title: Measurements of surgeons' exposure to ionizing radiation dose: comparison of conventional and mini C-arm fluoroscopy.
abstract: This study was performed to measure the equivalent scattered radiation dose delivered to susceptible organs while simulating orthopaedic surgery using conventional and mini C-arm fluoroscopy. In addition, shielding effects on the thyroid, thymus, and gonad, and the direct exposure delivered to the patient's hands were also compared. A conventional and mini C-arms were installed in an operating room, and a hand and an operator phantom were used to simulate a patient's hand and a surgeon. Photoluminescence dosimeters were used to measure the equivalent dose by scattered radiation arriving at the thyroid, thymus, and gonad on a whole-body phantom in the position of the surgeon. Equivalent scattered radiation doses were measured in four groups: (1) unshielded conventional C-arm group; (2) unshielded mini C-arm group; (3) lead-shielded conventional C-arm group; and (4) lead-shielded mini C-arm group. Equivalent scattered radiation doses to the unshielded group were significantly lower in the mini C-arm group than those in the conventional C-arm group for all organs. The gonad in the lead-shielded conventional C-arm group showed the highest equivalent dose among operator-susceptible organs, and radiation dose was reduced by approximately 96% compared with that in the unshielded group. Scattered radiation was not detected in any susceptible organ in the lead-shielded mini C-arm group. The direct radiation dose to the hand phantom measured from the mini C-arm was significantly lower than that measured from the conventional C-arm. The results show that the equivalent scattered radiation dose to the surgeon's susceptible organs and the direct radiation dose to a patient's hand can be decreased significantly by using a mini C-arm rather than a conventional C-arm. However, protective lead garments, such as a thyroid shield and apron, should be applied to minimize radiation exposure to susceptible organs, even during use of mini C-arm fluoroscopy.
authors.affiliation: Department of Orthopaedic Surgery, Myongji Hospital, Kyungki, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Sung
authors.affiliation: Department of IT Convergence, Korea University, Seoul, Korea.
authors.forename: E
authors.initials: E
authors.lastname: Min
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea.
authors.forename: C Y
authors.initials: CY
authors.lastname: Chung
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea.
authors.forename: B C
authors.initials: BC
authors.lastname: Jo
authors.affiliation: Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Kyungki, Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Park
authors.affiliation: School of Biomedical Engineering, Korea University, Seoul, Korea kisung@korea.ac.kr.
authors.forename: K
authors.initials: K
authors.lastname: Lee
mesh_terms: D005471:Fluoroscopy / Q000295:instrumentation*; D006066:Gonads; D006801:Humans; D016273:Occupational Exposure; D009985:Orthopedics; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D000069079:Radiation Exposure; D011839:Radiation, Ionizing; D013950:Thymus Gland; D013961:Thyroid Gland
keywords: Conventional C-arm; equivalent dose; mini C-arm; susceptible organ