Cranial radiation exposure during cerebral catheter angiography.
BACKGROUND
Radiation exposure to patients and personnel remains a major concern in the practice of interventional radiology, with minimal literature available on exposure to the forehead and cranium.


OBJECTIVE
In this study, we measured cranial radiation exposure to the patient, operating interventional neuroradiologist, and circulating nurse during neuroangiographic procedures. We also report the effectiveness of wearing a 0.5 mm lead equivalent cap as protection against radiation scatter.


METHODS
24 consecutive adult interventional neuroradiology procedures (six interventional, 18 diagnostic) were prospectively studied for cranial radiation exposures in the patient and personnel. Data were collected using electronic detectors and thermoluminescent dosimeters.


RESULTS
Mean fluoroscopy time for diagnostic and interventional procedures was 8.48 (SD 2.79) min and 26.80 (SD 6.57) min, respectively. Mean radiation exposure to the operator's head was 0.08 mSv, as measured on the outside of the 0.5 mm lead equivalent protective headgear. This amounts to around 150 mSv/year, far exceeding the current deterministic threshold for the lens of the eye (ie, 20 mSv/year) in high volume centers performing up to five procedures a day. When compared with doses measured on the inside of the protective skullcap, there was a statistically significant reduction in the amount of radiation received by the operator's skull.


CONCLUSIONS
Our study suggests that a modern neurointerventional suite is safe when equipped with proper protective shields and personal gear. However, cranial exposure is not completely eliminated with existing protective devices and the addition of a protective skullcap eliminates this exposure to both the operator and support staff.
Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA.
Muhammad Omar
MO
Chohan
Department of Radiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Daniel
D
Sandoval
Department of Safety and Risk Services, University of New Mexico, Albuquerque, New Mexico, USA.
Andrew
A
Buchan
Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA.
Cristina
C
Murray-Krezan
Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA Department of Radiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Christopher L
CL
Taylor
D000328:Adult; D002533:Cerebral Angiography / Q000009:adverse effects*; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D011482:Protective Devices / Q000592:standards; D011829:Radiation Dosage; D011835:Radiation Protection / Q000592:standards*; D012886:Skull / Q000528:radiation effects*; D014965:X-Rays / Q000009:adverse effects*