed workers (LD 101/2020). These results provide an assessment of brain exposure, highlighting the relatively low but non-negligible contribution of brain irradiation to the overall occupational dose constraint. Additionally, a correlation between entrance air kerma and the Kerma-Area Product was observed, providing a potential method for improved dose estimation and enhanced radiation safety for interventional radiologists.
介入放射学提供了在实时成像引导下的微创手术,降低了手术风险并促进了患者康复。虽然对患者有益,但由于长期暴露于电离辐射,这些进展增加了医生的职业危害。这种暴露会引发诸如辐射性白内障、心血管疾病和癌症等健康风险。尽管有欧洲理事会指令2013/59/EURATOM等规定,对全身和眼晶状体剂量设定了限制,但对于大脑和脑膜却没有剂量限制,因为传统上认为大脑是抗辐射器官。然而,最近的研究强调了辐射诱发的脑损伤,表明介入放射学中脑膜暴露可能被低估。本研究使用热释光剂量计和受控暴露模拟,评估介入放射学程序期间颅骨的入射空气累积平均年空气比释动能。通过改变暴露时间并分析头部两侧对入射空气比释动能的贡献来收集数据。结果表明,考虑到颅骨的衰减,通过对操作员头部右侧、前部和左侧的头部入射空气比释动能进行平均获得的大脑吸收剂量,可能占意大利暴露工人年平均有效剂量20 mSv年度监管限值的0.81%至2.18%(LD 101/2020)。这些结果提供了对脑部暴露的评估,突出了脑部照射对总体职业剂量限制的贡献相对较低但不可忽视。此外,观察到入射空气比释动能与比释动能-面积乘积之间的相关性,为改进剂量估计和提高介入放射科医生的辐射安全性提供了一种潜在方法。