Real-time dosimetry in interventional radiology - comparing the occupational radiation exposure in fluoroscopy-guided lower extremity and abdominal procedures.

Objective: Radiation safety concerns have spurred the development of real-time dosimetry systems. This study investigated the occupational dose exposure of interventional radiologists during lower extremity and abdominal procedures.

Materials and methods: Real-time dosimetry was performed during 102 consecutive interventions (51 lower extremity, 51 abdominal). Radiation protection measures included protective glasses (lead equivalent 0.5 mm), thyroid shielding (0.5 mm), vests (0.35 mm), aprons (0.25 mm), as well as movable acrylic and table shields (both 0.5 mm) during all procedures. Dosimeters were attached to the interventionalist's glasses on the side of the x-ray tube, to the back of the supporting hand, and under the vest. Using standardized values over time to account for exposure time differences between interventions, dose-area products and the dose equivalent H_P(10) were recorded in all three positions.

Results: Lower extremity angiographies were associated with a substantially lower median dose-area product (5.3 vs. 51.4 Gy × cm²) and exposure time (462 vs. 762 s) than abdominal interventions (both p < 0.001). For lower extremity procedures, H_P(10) per minute recorded by the hand, cranium/eye lens, and body trunk dosimeters was 2.45, 0.01, and < 0.01 µSv/min, respectively. Markedly higher dose equivalents were documented for the hand (7.54 µSv/min), cranium/eye lens (0.26 µSv/min), and body trunk (0.04 µSv/min) during abdominal interventions (all p < 0.001).

Conclusion: Real-time dosimetry confirmed sufficient radiation protection with the application of dedicated safety measures, even in dose-intensive abdominal procedures. Interventionalists' supporting hands are subjected to the highest radiation exposure, followed by the cranium/eye lens and the body trunk.

Key points: Question Active dosimetry facilitates real-time assessment of radiation exposure in different measurement sites, but a multi-dosimeter setup has not been explored for interventional radiology so far. Findings Occupational radiation exposure is considerably higher in abdominal than in lower extremity procedures. Interventionalists' supporting hands receive the highest dose equivalents regardless of procedure type. Clinical relevance Dose monitoring in real time is key to understanding the radiation burden of different anatomical features during image-guided interventions. Especially in dose-intensive abdominal procedures, protective measures are essential to minimize the occupational radiation exposure of the interventionalist.