Evaluation of Patients and Staff Radiation Doses in Intervention Radiology

Abstract

Interventional radiology (abbreviated IR or VIR for Vascular and Interventional Radiology, also referred to as Surgical Radiology) is a medical sub-specialty of radiology which utilizes minimally-invasive image-guided procedures to diagnose and treat diseases in nearly every organ system. This study intends to evaluate the patients and staff radiation doses in intervention radiology for four procedures; vascular, pacemaker, brain and orthopedic in Sudan to 826 adults patients and 44 staff. they were exposed in four hospitals equipped with C-Arm imaging modalities, 301 patients and 15 staff are exposure in Khartoum Teaching Hospital, 100 patients and 8 staff are exposure in Royal Care Hospital, 201 patients and 7 staff are exposure in Kuwait special Hospital and 224 patients and 14 staff are exposure in Elmek Nimer University Hospital. The mean Kv for vascular, pacemaker, brain and orthopedic intervention were 77.16, 76.41, 70.0 and 63.62 respectively. While the mean mAs for the four procedures were 1344.32, 291.25, 530.75 and 600 respectively. Also the mean ESD for the four procedures were 73.69, 33.73, 26.53 and 1.22 respectively while the mean DAP for the four procedures were 17.39, 4.31, 11.63 and 0.63 G. Cm2respectively.The mean doses of staff that exposed in vascular intervention procedures were 26.12, 13.04, 12.9 and 7.15 µsVr for physician, assistant, nurse and technician respectively. The mean doses of staff that exposed in brain intervention procedures were 21.05, 18.09, 15.98, and 16.05 µsVr for physician, assistant, nurse and technician respectively. The mean doses of staff that exposed in pacemaker intervention radiology procedures were 1.35, 1.08, 0.91 and 0.13 µsVr for physician, assistant, nurse and technician respectively. The mean doses of staff that exposed in orthopedic intervention radiology procedures were 7.15, 0.13, 0.05 and 0.05 µsVr for physician, assistant, nurse and technician respectively. ESD, DAP were the highest in vascular intervention radiology procedure this because of using high Kv, high mAs and long duration as measured, also the physician is the highest radiation dose one, Vascular intervention radiology which is highest procedure while in orthopedic intervention radiology is lowest one which are same as a major pervious studies . In this study correlations were done; between entrance skin dose ESD (mGy) compared to tube potential kVp (kV), duration of the procedure (minute) and dose area product DAP (mGy.Cm2); R2are 0.79, 0.30 and 0.51 respectively which are good in kVp and DAP and weakly in duration of the procedure. Also it is found that the correlation between ESD and kVp increased by 3.93 unit per 1 kVp unit while ESD increased by 3.83 unit per 1 DAP unit. From all this studies it found that factors affecting dose to patient and staff are fluoroscopy time, number of frames, field size, technical characteristics of radiation equipment, patient size and examination type and operation mode Patients and staff radiation doses vary widely among the different interventional radiology procedures but also among published studies. Discrepancies of the derived results are patient, procedure, physician, and fluoroscopic equipment related. Nevertheless, IR procedures can subject patients to considerable radiation doses and efforts to minimize patient exposure should always be undertaken. So advices the staff to use minimum Kv, minimum mAs, and minimum duration of the procedures as low as possible. Minimize the use of fluoroscopy and using low fluoroscopy modes when possible. An experience one in any field must be found in the interventional radiology to minimize the radiation dose. More studies in intervention radiology.