Personnel dose monitoring during fluoroscopy-guided interventional (FGI) procedures at Institut Kanser Negara

Abstract

The number of fluoroscopy-guided interventional (FGI) procedures has significantly increased recently. The radiology department staff such as the interventional radiologists (IR), medical officers (MO), radiographers and nurses who are involved in FGI procedures are usually working in a controlled area and receive doses primarily from scattered radiation off the patient. This was a one-year observation study conducted at the Radiology Department, Institut Kanser Negara (IKN), Putrajaya. Each interventional radiology staff member was given two opticallystimulated luminescence (OSL) dosimeters, used to measure the dose of radiation they received. In this study, two types of OSL dosimeter (OSLD) were used: InLight® XA dosimeter and nanoDot® dosimeter. The effective doses received by the interventional radiology staff after performing 230 FGI procedures were estimated using single and double dosimetry algorithms. Assessment on the interchangeability of the effective dose algorithms shows that both Niklason and Boetticher algorithms strongly supported the absence of statistical significance in the estimated effective doses using the Bland-Altman analysis. The effective dose received by the IRs, MOs, radiographers and nurses with double OSLDs were 9.82, 7.91, 6.42 and 6.02 mSv, respectively. The estimated annual eye dose for IR was 18.32 mSv y-1 and is below the recommended dose limit (20 mSv y-1). Due to the IR’s position on the left side of the patient, the right eye shows a lower dose than the left one. Radiation scattered throughout the FGI room shows the left anterior oblique 90° tube angulation has the highest single peak distribution (28.65 mSv h-1). The single peak distributions for the standard anteroposterior, left anterior oblique 45° and right anterior oblique 45° imaging were 13.32, 22.99 and 17.40 mSv h-1, respectively. Knowledge pertaining to radiation exposure levels is integral in order to avoid adverse risks, particularly amongst staff. It is highly recommended that interventional radiology staff use double OSLDs during FGI procedures in order to determine the occupational dose accurately.