EuroSafe Imaging 2020
Action 4 - Dose management systems, Interventional vascular, Radiographers, Radioprotection / Radiation dose, Catheter arteriography, Conventional radiography, Fluoroscopy, Angioplasty, Arthrography, Biopsy, Acute, Dosimetric comparison, Occupational / Environmental hazards, Prospective, Observational, Performed at one institution
U. S. Umer, Z. Sohail, A. Nawaz Khan, S. Ghulam ghaus, S. Gul, A. Nawaz
Dosimetry audit plays an important role in the development and safety of radiology procedures. The need for dosimetric and geometric accuracy in radiology is well established 1. Dosimeters are a form of radiation monitoring devices. They are used regularly for a number of key roles including both patient and personal dosimetry, environmental monitoring, spectroscopy, radiopharmaceutical and equipment checking. The film badge dosimeter or film badge is a personal dosimeter used for monitoring cumulative radiation dose due to ionizing radiation. The badge consists of two parts: photographic film, and a holder. The film emulsion is black and white photographic film with varying grain size to affect its sensitivity to incident radiation such as gamma rays, X-rays and beta particles.
Fluoroscopy uses ionizing radiation to guide small instruments such as catheters through blood vessels, in the body or to investigate any pathology using contrast. It represents an advantage over invasive invasive procedures. Therefore this modality is being used by a rapidly expanding number of health care providers in a wide range of medical specialties. However, many of these medical personnel have little training in radiation science or protection measures. The growing use and increasing complexity of these procedures have been accompanied by public health concerns resulting from increasing radiation exposure to both patients and health care personnel. Using fluoroscopy as imaging modality, medical staff and patients are exposed to intense radiation fields especially during interventional procedures. The development of new techniques caused a significant increase of the number of interventions under fluoroscopic guidance in the last few years 3. Consequently, doses received by patients and interventional staff has increased considerably. Therefore, it is important to optimize the procedures in order to reduce the dose delivered to the patient and also providing a direct benefit to the operator and assistants since scattered radiation is proportional to the patient dose. In other words, a reduction of patient dose leads to a reduction of dose to medical staff 4.
In this regard, the protective apron is a valuable means for reducing radiations. In this case, the dosimeter is placed under the apron. However, some parts of the body are not protected, such as the arms or the head. This leads to an underestimation of the effective dose determined from the only shielded dosimeter. Therefore, it is recommended to use an additional dosimeter, placed over the apron, if high doses are involved during intervention. A willingness to undergo radiation dosimetry audit, as one vital component in wider clinical audit, demonstrates the best practice and transparency of the overall process and is now a vital part of the radiology departments.