Medical staff monitoring in interventional cardiology: over apron dosemeter placement based on measurements and simulations.

Interventional cardiology is characterized by high radiation exposure for both the patient and the operator. Adequate shielding and monitoring of the operator are fundamental to comply with radiation protection principles. In a previous work, the effect on the dose of the dosemeter position on the chest was studied. In this paper, the investigation has been completed, employing an anthropomorphic thorax phantom, equipped with arms. Although there are differences between the Monte Carlo simulations and the measurements, similar trends are observed, showing that the reduction in dose, due to the arms, is between 20 and 60%, compared with the situation without arms. For that reason, considering a dosemeter placed on the chest, the upper position, which is the least affected by the arms, should be preferred while the extreme lateral position, near the armpit, should be avoided.

Physical and dosimetric characterisation of different Contrast-Enhanced digital mammographic systems: A multicentric study.

PURPOSE: Contrast-enhanced digital mammography (CEDM) is a relatively new imaging technique recombining low- and high-energy mammograms to emphasise iodine contrast. This work aims to perform a multicentric physical and dosimetric characterisation of four state-of-the-art CEDM systems. METHODS: We evaluated tube output, half-value-layer (HVL) for low- and high-energy and average glandular dose (AGD) in a wide range of equivalent breast thicknesses. CIRS phantom 022 was used to estimate the overall performance of a CEDM examination in the subtracted image in terms of the iodine difference signal (S). To calculate dosimetric impact of CEDM examination, we collected 4542 acquisitions on patients. RESULTS: Even if CEDM acquisition strategies differ, all the systems presented a linear behaviour between S and iodine concentration. The curve fit slopes expressed in PV/mg/cm2 were in the range [92-97] for Fujifilm, [31-32] for GE Healthcare, [35-36] for Hologic, and [114-130] for IMS. Dosimetric data from patients were matched with AGD values calculated using equivalent PMMA thicknesses. Fujifilm exhibited the lowest values, while GE Healthcare showed the highest. CONCLUSION: The subtracted image showed the ability of all the systems to give important information about the linearity of the signal with the iodine concentrations. All the patient-collected doses were under the AGD EUREF 2D Acceptable limit, except for patients with thicknesses ≤35 mm belonging to GE Healthcare and Hologic, which were slightly over. This work demonstrates the importance of testing each CEDM system to know how it performs regarding dose and the relationship between PV and iodine concentration.

Patient dose in angiographic interventional procedures: A multicentre study in Italy.

PURPOSE: The Council Directive 2013/59/EURATOM considers interventional radiology to be a special practice involving high doses of radiation and requiring strict monitoring to ensure the best quality assurance programs. This work reports the early experience of managing dose data from patients undergoing angiography in a multicentre study. MATERIALS AND METHODS: The study was based on a survey of about 15,200 sample procedures performed in 21 Italian hospitals centres involved on a voluntary basis. The survey concerned the collection of data related to different interventional radiology procedures: interventional cardiology, radiology, neuroradiology, vascular surgery, urology, endoscopy and pain therapy from a C-Arm and fixed units. The analysis included 11 types of procedures and for each procedure, air-kerma, kerma-area product and fluoroscopy time were collected. RESULTS: The duration and dose values of fluoroscopic exposure for each procedure is strongly dependent on individual clinical circumstances including the complexity of the procedure; the observed distribution of patient doses was very wide, even for a specified protocol. The median values of the parameters were compared with the diagnostic reference levels (DRL) proposed for some procedures in Italy (ISTISAN) or internationally. This work proposes local DRL values for three procedures. CONCLUSION: This first data collection serves to take stock of the situation on patient's dosimetry in several sectors and is the starting point for obtaining and updating DRL recalling that these levels are dependent on experience and technology available.