title: Optimisation of occupational radiological protection in image-guided interventions: potential impact of dose rate measurements.
abstract: The optimisation of occupational radiological protection is challenging and a variety of factors have to be considered. Physicians performing image-guided interventions are working in an environment with one of the highest radiation risk levels in healthcare. Appropriate knowledge about the radiation environment is a prerequisite for conducting the optimisation process. Information about the dose rate variation during the interventions could provide valuable input to this process. The overall purpose of this study was to explore the prerequisite and feasibility to measure dose rate in scattered radiation and to assess the usefulness of such data in the optimisation process.Using an active dosimeter system, the dose rate in the unshielded scattered radiation field was measured in a fixed point close to the patient undergoing an image-guided intervention. The measurements were performed with a time resolution of one second and the dose rate data was continuously timed in a data log. In two treatment rooms, data was collected during a 6 month time period, resulting in data from 380 image-guided interventions and vascular treatments in the abdomen, arms and legs. These procedures were categorised into eight types according to the purpose of the treatment and the anatomical region involved.The dose rate varied substantially between treatment types, both regarding the levels and the distribution during the procedure. The maximum dose rate for different types of interventions varied typically between 5 and 100 mSv h(-1), but substantially higher and lower dose rates were also registered. The average dose rate during a complete procedure was however substantially lower and varied typically between 0.05 and 1 mSv h(-1). An analysis of the distribution disclosed that for a large part of the treatment types, the major amount of the total accumulated dose for a procedure was delivered in less than 10% of the exposure time and in less than 1% of the total procedure time.The present study shows that systematic dose rate measurements are feasible. Such measurements can be used to give a general indication of the exposure level to the staff and could serve as a first risk assessment tool when introducing new treatment types or x-ray equipment in the clinic. For example, it could provide an indication for when detailed eye dose measurements are needed. It also gives input to risk management considerations and the development of efficient routines for other radiological protection measures.
authors.affiliation: Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden. Department of Radiation Physics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SE-413 45 Gothenburg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Almén
authors.forename: V
authors.initials: V
authors.lastname: Sandblom
authors.forename: M
authors.initials: M
authors.lastname: Båth
authors.forename: C
authors.initials: C
authors.lastname: Lundh
mesh_terms: D001822:Body Burden; D005240:Feasibility Studies; D006282:Health Personnel; D006801:Humans; D016273:Occupational Exposure / Q000032:analysis* / Q000517:prevention & control*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D011874:Radiometry / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects; D013548:Sweden; D014965:X-Rays