Patient and staff dosimetry in vertebroplasty.
METHODS
Eleven vertebroplasty operations were studied in terms of radiation dose.


OBJECTIVE
Doses to patients and staff associated with vertebroplasty were measured. Occupational doses were compared with the annual dose limits, and the effectiveness of the used radiation protection means was estimated. Patient dose was estimated by means of both surface and effective dose, and the radiation-induced risk was evaluated.


BACKGROUND
Vertebroplasty is a recent minimally invasive technique for the restoration of vertebral body fractures. It involves fluoroscopic exposure, and so, it demands dose measurements for both patient and staff exposed to radiation.


METHODS
Thermoluminescent dosimeters (TLDs) were placed on the medical personnel and the effective dose was derived. Slow films were placed to patients' skin to measure entrance surface dose. Furthermore, a Rando phantom loaded with TLDs was irradiated under conditions simulating vertebroplasty, in order to estimate effective dose to the patient.


RESULTS
Mean fluoroscopy time was 27.7 minutes. Patient's mean skin dose was 688 mGy, while effective dose was calculated to be 34.45 mGy. It was estimated that the primary operator can perform about 150 vertebroplasty operations annually without exceeding the annual dose constraints, whereas occupational dose can be reduced by 76% using mobile shielding.


CONCLUSIONS
Measures have to be taken to reduce patient's skin dose, which, in extreme cases, may be close to deterministic effects threshold. The highest dose rates, recorded during the procedure, were found for primary operator's hands and chest when no shielding was used.
Fitousi
Niki T
NT
Department of Medical Physics, School of Medicine, University of Patras, Patras, Greece.
Efstathopoulos
Efstathios P
EP
Delis
Harry B
HB
Kottou
Sofia
S
Kelekis
Alexis D
AD
Panayiotakis
George S
GS
D005471:Fluoroscopy; D006282:Health Personnel; D006801:Humans; D019060:Minimally Invasive Surgical Procedures; D016273:Occupational Exposure; D019637:Orthopedic Procedures; D010361:Patients; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011835:Radiation Protection; D011874:Radiometry; D012867:Skin / Q000528:radiation effects; D013131:Spine / Q000601:surgery*; D025321:Surgery, Computer-Assisted