title: Radiation dose to the radiologist's hand during continuous CT fluoroscopy-guided interventions.
abstract: Computed tomography fluoroscopy (CT fluoroscopy) enables real-time image control over the entire body with high geometric accuracy and, for the most part, without significant interfering artifacts, resulting in increased target accuracy, reduced intervention times, and improved biopsy specimens [1--4]. Depending on the procedure being used, higher radiation doses than in conventional CT-supported interventions might occur. Because the radiologist is present in the CT room during the intervention, he is exposed to additional radiation, which is an important aspect. Initial experience with CT fluoroscopically guided interventions is from the work of Katada et al. in 1994 [5] and only relatively few reports on radiation aspects in CT fluoroscopy are found in the literature [1, 2, 6--11]. To date, there are no reported injuries to patients and radiologists occurring with CT fluoroscopy. The time interval since the wide use of CT fluoroscopy is too short to have data on late effects to the operator using CT fluoroscopy on a daily basis. In addition, the spectrum of CT fluoroscopically guided interventional procedures will expand and more sophisticated procedures requiring longer fluoroscopy times will be performed. Thus, effective exposure reduction is very important. The purpose of our study was to assess the radiation dose to the operator's hand by using data from phantom measurements. In addition, we investigated the effect of a lead drape on the phantom surface adjacent to the scanning plane, the use of thin radiation protective gloves, and the use of different needle holders.
authors.affiliation: Department of Radiology, University of Luebeck, Luebeck 23538, Germany. stoeckel@medinf.mu-luebeck.de
authors.forename: Beate M
authors.initials: BM
authors.lastname: Stoeckelhuber
authors.forename: Thorsten
authors.initials: T
authors.lastname: Leibecke
authors.forename: Edda
authors.initials: E
authors.lastname: Schulz
authors.forename: Uwe H
authors.initials: UH
authors.lastname: Melchert
authors.forename: Claudia U
authors.initials: CU
authors.lastname: Bergmann-Koester
authors.forename: Thomas
authors.initials: T
authors.lastname: Helmberger
authors.forename: Joerg
authors.initials: J
authors.lastname: Gellissen
mesh_terms: D000328:Adult; D005471:Fluoroscopy / Q000009:adverse effects*; D017575:Gloves, Protective; D006225:Hand / Q000528:radiation effects*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008875:Middle Aged; D009010:Monte Carlo Method; D016273:Occupational Exposure / Q000009:adverse effects*; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011834:Radiation Monitoring; D011835:Radiation Protection / Q000295:instrumentation; D015642:Radiology, Interventional; D012542:Scattering, Radiation; D014057:Tomography, X-Ray Computed