EuroSafe Imaging 2020
Performed at one institution, Not applicable, Retrospective, Quality assurance, Radiation safety, Physics, Fluoroscopy, Radioprotection / Radiation dose, Interventional vascular, Action 5 - Performance indicators for radiation protection management
R. M. Sanchez, E. Vano, J. I. Ten, P. Salinas, N. Gonzalo, J. Escaned, J. M. Fernández Soto
European regulation stress the importance of optimization in interventional practices . The International Commission on Radiological Protection (ICRP) recommends adopting an integral approach for radiation protection during interventional procedures and auditing not only patient doses but also occupational doses , while never losing sight of the clinical outcome in any medical procedure. Manufacturers of X-ray and imaging systems have also made important efforts to optimize their products by improving the post-processing of the images and making it possible to reduce the patient doses by more than 50% while maintaining or improving the image quality [3-10]. These dose-reduction systems may require increasing the X-ray spectral filters to reduce the patient dose and using image postprocessing algorithms to maintain the contrast in the image at an acceptable level. It would be easy to assume that a reduction in patient dose would lead to a reduction in occupational dose: this could be true if the radiation quality did not change but, in such dose reduction systems, the quantity of primary radiation is reduced but the quality (mean energy of the spectra) is increased. Then, how does the level of scatter radiation around the patients change for the operators? Are occupational doses also decreasing in a similar way as patient doses? There is an agreement among physicists that the scatter level of radiation also increases when the primary beam filtration is increased [11-13], and it is not clear if the reduction in patient dose is more important than the increment of scatter radiation and using high filtration beams provides also a reduction in occupational dose.
The aim of this work is to quantify the effect of one of these dose reduction systems on the scatter radiation measured by a reference dosimeter at the C-arm. Phantom simulation has been performed and so have measurements during a large sample of clinical procedures.