Eye Lens Dose Research Articles

Estimation of inhomogeneous occupational exposure to the lens of the eyes and the extremities of radiation workers in a research accelerator facility.

We performed an experimental investigation on occupational exposure of the eye lens and the extremity of radiation workers engaged in handling of highly activated materials in a small research accelerator facility. Using a simplified physical phantom to simulate the relevant inhomogeneous radiation exposure situations, the personal dose equivalents obtained at the eye lens and the extremities of radiation workers handling heavily radioactive converters were measured together with the dose measured by personal dosemeters worn on their trunk. Results of mockup experiments and the Monte Carlo calculations suggest that the quantitative estimation of the eye lens doses can be estimated from the trunk dose, while the extremity doses vary considerably from the dose readings from the trunk, depending on the use of simple point-source or volume source geometry.

Preliminary study on individual radiation dose received by medical staff for dose constraint determination.

The staff of the Radiation Protection Service of a European clinical center measured the radiation dose by type-tested thermoluminescent dosemeter systems to which the medical staff was exposed, to assess the effectiveness of current procedures and equipment for optimalisation prompted by the requirements EU Basic Safety Standard 2013. There were three participating sites, the Site 1 was an external hospital, whereas Sites 2 and 3 are part of the same clinical center, who provided data regarding their personnel, from technologists, nurses and medical doctors. In this preliminary study, only a low number of cases were available and used to establish a new, more realistic yearly dose constraint, namely 6 (from two) mSv for whole-body effective dose, 15 (from two) mSv for eye lens dose and 300 (from 50) mSv for extremity dose. Furthermore, the state of safety culture and protection equipment was assessed. Collection of the sufficient amount of data for statistical evaluation is ongoing.

Evaluation of operator eye exposure and eye protective devices in interventional radiology: Results on clinical staff and phantom

PurposeTo assess occupational eye lens dose based on clinical monitoring of interventional radiologists and to assess personal protective eyewear (PPE) efficacy through measurements with anthropomorphic phantom. MethodsTwo positions of the operator with respect to X-ray beam were simulated with phantom. Dose reduction factor (DRF) of four PPE was assessed, as well as correlation between eye lens and whole-body doses. Brain dose was also assessed. Five radiologists were monitored for one-year clinical procedures. All subjects were equipped with whole-body dosimeter placed over lead apron at the chest level and eye lens dosimeter placed over the left side of the PPE. Kerma-Area Product (KAP) of procedures performed during the monitoring period was recorded. The correlation of eye lens dose with whole-body dose and KAP was assessed. ResultsDRF was 4.3/2.4 for wraparound glasses, 4.8/1.9 for fitover glasses, 9.1/6.8 for full-face visor in radial/femoral geometries. DRF of half-face visor depended on how it is worn (range 1.0–4.9). Statistically significant correlation between dose value over the PPE and chest dose was observed, while there was no correlation between eye lens dose and chest dose. The results on clinical staff showed statistically significant correlation between dose values over the PPE and KAP. ConclusionsAll PPE showed significant DRF in all configurations, provided they were worn correctly. Single DRF value is not applicable to all clinical situations. KAP is a valuable tool for determining appropriate radiation protection measures.

Radiation-induced cataract-an occult risk for urologists

Radiation-induced cataracts represent arelevant risk to people occupationally exposed to radiation. The annual limit dose for the eye lens was reduced to 20 mSv per year by German legislation (radiation protect law StrlSchG 2017; 2013/59/Euratom) based on recommendation of International Commission on Radiation Protection (2011 ICRP) to avoid radiation-induced cataracts. Is there arisk of exceeding the annual limit dose for the eye lens in routine urological practice without special radiation protection for the head? As part of aprospective, monocentric dosimetry study, of 542 different urological, fluoroscopically guided interventions, the eye lens dose was determined using aforehead dosimeter (thermo-luminescence dosemeter TLD, Chipstrate) over aperiod of 5months. An average head dose of 0.05 mSv per intervention (max. 0.29 mSv) was found with an average dose area product of 485.33 Gy/cm2. Significant influencing factors for ahigher dose were ahigher patient body mass index (BMI), alonger operation time, and ahigher dose area product. The level of experience of the surgeon showed no significant influence. With 400 procedures per year or an average of 2procedures per working day, the critical annual limit value for the eye lenses or for the risk of radiation-induced cataract would be exceeded without special protective measures. Consistently effective radiation protection of the eye lens is essential for daily work in uroradiological interventions. This may require further technical developments.

Eye lens dose for medical staff assisting patients during computed tomography: comparison of several types of radioprotective glasses

Medical staff sometimes assists patients in the examination room during computed tomography (CT) scans for several purposes. This study aimed to investigate the dose reduction effects of four radioprotective glasses with different lead equivalents and lens shapes. A medical staff phantom was positioned assuming body movement restraint of the patient during chest CT, and Hp(3) at the eye surfaces of the medical staff phantom and inside the lens of the four types of radioprotective glasses were measured by changing the distance of the staff phantom from the gantry, eye height, and width of the nose pad. The Hp(3) at the right eye surface with glasses of 0.50–0.75 mmPb and 0.07 mmPb was approximately 83.5% and 58.0%, respectively, lower than that without radioprotective glasses. The dose reduction rates at left eye surface increased with over-glass type glasses by 14%–28% by increasing the distance from the CT gantry to the staff phantom from 25 to 65 cm. The dose reduction rates at the left eye surface decreased with over-glass type glasses by 26%–31% by increasing the height of the eye lens for the medical staff phantom from 130 to 170 cm. The Hp(3) on the left eye surface decreased by 46.9% with the widest nose pad width compared to the narrowest nose pad width for the glasses with adjustable nose pad width. The radioprotective glasses for staff assisting patients during CT examinations should have a high lead equivalent and no gap around the nose and under the front lens.

Assessment of occupational exposure in medical practice in Gabon during 2013–2020

ObjectiveTo evaluate whole-body, extremity and eye-lens occupational dose equivalents of ionizing radiation to Occupationally Exposed Workers (OEWs) in Gabon, monitored by the national Individual Monitoring Service (IMS), in the medical practice. MethodsA total of 816 dose records for 205 OEWs were evaluated. Doses were collected for an eight-year period, from 2013 to 2020. Twelve public and private hospitals were involved, including a cancer centre where radiotherapy (RT) and nuclear medicine (NM) procedures are regularly performed. OEWs were monitored, on a monthly or quarterly basis, for whole-body dose and extremity dose using an optically stimulated luminescence (OSL) dosimeter worn on the torso or the wrist, as appropriate. Eye-lens dose was estimated from whole-body dose results. ResultsThe whole-body dose distribution was skewed and the zero dose was associated with a probability of 47%. Some recorded doses were associated with estimated X-ray energies above those typically encountered in diagnostic radiology, thus suggesting that some doses attributed to workers and believed to be due to X-rays may in fact be due to background radiation (false positive dose records). For the period 2013–2020, annual doses to OEWs in diagnostic radiology (DR), NM and RT departments were 0.40 ​mSv, 0.38 ​mSv and 0.09 ​mSv, respectively. For the same period, the mean annual extremity and eye-lens doses were 0.78 ​mSv (range: 0–5.24 ​mSv) and 0.35 ​mSv (range: 0–3.74 ​mSv), respectively. ConclusionWith little effort by the national IMS and the regulatory body, annual whole-body doses to workers can be kept well below 6 ​mSv, thus efficiently contributing to the optimization of worker's protection. However, extremity doses may in fact be greater than those reported for OEWs in the NM department. Finally, eye-lens doses were well below the new annual dose limit of 20 ​mSv, thus demonstrating that, in the current situation, OEWs in the NM department do not require routine eye lens dose monitoring. Rather, whole-body dose may be used as an indicator of eye-lens dose.

Eye-Lens Dose Reduction using Region of Interest (ROI) Attenuators in Neuroimaging.

Lens dose can be high during neuro-interventional procedures, increasing the risk of cataractogenesis. Although beam collimation can be effective in reducing lens dose, it also restricts the FOV. ROI imaging with a reduced-dose peripheral field permits full-field information with reduced lens dose. This work investigates the magnitude of lens-dose reduction possible with ROI imaging. EGSnrc Monte-Carlo calculations of lens dose were made for the Zubal head phantom as a function of gantry angulation and head shift from isocenter for both large and small FOV's. The lens dose for ROI attenuators of varying transmission was simulated as the weighted sum of the lens dose from the small ROI FOV and that from the attenuated larger FOV. Image intensity and quantum mottle differences between ROI and periphery can be equalized by image processing. The lens dose varies considerably with beam angle, head shift, and field size. For both eyes, the lens-dose reduction with an ROI attenuator increases with LAO angulation, being highest for lateral projections and lowest for PA. For an attenuator with small ROI field (5 × 5 cm) and 20% transmission, the lens dose for lateral projections is reduced by about 75% compared to a full dose 10 ×10 cm FOV, while the reduction ranges between 30 and 40% for PA projections. Use of ROI attenuators can substantially reduce the dose to the lens of the eye for all gantry angles and head shifts, while allowing peripheral information to be seen in a larger FOV.

Assessment of radiation exposure in a nuclear medicine department of an oncology hospital

BackgroundMedical personnel in nuclear medicine departments are exposed to ionizing radiation which is associated with cancer induction and mortality risks. Examples of such personnel are those working in the hot-areas where radioisotopes for nuclear medicine examinations are prepared. This work aims to estimate the occupational radiation exposure for workers at the Nuclear Medicine department in Da Nang Oncology Hospital, Vietnam. Materials and methodsThe study was conducted from 2020 to 2021. The personal dose equivalents (Hp) were quantified for soft tissues for deep dose (Hp(10)), eye lens dose (Hp(3)), skin dose (and Hp(0.07)) were quantified utilizing optically stimulated luminescence dosimeters (OSLD) crystals. In this study, the dose equivalent at the hot area is measured by 9 OSLD, while that for staff was measured using 16 OSLD. ResultsIn 2020, the annual average Hp(10) was (0.38 mSv ± 1.39); in 2021 Hp(10) was (0.25 mSv ± 1.27). The average Hp(10) was well below the annual occupational dose limits (20 mSv.year−1). Regarding the annual dose, all recorded values were quite low compared to the annual radiation dose limits for radiation staff (20 mSv annual ∼ 1.67 mSv.month−1). Nevertheless, some points of measurement revealed a high-value dose of 5.69 mSv ± 2.83. This suggests that rigorous evaluation of the workplace is essential to ensuring workers' exposure is kept within safe levels. ConclusionsIt is concluded that the Hp(10) and Hp(0.07) for the working environment and radiation workers were below the dose limits from ICRP. In addition, it is recommended that continuous monitoring of the occupational dose in nuclear medicine department is essential to reduce the dosimetric hazards of personnel working in the department.

Occupational radiation dose from gastrointestinal endoscopy procedures with special emphasis on eye lens doses in endoscopic retrograde cholangiopancreatography.

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) procedures may result in remarkable radiation doses to patients and staff. The aim of this prospective study was to determine occupational exposures in gastrointestinal endoscopy procedures, with a special emphasis on eye lens dose in ERCP. Methods Altogether 604 fluoroscopy-guided procedures, of which 560 were ERCPs belonging to four American Society for Gastrointestinal Endoscopy procedural complexity levels, were performed using two fluoroscopy systems. Personal deep-dose equivalent H p (10), shallow-dose equivalent H p (0.07), and eye lens dose equivalent H p (3) of eight interventionists and H p (3) for two nurse dosimeters were measured. Thereafter, conversion coefficients from kerma-area product (KAP) for H p (10), H p (0.07), and H p (3) were determined and dose equivalents per procedure to an operator and assisting staff were estimated. Further, mean conversion factors from H p (10) and H p (0.07) to H p (3) were calculated. Results The median KAP in ERCP was 1.0 Gy·cm 2 , with mobile c-arm yielding higher doses than a floor-mounted device ( P < 0.001). The median H p (3) per ERCP was estimated to be 0.6 µSv (max. 12.5 µSv) and 0.4 µSv (max. 12.2 µSv) for operators and assisting staff, respectively. The median H p (10) and H p (0.07) per procedure ranged from 0.6 to 1.8µSv. ERCP procedural complexity level ( P ≤ 0.002) and interventionist ( P < 0.001) affected dose equivalents. Conclusions Occupational dose limits are unlikely to be exceeded in gastrointestinal endoscopy practice when following radiation-hygienic working methods and focusing on dose optimization. The eye lens dose equivalent H p (3) may be estimated with sufficient agreement from the H p (10) and H p (0.07).

The HP(3,α) dose response of direct reading survey meters

Direct reading survey meters, designed for the measurement of shallow dose rates, are commercially available. Examples of such instruments include the Fluke 451B, the BOT P200 m with SM20 probe, the Eberline RO-2A and the RAM-Ion. We investigated the potential use of these instruments, as eye lens dose rate meters, with the addition of low-Z filters of suitable thicknesses. Their responses to 90Sr/90Y beta particles and to photons of varied qualities, as functions of angles of incidence, were measured. It was determined that most instruments can be suitably modified to operate as useful eye-lens dose rate meters. Their use in the field could assist radiation protection professionals in the assessment of radiological risk to the lens of the eye. This will allow recommendations on appropriate PPE and dosimetry in individual workplace settings.

Android Application for Eye Lens Dose Hp3 Estimator Base on Personal Dose Hp10 TLD Harshaw for Radiation Workers in Diagnostic and Interventional Radiology

Android Application for Eye Lens Dose Hp3 Estimator Base on Personal Dose Hp10 TLD Harshaw for Radiation Workers in Diagnostic and Interventional Radiology

Eye-lens dose rate conversion factors due to hot particles and surface contaminations on the cornea

In 2012, the International Commission on Radiological Protection issued new recommendations, in publication 118, regarding the dose limits to the eye-lens. New analyses of historical exposure data had indicated that radiation-induced cataracts may appear at lower doses than previously assumed. This spurred largescale efforts in a variety of fields including dosimetry, radiation effects simulations, and the review of national regulatory limits. On the simulation side, much work led to the publication of dose rate conversion factors (DRCFs), to calculate the dose to the radiosensitive part of the eye-lens, and to the whole eye-lens as functions of the incident fluence of electron, photon, positron, and neutron radiation. The standard, ISO-15382 (2015 Radiological Protection—Procedures for Monitoring the Dose to the Lens of the Eye, the Skin and the Extremities), from the International Organization for Standardization (ISO), stated that the direct contact of a hot radioactive particle on the eye-lens represents a special contamination condition that must be considered. The aim of this work was to produce tabulated data of eye-lens dose rates, per activity (MBq), for a variety of radionuclides. In this work, the dose to the eye-lens from contamination directly in contact with the cornea, expressed in terms of DRCFs for eye-lens, in units of Gy h−1 MBq−1, are presented for 102 radionuclides of interest. These radionuclides were selected as they had been considered by the International Atomic Energy Agency of importance for skin dose. The method consisted of two steps. The first was the determination of the DRCFs for mono-energetic electrons and photons for a hot particle in contact with the eye-lens, followed by the folding of these quantities with the emissions of the radionuclides of interest. Contributions from spontaneous fission neutrons were considered separately. Exposure geometries for spherical hot particles of different dimensions, materials and locations on the cornea were considered. In addition, partial surface coverage of the cornea, consistent with an accidental exposure to a contaminated liquid, was also modelled. Resulting radionuclide DRCFs were verified, for a few specific geometries and radionuclides with dedicated Monte Carlo simulations. The final data are presented in several tables included in this paper.

Surgeon eye lens dose monitoring in interventional neuroradiology, cardiovascular and radiology procedures

PurposeThis study investigated the radiation dose to surgeon eye lens for single procedure and normalised to exposure parameters for eight selected neuroradiology, cardiovascular and radiology interventional procedures. MethodsThe procedures investigated were diagnostic study, Arteriovenous Malformations treatment (AVM) and aneurysm embolization for neuroradiology procedures, Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty (CA-PTCA), Pacemaker and Implantable Cardioverter-Defibrillator implantation (PM-ICD), Endovascular Aortic Repair (EVAR) and Fenestrated Endovascular Aortic Repair (FEVAR) for cardiovascular and electrophysiology procedures. CT-guided lung biopsy was also monitored.All procedures were performed with table-mounted and ceiling-suspended shields (0.5 mm lead equivalent thickness), except for FEVAR and PM-ICD where only a table mounted shield was present, and CT-guided lung biopsy where no shield was used. Dose assessment was performed using a dosemeter positioned close to the most exposed eye of the surgeon, outside the protective eyewear. ResultsThe surgeon most exposed eye lens median Hp(3) equivalent dose for a single procedure, without protective eyewear contribution, was 18 μSv for neuroradiology diagnostic study, 62 μSv for AVM, 38 μSv for aneurysm embolization, 33 μSv for CA-PTCA, 39 μSv for PM-ICD, 49 μSv for EVAR, 2500 μSv for FEVAR, 153 μSv for CT-guided lung biopsy. ConclusionsIn interventional procedures, the 20 mSv/year dose limit for surgeon eye lens exposure might be exceeded if shields or protective eyewear are not used.Surgeon eye lens doses, normalised to single procedures and to exposure parameters, are a valuable tool for determining appropriate radiation protection measures and dedicated eye lens dosemeter assignment.

Investigation of the effectiveness of ECOLAB ’Drape ArmourTM’ Radiation Protection in limiting eye-lens doses of healthcare personnel exposed to ionizing radiation during gastroenterology - interventional radiology procedures

Objectives: To investigate the efficiency of the ECOLAB “Drape ArmourTM” device in limiting the eye-lens doses absorbed by healthcare personnel exposed to ionizing radiation, in a four-month trial during gastroenterology interventional radiology procedures. Methods: Eyelens doses measured with eye-lens dosimeters calibrated in terms of equivalent dose at 3 mm depth ( Hp(3) ) were collected and analyzed since 2016 along with the irradiation parameters (Dose Area Product - DAP). The eye-lens doses received during the four-month trial, have been compared with doses normally received, in the same conditions of irradiation, in the absence of the protection drape. Results: During the period of use of Drape ArmourTM, the average dose to the eye lens was estimated to be 0.73 mSv (St.dev = 0.40 mSv). The average dose to the eye lens, measured in the same four-month period, across different years from 2017 to 2021, was equal to 1.30 mSv (st. dev = 0.35 mSv). Conclusions: Results suggest the effectiveness of Drape ArmourTM in containing the doses to the eye lens. Keypoint: Limiting eye-lens doses to a maximum value of 20 mSv/year is a real challenge, especially in interventional radiologic facilities. The use of suitable radio-opaque drapes may help healthcare workers involved in such facilities. The aim of the work is to evaluate the efficiency of the ECOLAB “Drape ArmourTM” sterile mono-use drape.

Eye lens dose assessment in interventional cardiology

Introduction: Medical professionals performing fluoroscopy guided interventional procedures in cardiology are exposed to a risk of radiation induced cataract, especially if the eye lens dose exceeds the annual dose limit of 20 mSv. Aim: The aim of the current study is to measure the eye lens exposure in three interventional cardiology departments, to analyze the relationship between patient dose and eye lens dose and to study the effectiveness of lead goggles without side protection. Material and methods: Measurements were performed in three departments with participation of 4 interventional cardiologists and 6 nurses. The exposure of the eye lens was measured with EYE-DTM (Radcard) passive dosimeters. Results: For nurses the annual eye lens dose varied from 1.6 mSv to 4.3 mSv. For the interventional cardiologists the results were between 3.2 mSv and 31.4 mSv. The dose reduction factor of the studied safety goggles without side protection is 1 and 1.1. Conclusions: There is a risk of exceeding the annual exposure limit of 20 mSv among interventional cardiologists The eye lens exposure depends on the workload and the clinical complexity of the procedures, as well as on the use of radiation protection devices. Due to the specifics of the procedures, the use of goggles with side protection is recommended. The eye lens dose for nurses is lower than the annual limit, which can be explained with the larger distance between the patient and the nurses and partial shielding by the main operator. Lead glasses without side shielding are not recommended because the exposure occurs from the side.

RELATIONSHIPS BETWEEN TYPES OF PROTECTIVE EYEWEAR AND EYE LENS DOSE WITHIN ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY.

In this study, variations in eye lens dose across different types of protective operator eyewear as well as the most appropriate protective methods when conducting endoscopic retrograde cholangiopancreatography were evaluated. The eye lens doses of 10 types of commercially available protective eyewear were compared. The ratio of the measured value near the eye to the measured value at the eye lens position ranged from 0.65 to 5.40 and it varied according to the mounting position of the dosemeter as well as the type of protective eyewear. Thus, the eye lens dose may have been overestimated or underestimated. Regardless of the working conditions, a face shield type of protective eyewear is recommended to reduce the eye lens dose. Moreover, it is preferable to attach a lens dosemeter near the eye to measure and evaluate the eye lens dose.

Radiation exposure to extremities in medical applications and its implications for the radiation protection of workers in the Philippines

In medical applications, non-homogeneous radiation exposure conditions may be encountered and whole-body monitoring alone may not be an adequate assessment of doses received by workers. This paper investigated the exposure to extremities in medical applications in the Philippines in terms of personal dose equivalent Hp(0.07). Profiles of monitored workers, dose levels, implications on optimization of occupational exposures, and factors affecting the extremity monitoring implementation were studied. The results show that <3% of workers are monitored for extremities, and there is no monitoring of eye lens dose. There is no extremity monitoring in diagnostic radiology, particularly interventional radiology. Dose levels to extremities were higher and more varied than whole-body doses. In nuclear medicine, the median annual extremity dose is 1.2 mSv, the interquartile range (IQR) is 7.6 mSv (Q1 = 0.5 mSv, Q3 = 8.1 mSv), and the maximum dose is 35 mSv. These median and IQR dose values are four and eight times higher, respectively, compared to the whole-body dose. In radiopharmaceutical distribution, the extremity median annual dose is five times higher than the whole-body dose, and the IQR value is 12 times higher where IQR is 12.1 mSv (Q1 = 0.1 mSv, Q3 = 12.2 mSv). Most notable is in cyclotron operations where <40% of workers were monitored on their extremities; however, the median dose is 100 times higher than the whole-body dose, with a maximum dose of 148 mSv. The results imply that there may be an underassessment of occupational exposure of workers in medical applications. As monitoring results are used for the establishment of a radiation protection program, lack of consideration of extremity doses can lead to inadequate measures in the optimization of worker protection. This study thus shows the need to enhance the implementation of extremity and eye lens dose monitoring in the Philippines to further strengthen the radiation protection of workers in medical applications.

On the operational quantity for eye lens neutron dosimetry considering ICRU 95 report

For planned occupational exposure situations, the International Commission on Radiological Protection (ICRP) publication 118 recommends an equivalent dose limit for the lens of the eye of 20 mSv yr−1 averaged over 5 yr with no single year exceeding 50 mSv. Regulatory authorities of various jurisdictions worldwide followed some or all, of the ICRP recommendations and implemented reduced occupational lens of eye dose limits in their legislation. As compliance with the eye-lens dose limit will be based on the summation of doses received from all types of radiation, applicable to a variety of workplaces, the contribution of neutrons to eye lens dose will be important where it contributes a significant fraction of the total dose to the eye lens. This work presents and discusses computed personal absorbed dose (D lens/Φ), and personal dose equivalent (H p(3)/Φ) as well as a newly proposed relative biological effectiveness (RBE)-weighted absorbed dose (RBE × D lens/Φ) conversion coefficients for the lens of the eye for neutron exposure at incident energies from thermal to ∼20 MeV. The D lens/Φ coefficients were obtained from a simulation model developed for this study that contains the stylised eye model embedded in the adult UF-ORNL mathematical phantom. The modelling techniques used in these simulations were also used to calculate H p(3)/Φ for the International Commission on Radiation Units and Measurements (ICRU) slab and cylinder phantoms. All simulations carried out for this study utilised the Monte Carlo N-Particle (MCNP) series of codes. The results are compared with the related published data. The issue of compliance with the current equivalent dose limit for the lens of the eye is addressed from a neutron perspective considering the recent proposed redefinition of the operational quantities for external radiation exposure in ICRU report 95. The use of a radiation weighted absorbed dose (RBE × D lens, in Gy) is proposed for the tissue reactions in the eye-lens for neutron radiation as per the National Council on Radiation Protection and Measurements report 180, and in line with the recent review and revision of the System of Radiological Protection To Keeping the ICRP Recommendations Fit for Purpose, which states that RBE weighted dose should be used for high-Linear energy transfer (LET) radiations such as neutrons. This confirms the earlier statement in ICRP publication 92, paragraph 297 and reiterated in the Executive summary, paragraph (q) of ICRP publication 118. The proposed approach would provide an operational quantity consistent with the units of the new eye-lens dose limits without being overly conservative.

Impact of Simulation-Based Training on Radiation Exposure of Young Interventional Cardiologists

Reducing radiation exposure during cardiovascular catheterization is of paramount importance to ensure patient and staff safety. Our study aimed to assess the transferability of acquired skills from virtual reality to the real world, including radioprotection measures during mentored simulation training (ST) in coronary angiography. A total of 10 cardiology residents were evaluated during real-life cases in the catheterization laboratory before (group A) and after mentored ST. The educational effect of mentored simulator training on real-life case performance was evaluated at 2 different time points: within the first week (group B) and after 12 weeks (group C). Compared with group A, the total dose area product (DAP) (µGy•m2) and total air kerma (mGy) were lower after ST: group A: 2,633 (1,723 to 3,617) versus group B: 1,618 (1,032 to 2,562), p <0.05 and 214 (136 to 297) versus 135 (84 to 222), p <0.05, respectively. Concerning operator radiation exposure (µSv), left finger dose: 1,090 (820 to 1,460) versus 635 (300 to 900), p=0.028; left leg dose 80 (0 to 110) versus 0 (0 to 0), p=0.027; left eye lens dose: 39 (24 to 69) versus 11 (8 to 20), p <0.0001; and chest dose outside the lead apron: 50 (34 to 88) versus 29 (21 to 50), p <0.003 were significantly lower in the group B than group A. A total of 12 weeks after ST, the total DAP and total air kerma remained stable along with operator exposure except left eye lens dose (µSv): group B: 11 (8 to 20) versus group C: 16 (12 to 27), p=0.02. In addition, left eye lens dose, left wrist dose, and chest dose outside the lead apron were significantly correlated with total DAP (rs=0.635, rs=0.729, and rs=0, 629, respectively) and total air kerma (rs=0.488, rs=0.514, and rs=0.548, respectively) at 12 weeks. In conclusion, ST for coronary angiography may improve radioprotection learning and should be incorporated into training curricula.

DOSE MEASUREMENT PRECISION OF AN RPLD-BASED EYE LENS DOSEMETER APPLICABLE TO THE MEDICAL SECTOR.

We demonstrate a practical calibration method and its applicability for a commercially available radiophotoluminescence dosemeter (RPLD), i.e. the GD-352M (AGC Techno Glass, Shizuoka, Japan) to eye lens dose monitoring, by performing the calibration according to the ISO recommendations. The calibration was then verified through a series of experiments. For verification of the derived calibration factor (1.21 ± 0.04, k = 1) of the RPLD, we performed standard irradiations in the ISO narrow series X-ray reference fields and the simulation measurements in the actual radiation fields in a hospital. The TLD-based commercially available dosemeters, DOSIRIS™ was also put on the ISO cylinder phantom and the RANDO phantom together with the GD-352M in the verification experiments. The personal dose equivalents Hp(3) obtained from the GD-352M and those obtained from the DOSIRIS™ were in good agreement with each other. Our results demonstrate the proper calibration of a commercially available RPLD that is applicable to the additional monitoring of the lens of the eyes for medical staff.