Room staff radiation dose in a vascular surgery hybrid operating room and evaluation of a real-time radiation dosimeter

Abstract

Abstract Objective Real-time radiation dosimeter have been shown to decrease radiation exposure of the staff. This effect is mainly explained by increased awareness of the radiation due to direct radiation exposure feedback to the operator. We aimed to measure the radiation exposure of all staff members working in a hybrid operating room and wanted to compare the equivalent doses of real-time radiation dosimeters with thermoluminescence dosimeters. Methods Prospective non-randomized comparative trial. From April – October 2019, all staff members working in a hybrid operating room were equipped with real-time radiation dosimeters (Unfors RaySafe i3). The table positions of all staff members were documented. In addition, the first operator was equipped with a thermoluminescence Hp(3) eye lens dosimeter (TLD) placed outside the lead glasses to validate the real-time radiation dosimeter. Results The median dose of the operator / the first assistant was 73.6 µSv / 21.8 µSv for EVAR (n = 30); 57.25 µSv / 18.2 µSv for TEVAR (n = 23); 207.0 µSv / 76.65 µSv for more complex aortic procedures (f/bEVAR etc.; n = 15); 14.85 µSv / 8.5 µSv for occlusive disease of the iliac arteries (n = 27) and 6.1 µSv / 3.4 µSv for occlusive disease of the peripheral arteries (n = 53). The anesthesiologist’s median dose was 0.3 µSv, with highest values in f/bEVAR (3.9µSv). The scrub nurse’s median dose was 2 µSv with highest values in f/bEVAR (24 µSv). The position of any staff member at the left arm for transbrachial cannulation in f/bEVAR was associated with higher median equivalent radiation doses compared to the right femoral position (272.5 vs. 207 µSv for the operator (p=ns), 175.3 vs. 27.8 µSv for the first assistant (p = 0.027) and 45.55 vs. 8.0 µSv for the scrub nurse (p = 0.14)). The equivalent doses of the TLD and RaySafe did not correlate well using simple lineal regression analysis (r2 0.1713, p = 0.0014). Conclusion With the RaySafe real-time radiation dosimeter, table positions with increased radiation exposure can be identified. This allows for improvement in shielding at these positions, possibly leading to lower radiation exposure of the staff.