Scatter radiation dose at the height of the operator's eye in interventional cardiology

Abstract

This paper presents the first experimental result for scatter dose at the height of the operator's eye measured for a Polymethyl methacrylate (PMMA) phantom simulating an adult patient in an interventional laboratory at Belo Horizonte, Brazil. Values for scattered radiation doses at the height of the operator's eye are reported for procedures performed with and without a ceiling-suspended screen. Correlations between scatter radiation doses and different angiographic projections, phantom entrance dose and kerma area product, were obtained.Experimental measurements were made in an angiography X-ray system equipped with flat-panel detector. A cine and three fluoroscopy modes: low, medium and high dose were available. Scattered radiation doses were measured at three angiographic projections: anterior-posterior (AP), left anterior oblique 90° and left anterior oblique 45° with cranial 30° (spider) angulations. The detector measuring scatter radiation was positioned at the usual distance of the cardiologist's eye and the detector measuring phantom entrance dose was positioned at the bottom of the PMMA phantom.The phantom entrance dose for fluoroscopy low, medium, high and cine were 15, 29, 36 ± 4 and 184 ± 18 mGy/min, respectively to AP projection. A good linear correlation exists between phantom entrance doses rate and scatter dose rate to AP projection. There is a good linear correlation between the kerma-area product and scatter dose at the height of the operator's eye, coefficient of determination R2 were 0.9728 and 0.9913 with and without ceiling-suspended screen. An experimental correlation factor of 0.1 and 3.5 μSv/Gy*cm2 has been found for the AP projection with and without ceiling-suspended screen, respectively. Scatter dose at the eyes cardiologist position depends on the C-arm angulation an increase of the scatter radiation dose by a factor of 5 was found.The highest dose rate in the lens was 19.74 ± 1.97 mSv/h without ceiling-suspended screen in cine mode for “spider” projection. For lateral projection in cine mode, the ceiling-suspended screen reduced dose by a factor 0.01. Interventional operator may therefore easily exceed the lens dose limit if ceiling-suspended screen is not used.