title: Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice.
abstract: OBJECTIVE
  Knowledge of medical radiation exposure permits application of radiation protection principles. In our center, the first dedicated real-time, automated patient and staff dose monitoring system (DoseWise Portal, Philips Healthcare) was installed. Aim of this study was to obtain insight in the procedural and occupational doses.
  
  
  METHODS
  All interventional radiologists, vascular surgeons, and technicians wore personal dose meters (PDMs, DoseAware, Philips Healthcare). The dose monitoring system simultaneously registered for each procedure dose-related data as the dose area product (DAP) and effective staff dose (E) from PDMs. Use and type of shielding were recorded separately. All procedures were analyzed according to procedure type; these included among others cerebral interventions (n = 112), iliac and/or caval venous recanalization procedures (n = 68), endovascular aortic repair procedures (n = 63), biliary duct interventions (n = 58), and percutaneous gastrostomy procedure (n = 28).
  
  
  RESULTS
  Median (±IQR) DAP doses ranged from 2.0 (0.8-3.1) (percutaneous gastrostomy) to 84 (53-147) Gy cm2(aortic repair procedures). Median (±IQR) first operator doses ranged from 1.6 (1.1-5.0) μSv to 33.4 (12.1-125.0) for these procedures, respectively. The relative exposure, determined as first operator dose normalized to procedural DAP, ranged from 1.9 in biliary interventions to 0.1 μSv/Gy cm2in cerebral interventions, indicating large variation in staff dose per unit DAP among the procedure types.
  
  
  CONCLUSIONS
  Real-time dose monitoring was able to identify the types of interventions with either an absolute or relatively high staff dose, and may allow for specific optimization of radiation protection.
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands. karmanna@stanford.edu.|Department of Radiology, Stanford University Medical Centre, 300 Pasteur Drive, R354, Stanford, CA, 94303, USA. karmanna@stanford.edu.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Sailer
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Leonie
authors.initials: L
authors.lastname: Paulis
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Laura
authors.initials: L
authors.lastname: Vergoossen
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Axel O
authors.initials: AO
authors.lastname: Kovac
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Geert
authors.initials: G
authors.lastname: Wijnhoven
authors.affiliation: Department of Vascular Surgery, Maastricht University Medical Centre, Debyelaan 25, 6229 HX, Maastricht, The Netherlands.|CARIM School of Cardiovascular Diseases, Maastricht University Medical Centre, 6229 HX, Maastricht, The Netherlands.
authors.forename: Geert Willem H
authors.initials: GW
authors.lastname: Schurink
authors.affiliation: Department of Vascular Surgery, Maastricht University Medical Centre, Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Barend
authors.initials: B
authors.lastname: Mees
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.|CARIM School of Cardiovascular Diseases, Maastricht University Medical Centre, 6229 HX, Maastricht, The Netherlands.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.|CARIM School of Cardiovascular Diseases, Maastricht University Medical Centre, 6229 HX, Maastricht, The Netherlands.
authors.forename: Joachim E
authors.initials: JE
authors.lastname: Wildberger
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Michiel W
authors.initials: MW
authors.lastname: de Haan
authors.affiliation: Department of Radiology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
authors.forename: Cécile R L P N
authors.initials: CR
authors.lastname: Jeukens
mesh_terms: D003199:Computer Systems; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008505:Medical Staff, Hospital; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control*; D011446:Prospective Studies; D011829:Radiation Dosage; D011834:Radiation Monitoring / Q000295:instrumentation*; D011835:Radiation Protection / Q000295:instrumentation; D015642:Radiology, Interventional / Q000295:instrumentation; D011880:Radiotherapy Planning, Computer-Assisted / Q000295:instrumentation*; D013223:Statistics as Topic
keywords: Endovascular procedures; Interventional radiology; Patient dose; Radiation dosimetry; Radiation exposure; Radiation monitoring; Radiation protection