Alternative Methodology for Occupational Dose Estimation in Cardiac Electrophysiology Procedures
DOI:
https://doi.org/10.15392/2319-0612.2022.2004Keywords:
Cardiac Electrophysiology, Occupational Radiation Protection, Radiation Dosage.Abstract
Fluoroscopy-guided cardiac electrophysiology procedures are among the most critical x-ray exposures. However, occupational doses are still little-known. In this study, an alternative methodology was developed to estimate the occupational dose and evaluated its optimization in cardiac electro-physiology procedures. The procedures were reproduced by simulation and the dose rates of the staff were measured at chest and eyes height through electronic dosimeters. The dose rate for different modes of operation and FOV were evaluated. The occupational dose was estimated through the product of the dose rate in the staff's position in the room, the median time of exposure and the mean of these procedures performed by the HCPA in 2019. As a result, it was observed that the decreasing order of the estimated occupational dose was Physician A - Physician R - Nursing Staff and Radiographer - Physician B and Supplier, with the following values in mSv/year of 6.16 - 3.98 - 2.54 - 2.17, respectively. A 37.04% reduction in the occupational dose was observed with the change in FOV, up to 59.26% with different modes of acquisition and 31.82% distancing 50 cm from the most exposed position. The dose of staff is significant. However, due to the optimization of protocols already implemented in HCPA, the estimated doses are in accordance with the recommended dose limits. As optimization actions verified in this study, it is suggested the proper selection of FOV, the adoption of acquisition modes with dose reduction and the distance from the x-ray source.
Downloads
References
L. Canevaro, “Aspectos físicos e técnicos da Radiologia Intervencionista,” Rev. Bras. Física Médica, vol. 3, no. 1, pp. 101–115, 2009.
H. J.W. et al., “2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging: Best Practices for Safety and Effectiveness,” Catheter. Cardiovasc. Interv., vol. 92, no. 2, pp. E35–E97, 2018, doi: 10.1002/ccd.27659. DOI: https://doi.org/10.1002/ccd.27659
K. A. Wunderle, M. K. Chung, S. Rayadurgam, M. A. Miller, N. A. Obuchowski, and B. D. Lindsay, “Occupational and patient radiation doses in a modern cardiac electrophysiology laboratory.,” J. Interv. Card. Electrophysiol. an Int. J. Arrhythm. pacing, vol. 56, no. 2, pp. 183–190, Nov. 2019, doi: 10.1007/s10840-018-0462-8. DOI: https://doi.org/10.1007/s10840-018-0462-8
ANVISA, “Resolução Da Diretoria Colegiada - Rdc No 330, De 20 De Dezembro De 2019,” Diário Of. da União, vol. 234, no. 1, p. 85, 2019.
E. Vano, N. J. Kleiman, A. Duran, M. M. Rehani, D. Echeverri, and M. Cabrera, “Radiation Cataract Risk in Interventional Cardiology Personnel,” Radiat. Res., vol. 174, no. 4, pp. 490–495, Oct. 2010, doi: 10.1667/RR2207.1. DOI: https://doi.org/10.1667/RR2207.1
ICRP, “ICRP Publication 117: Radiological Protection in Fluoroscopically Guided Procedures Performed Outside the Imaging Department,” 2010. doi: 10.1016/j.icrp.2012.03.001. DOI: https://doi.org/10.1016/j.icrp.2012.03.001
IAEA, “Assessment of Occupational Exposure Due to External Sources of Radiation. Safety Standard RS-G-1.2,” 1999.
CNEN. Ministério da Ciência Tecnologia e Inovação, “Norma CNEN NN 3.01: DIRETRIZES BÁSICAS DE PROTEÇÃO RADIOLÓGICA,” vol. 05, pp. 1–22, 2014, [Online]. Available: http://appasp.cnen.gov.br/seguranca/normas/pdf/Nrm301.pdf.
AAPM, Cardiac Catheterization Equipment Performance, no. 70. 2001.
SEFM-SEPR-SERAM, Protocolo Español de Control de Calidad en Radiodiagnóstico, vol. 5, no. 1. 2011.
“RaySafe i3 Product Leaflet,” [Online]. Available: http://mediabank.raysafe.com/downloadAsset.jsp?catalog=RaySafe+Media+Bank&id=299&.
W. M. B. e S. V. Juliana Pimentel, “AVALIAÇÃO DA ATENUAÇÃO DE AVENTAIS PLUMBÍFEROS COM DIFERENTES EQUIVALÊNCIAS DE CHUMBO PARA USO EM SERVIÇOS DE RADIOLOGIA,” Soc. DEPROTEÇÃO RADIOLÓGICA, pp. 0–5, 2014.
J. T. Bushberg, J. A. Seibert, E. M. Leidholdt, J. M. Boone, and E. J. Goldschmidt, The Essential Physics of Medical Imaging, vol. 30, no. 7. 2003. DOI: https://doi.org/10.1118/1.1585033
IAEA, “10 Recomendações para proteção de pacientes em fluoroscopia 64,” pp. 1–2.
Published
Issue
Section
License
Copyright (c) 2022 Brazilian Journal of Radiation Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing: The BJRS articles are licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
How to Cite
