VERIFICACI

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IN VIVO DOSIMETRY IN INTERVENTIONAL CARDIOLOGY.

• M. Pinto Monedero1, C. Rodríguez Cobo1, X.
  Pifarré Martínez1, J. Ruiz Martín1, J.M. Barros
  Candelero1, J. Goicolea Ruigómez2, G. Díaz
  Blaires2, I. García Lunar2
• Medical Physics and Radiation Protection
  Department.
• Interventional Cardiology Unit.
• Hospital Universitario Puerta de Hierro
  Majadahonda

19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
INTRODUCTION
Workers at catheterisation laboratories are among
the most exposed to ionising radiation in
medicine.
Difficulty to know with certainty the exposure of
professionals

• Incorrect use of personal dosemeters.
• Personal dosimetry record not representative.

19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
OBJECTIVES
1. Know the typical exposure of workers at
catheterisation laboratories through a in vivo
dosimetry system.

• Measure and visualization os dose rate in real
  time.
• Record and storage of dosimetric information for
  further analysis.

2. Evaluate the utility of this system as a
learning tool for radiation protection purposes,
simultaneously with video-recording of procedures
for futher analysis.
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
4
In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS
In vivo Dosimetry System Dose Aware PHILIPS

• 6 semiconductor electronic dosemeters.
• Dose Range 1 mSv - 10 Sv.
• Dose Rate Range 3 nSv/s - 15 mSv/s.
• Base, LCD screen.
• WIFI connection Dosemeters-Base

Electronic Dosemeter
Base
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
5
In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS
In vivo Dosimetry System Dose Aware PHILIPS

• 6 semiconductor electronic dosemeters.
• Dose Range 1 mSv - 10 Sv.
• Dose Rate Range 3 nSv/s - 15 mSv/s.
• Base, LCD screen.
• WIFI connection Dosemeters-Base

Dose rate can be watched inside the room.

• Low dose rate.
• Medium dose rate.
• High dose rate.

19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
6
In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS
Management of the dosimetric information with
software Dose Manager.
Dosimetric information is storage on a database.
This allows

• To investigate dose rate over a threshold.
• To know the total dose during a single
  procedure.
• To compare dose rates/doses of two workers
  participating at the same procedure.

19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS
In a two month period a total number of 83
procedures were analysed.
Procedures were classified according to its
complexity, length and level of irradiation.
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS

• Dosemeters were assigned to four workers
• FAC 1 main doctor in charge of procedure
• FAC 2 second doctor
• DUE 1 main nurse
• DUE 2 second nurse

Reference dosemter located at the C-arm of the
equipement.
Equipment Allura XPER FD 10 from Philips.
Dosemeters were carried at the front pocket of
the apron lead (over the apron)
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
MATERIALS METHODS
Video-recording of 36 procedures.
Images were synchronized with dosimetric
information from Dose Manager
Relevant increment of dose rate were investigated
and correlated to images.
A complete analysis of dosimetric relevant
findings with their correspondent images were
presented to workers in a learning session.
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Apron attenuation factor FA 0,32,55 0,7
1,04 1,49
Filtración /kV 60 70 80 90 100 110 120
0,0 mm Cu 0,06 0,23 0,57 1,04 1,59 2,20 2,77
0,2 mm Cu 0,10 0,33 0,82 1,46 2,19 2,94 3,63
0,9 mm Cu 0,28 0,62 1,32 2,55 3,65 4,79 5,64
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Average dose received by main doctor is really
low (0,37 µSv)
7400 procedures to reach legal limit for A
workers (20 mSv)
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Complex diagnostic procedure
Total dose per procedure (?Sv) Total dose per procedure (?Sv) Total dose per procedure (?Sv) Total dose per procedure (?Sv)
Length DAP total(Gycm²) FAC 1 FAC 2 DUE 1 DUE 2
35 min 36,9 22 - 12 20
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Simple diagnostic procedure
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Simple diagnostic procedure
Total Dose per procedure (?Sv) Total Dose per procedure (?Sv) Total Dose per procedure (?Sv) Total Dose per procedure (?Sv)
Length DAP total(Gycm²) FAC 1 FAC 2 DUE 1 DUE 2
35 min 59,8 7 - 16 2
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
RESULTS
Complex diagnostic procedure
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
16
In vivo Dosimetry in Interventional Cardiology.
RESULTS
Complex diagnostic procedure
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
CONCLUSIONS
Workers at catheterisation laboratories received
very low radiation doses.

• Participating in a normal number of procedures
  (100), anual dose is significantly lower than
  the legal limit.

'Dose-Aware in vivo Dosimetry System showed to
be a valuable learning tool.

• In real time, it allows workers to be aware of
  their exposure to radiation.

• Together with the recording of procedures, it
  allowed us to detect behaviourswhich can be
  improvedfor radiation protection purposes.

19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
BIBLIOGRAPHY
1 Vañó E, Fernández JM, Sánchez R. Occupational
dosimetry in real time. Benefits for
interventional radiology. Radiation Measurements
2011 46(11)1262-1265. 2 Sánchez R, Vañó E,
Fernández JM, Gallego JJ. Staff Radiation Doses
in a Real-Time Display Inside the Angiography
Room. Cardiovasc Intervent Radiol 2010
331210-1214.
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013
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In vivo Dosimetry in Interventional Cardiology.
THANK YOU FOR YOUR ATTENTION
19º SEFM- 14º SEPR Congreso Conjunto. Cáceres, 20
de junio 2013