title: Step back from the patient: reduction of radiation dose to the operator by the systematic use of an automatic power injector for contrast media in an interventional angiography suite.
abstract: BACKGROUND
  During arterial interventional procedures, power injectors allow the operator to step back from the patient or exit the angiography suite during digital subtraction angiography (DSA) acquisitions. Increasing the distance to the radiation source reduces exposure to the operator and staff.
  
  
  OBJECTIVE
  To systematically investigate the effect of increasing the distance between the radiation source and the operator during DSA acquisitions in a daily clinical setting, regarding radiation exposure to the operator and patient, as well as the duration of the procedure using a power injector to deliver contrast media.
  
  
  METHODS
  Patients scheduled for arterial interventional procedures in the pelvis or lower extremities were consecutively included. In phase one (duration 6 weeks, 44 patients) contrast media were injected manually. In phase two (duration until the total dose area product [DAP] was equal to phase 1, 41 patients) the operator used a power injector and exited the suite whenever possible. Patient, procedure, and examination data were recorded. Collective dose to the operator's collar, lead apron, and hands was recorded using thermo luminescent dosimetry (TLD).
  
  
  RESULTS
  Our results showed a dose reduction of 50% to the operator's hands, lead apron, and thyroid collar when using a power injector during DSA, with no significant increase in DAP or procedure time when performing pelvic procedures. For lower extremity procedures there was a small but significant increase in procedure time and DAP. Pelvic procedures yielded substantially higher DAP than lower extremity procedures during both phases.
  
  
  CONCLUSIONS
  Utilization of a power injector, thus allowing the operator to step back from the patient, facilitates a radiation dose reduction to the operator of approximately 50% with no significant increase in patient dose or procedure time during pelvic procedures.
authors.affiliation: Østfold Hospital Trust, Department of Radiology, University of Oslo, Norway. annesof@online.no
authors.forename: Anne Sofie F
authors.initials: AS
authors.lastname: Larsen
authors.forename: Bjørn Helge
authors.initials: BH
authors.lastname: Osterås
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D001822:Body Burden; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous / Q000295:instrumentation; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data; D011829:Radiation Dosage; D011835:Radiation Protection / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D011872:Radiology Department, Hospital; D013819:Thermoluminescent Dosimetry / Q000379:methods / Q000706:statistics & numerical data
chemical_list: D003287:Contrast Media