Ces radiol. 2016, 70(2):93-99 | DOI: 10.55095/CesRadiol2016/014

Radiation dose during interventional procedures under CT fluoroscopy - first experienceOriginal article

Kateřina Daníčková¹, Dáša Chmelová², Vojtěch Suchánek¹, Radek Pádr¹, Miloslav Roček¹

¹ Klinika zobrazovacích metod FN Motol, Praha

² PTÚ FN Motol, Praha

Aim: CT fluoroscopy (CTF) is a safe and effective method for performing percutaneous interventional procedures. The main problem with its use is relatively high radiation burden. The aim of this pilot study was to map doses to the radiologists and patient doses and to explore different methods of optimizing the use of various types of protection devices.

Methodology: For each individual intervention using CTF cumulative dose to the radiologist's hand was measured using the direct dosimeter Unfors EDD. The dosimetr was located on the dorsal side of the interventionalist's hand. Furthermore, measurements were taken using water phantom in order to identify potential use of protective gloves and pads. We used the dosimetric system RADCAL with ionisation chamber and measured cumulative dose to the hands and the body radiologist CTF under various circumstances with different protective device used.
For an overview of the radiation exposure of patients during CTF we established local diagnostic reference levels for the most commonly performed procedures. The process was in accordinance with National Radiological Standards for Radiological Physics. We had data from two dedicated CT devices. The dose data obtained were further analyzed to determine the correlation between the dose and other exposure parametrs.

Results: Among the monitored interventional procedures with CTF the periradicular therapy is associated with the smallest dose to the hands of the interventionalist. Biopsies and drainages are associated with doses 3-4 times higher.
The most effective protective equipment for hand exposure reduction while using CTF is use the software protection. Protective gloves even further reduced the dose by about 8%. Using masks reduces body irradiation intervening radiologist by 15%.
The study showed that patient dose data does not change much over time. Due to the absence of national reference levels, obtained local DRLs cannot be compared with other benchmarks in the republic. Data analysis showed that the intervention procedure under CTF, the pre-intervention and post-intervention scan represents more than 2/3 of the radiation load to the patient.

Conclusion: Interventions performed under CT guidance are fast, efficient and minimally invasive diagnostic or therapeutic procedures. Although the CTF is relatively high dose method, the dose can be optimized by selecting the correct exposure parametrs and proper use of an appropriate protective equipment.

Keywords: CT fluoroscopy, interventional radiology, radiation protection optimization, RADPAD^©, protective gloves

Accepted: April 21, 2016; Published: June 1, 2016  Show citation