Measurement Of Radiation Exposure Research Articles

Real-time measurement of radiation exposure in interventional radiologists during CT-guided intrathecal injections of nusinersen.

Some patients with spinal muscular atrophy and scoliosis require CT guidance during injections of nusinersen. The radiation applied to the operator in such procedures becomes an important issue in terms of staff health and safety. The aim of the study was to assess the operator's radiation exposure during CT-guided nusinersen injections in patients with spinal muscular atrophy and scoliosis. Consecutive 40 CT-guided nusinersen injections were analyzed in terms of operator's radiation exposure measured in real time. The median radiation dose measured under the physician's lead apron and patient dose in terms of DLP was 0.20 µSv and 31.90 mGy*cm respectively. The radiation doses were significantly higher (p = 0.047) in patients with spinal instrumentation. The results show that CT-guided nusinersen injection is a relatively safe procedure in terms of operator's radiation exposure. This can allow for interventional radiologists to perform more procedures without exceeding their annual dose limit.

The Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) Study: Protocol for a Trial of Personalized Sun Protection Interventions for Skin Cancer Prevention among Undergraduate Students

BackgroundAddressing the increasing incidence of skin cancer among young adults is a priority. The objective of the Risk Information and Skin-cancer Education for Undergraduate Prevention (RISE-UP) study is to identify personalized intervention components to prevent sunburn, a clinically significant outcome highly associated with skin cancer, in college students. MethodsGuided by the Elaboration Likelihood Model, the study will use Multiphase Optimization Strategy (MOST) methodology to test three intervention components (ultraviolet photography, MC1R genetic testing, and action planning) each with two levels (yes v. no) in a full-factorial experiment to evaluate unique and combined effects of these components to improve outcomes over the longer-term, with seasonally timed follow-up. At-risk University of Utah students (N = 528) will be recruited. Eligibility criteria include self-reported sunburn or tanning in the past year, or not utilizing recommended sun protection. After baseline assessment, participants will be randomized to intervention group, stratified by sex. Assessments will be completed at (1) Baseline; (2) Intervention; (3) 1 month after intervention; (4) 4 months after intervention (the end of the first summer); and (5) 15 months after intervention (the end of the second summer). The primary outcome will be participants' self-reported number of sunburns. Secondary outcomes will include self-reported sun protection and tanning behaviors and, in a randomly selected subgroup, an objective measure of ultraviolet radiation (UVR) exposure. ConclusionThe RISE-UP study will determine the efficacy of different combinations of personalized skin cancer preventative interventions for young adults and determine the optimal combination of intervention components to prevent skin cancer.Clinical Trial Registration:NCT05634252

Radiation Exposure and Protection for (Assumed) Pregnant Interventional Cardiologists and Electrophysiologists.

Concern about fetus radiation dose and assumed health effects remains a barrier for women considering a career in invasive cardiology. However, there is a lack of real-world fetus exposure data that can be used to support career decisions. The purpose of this work was to measure radiation exposure to invasive cardiologists which would contribute to dose to the fetus during pregnancy. Radiation exposure to 42 female and male interventional cardiologists and electrophysiologists was monitored during their clinical routine. Multivariate analysis was used to assess the influences of patient radiation exposure, radioprotective garment material thickness (0.25, 0.35, 0.5 mm Pb equivalent), and cardiologist sex, height, and clinical role on occupational radiation exposure to the abdomen. Exposure to the abdomen of invasive cardiologists increased proportional to patient exposure and decreased predictably with increasing radioprotective material thickness. The median abdomen exposure when covered with a 0.5 mm Pb equivalent radioprotective material over a 40-week period was 0.22 mGy (95th percentile, 0.8 mGy). Physician sex, height, and clinical role did not influence occupational exposure. The use of a 0.5 mm Pb equivalent radioprotective garment covering the abdomen, combined with appropriate radiation safety practices, can ensure that fetus radiation dose is below both US and international limits. Assumed fetus risk due to very low occupational radiation exposure is likely inconsequential in light of other known pregnancy risks.

CORR Insights®: Is Ocular Safety in Orthopaedics Overlooked? A Systematic Review of Annual Ocular Radiation Exposure and Protective Measures.

CORR Insights®: Is Ocular Safety in Orthopaedics Overlooked? A Systematic Review of Annual Ocular Radiation Exposure and Protective Measures.

Developing a novel radiosensitive metal ion-loaded PVA/NBT film as medical low-dose X-ray dosimeter

The hazards associated with ionizing radiation exposure has spurred the advancement of reliable and precise dosimetry techniques. Currently, there still lacks a viable and efficient dosimetry methods for measuring radiation expo-sure within low dosage ranges. This raises a concern in certain domains, such as radiodiagnostics and practitioners that employ low-dose X-ray radiation. Hence, this study aims to produce PVA/NBT film dosimeters that are capable in effectively detecting low dosages of X-ray radiation. Moreover, PVA/NBT films loaded by various metal ions will also be studied. The films were synthesized by the solvent casting method. The films were subjected to X-ray irradiation with a dosage ranging from 0 to 2.626 mGy. The films were further examined through EDX analysis, UV–Vis spectroscopy, optical density measurement, FTIR spectroscopy, and SEM analysis. It was observed that X-ray radiation exposure caused a broadening in the UV–Vis absorbance spectrum, which enhances its light absorption capability and making it more opaque. Furthermore, the careful selection of metal ion enhanced the film's ability in detecting X-ray radiation. Silver-loaded films were proven to significantly enhance the linearity and sensitivity of the PVA/NBT dosimeter film. These findings showed that silver-loaded PVA/NBT films exhibit a promising prospect for further applications in the domain of medical radiation.

OR12-2 | In-Practice Measurement of Radiation Exposure and Protection for (assumed) Pregnant Cardiologists Performing Cardiac Catheterization and Electrophysiology Procedures

OR12-2 | In-Practice Measurement of Radiation Exposure and Protection for (assumed) Pregnant Cardiologists Performing Cardiac Catheterization and Electrophysiology Procedures

Radiation exposure in therapeutic endoscopic retrograde cholangiopancreatography with two types of fluoroscopy systems

AbstractFluoroscopy is necessary for endoscopic retrograde cholangiopancreatography (ERCP). Occupational radiation exposure of staff (endoscopists, nurses, or assistants) is inevitable. Fluoroscopes with a tube over‐couch (OC) rather than under‐couch (UC) may have more radiation reflection dosage on the staff's upper body theoretically, where the most vital organs are. In the study, we assessed the radiation exposure on staff by two different types of fluoroscopes in real‐world practice. Using a radiation dosimeter to measure the radiation dosage on endoscopists and assistants in each ERCP procedure under two different fluoroscopic systems (UC vs. OC). Forty‐one ERCP procedures were enrolled. Dosimeters were used NanoDots for the measurement of personal radiation exposure. Those dosimeters were attached to the left forearm and chest of the endoscopist and only the chest of two assistants, the wall of the ERCP room, and the controlling room in every procedure. Nine‐teen ERCPs were performed under the OC unit, and the other 22 ERCPs were UC method. Fluoroscopic time and output of radiation dose showed no significant difference between the two groups. Radiation exposure in endoscopist were 0.0911[0.1041–0.3974] mGy (OC) versus 0.0276 [0.0080–0.2924] mGy (UC), p < .01 for the forearm; and 0.0318 [0.0070–0.2628] mGy (OC) versus 0.0182 [0.0088–0.1628] mGy (UC), p = .04 for the endoscopist's body. There was no difference in radiation exposure from assistants in both groups. For all the ERCP procedures, the measurement of radiation exposure from high to low is endoscopist's hand, endoscopist's body, assistant 1, assistant 2, and ERCP room (p < .01). Radiation detection from ERCP room is slightly higher but close to controlling room (p = .06). For the safety of occupational radiation protection, tube of fluoroscope UC is better than OC for the endoscopists more than assistants. Besides, the assistant 1 took higher radiation exposure than assistant 2 for each ERCP procedure.

Innovations in Image-Guided Procedures: Unraveling Robot-Assisted Non-Hepatic Percutaneous Ablation.

Interventional oncology is routinely tasked with the feat of tumor characterization or destruction, via image-guided biopsy and tumor ablation, which may pose difficulties due to challenging-to-reach structures, target complexity, and proximity to critical structures. Such procedures carry a risk-to-benefit ratio along with measurable radiation exposure. To streamline the complexity and inherent variability of these interventions, various systems, including table-, floor-, gantry-, and patient-mounted (semi-) automatic robotic aiming devices, have been developed to decrease human error and interoperator and intraoperator outcome variability. Their implementation in clinical practice holds promise for enhancing lesion targeting, increasing accuracy and technical success rates, reducing procedure duration and radiation exposure, enhancing standardization of the field, and ultimately improving patient outcomes. This narrative review collates evidence regarding robotic tools and their implementation in interventional oncology, focusing on clinical efficacy and safety for nonhepatic malignancies.

Assessment of dosimetric approaches in evaluating radiation exposure for interventional cardiologists in Sri Lanka.

Interventional cardiologists face significant radiation exposure during interventional cardiology procedures. Therefore, this study focuses on assessing radiation exposure among interventional cardiologists during their procedures. Specifically, it aims to determine the effectiveness of both single and double dosimeter methods in estimating annual occupational radiation doses. This research holds pioneering significance as it represents the very first study undertaken in Sri Lanka. Thirteen interventional cardiologists performed 486 interventional cardiology procedures over three months in three different healthcare institutes. Active Hp(10) dosimeters were placed to measure radiation exposure. Effective doses were calculated using single and double dosimetric algorithms. Annual occupational doses were assessed on an operator basis. Statistical analyses were conducted to assess algorithmic differences and dose variations using the Kruskal-Wallis test and linear regression. The highest annual occupational dose for each dosimetric algorithm received as 2.00 ± 0.24 mSv, 2.29 ± 0.48 mSv, 3.35 ± 0.71 mSv, and 2.64 ± 0.42 mSv, respectively, and remained below the recommended safety limit of 20 mSv/year. The Kruskal-Wallis test revealed no significant differences in the effective doses among double dosimetric algorithms, as well as between single and double dosimetric algorithms (p > 0.05). Linear regression showed strong correlations among various algorithms, demonstrating consistency. The findings of this study hold significant effects on interventional cardiology practice in Sri Lanka, enhancing radiation safety and monitoring.

Measurement of X-Ray Radiation Exposure in Thorax Examinations at Radiology Installation of Wajak Husada General Hospital

The Study aims to measure radiation exposure on X-ray aircraft on chest radiography at the Radiology installation at Wajak Husada General Hospital. Measurements were carried out on the X-ray source tube and in the X-ray room environment at Wajak Husada General Hospital. This research aims to determine the value of radiation exposure and whether the examination room is safe for workers and the general public. Data collection in this research was direct observation in the radiology examination room; then, radiation exposure using a survey meter at points around the X-ray room. The highest exposure to X-ray aircraft was in the control panel room, which was 0.19 µSv/h or 0.88 mSv/y and was still below the dose limit value set by the Regional Head of Bapeten Regulation Number 4 of 2020, namely the dose limit value for workers of 20 mSv/ year and the community it is one mSv/year, concluded that the X-ray aircraft and environment are suitable for use and safe to occupy to implement radiology services.

Measurement and evaluation of electromagnetic radiation exposure from antennas in cellular networks in Ghana

Measurement and evaluation of electromagnetic radiation exposure from antennas in cellular networks in Ghana

Radiation exposure doses to the surgical team during hip surgery is significantly higher during lateral imaging than posteroanterior imaging: a cadaveric simulation study

BackgroundFluoroscopy is indispensable when determining appropriate and effective interventions in orthopedic surgery. On the other hand, there is growing concern about the health hazards of occupational radiation exposure. The aim of this cadaveric simulation study was to measure radiation exposure doses to the surgical team during hip surgery.MethodsWe reproduced the intraoperative setting of hip surgery using 7 fresh frozen cadavers (5 male, 2 female) to simulate patients and mannequins to simulate the surgeon, scrub nurse, and anesthesiologist. Six real-time dosimeters were mounted at sites corresponding to the optic lens, thyroid gland, chest, gonads, foot, and hand on each mannequin. The radiation exposure dose to each team member was measured during posteroanterior and lateral fluoroscopic imaging.ResultsRadiation exposure doses to the surgeon were significantly higher during 3 min of lateral imaging than during 3 min of posteroanterior imaging at the optic lens (8.1 times higher), thyroid gland (10.3 times), chest (10.8 times), and hand (19.8 times) (p = 0.018, p = 0.018, p = 0.018, and p = 0.018, respectively). During lateral imaging, the radiation doses to the nurse were 0.16, 0.12, 0.09, 0.72, and 0.38 times those to the surgeon at the optic lens, thyroid, chest, gonads, and foot, respectively. The radiation dose to the anesthesiologist was zero at all anatomic sites during posteroanterior imaging and very small during lateral imaging.ConclusionsRadiation exposure dose was significantly higher during lateral imaging up to 19.8 times comparing to the posteroanterior imaging. It is effective to reduce the lateral imaging time for reducing the intraoperative radiation exposure. In addition, appropriate distance from fluoroscopy resulted in very low exposure for nurses and anesthesiologists. Surgeon should pay attention that surgical staff do not get closer than necessary to the irradiation field.

Measurement of Radiation Exposure of Hands and Fingers of Nuclear Medicine Personnel Using Innovative Low-Cost GM Based System

Pocket dosimeters are used commonly in Nuclear Medicine or radiology workers for daily dose measurement or during certain high radiation exposure procedures for short periods of time. These are expensive and have many maintenance costs. It may not be feasible to procure many at a time due to cost restraints. We designed a low cost remote dose monitoring device for measurement of radiation for short periods of time. Measuring device was constructed using micro Geiger Muller Counter. The micro-Geiger Counter with model no SBM21 was connected to high voltage circuit and the output signal was obtained. After this, output signal was sent it to Arduino circuit running custom code ESP8266 and readings was made on the mobile/ laptop application after connecting to Arduino circuit running custom code ESP8266 via internet. Readings were taken for short durations during certain periods. Readings were compared to the standard measuring instrument simultaneously. The tube was connected to their hands for hand exposure with a wire. Readings were recorded in the form of μSv/h or mSv/h. RESULT: Total readings were taken during various occasions while preparing (59) and dispensing (45) radioisotopes. During preparation of radiopharmaceuticals, average readings for 99mTc-Sestamibi[16 SAMPLE] (100mCi to 250mCi), 99mTc-MDP [21SAMPLE] (150-200mCi) and 99mTc-DTPA [22SAMPLES] (10-20mCi) were 1115 μSv/h, 3083 μSv/h and 453 μSv/h respectively. During dispensing of radiopharmaceuticals, average readings of total 15 sample each for 99mTc-Sestamibi (100mCi to 250mCi), 99mTc-MDP (150-200mCi) and 99mTc-DTPA (10-20mCi) were 351μSv/h, 209 μSv/h and 235 μSv/h respectively. It was feasible for the worker to fit the measuring device in their pocket while working. Conclusion: Our pilot study revealed accurate readings >95% of the times for short periods of time. Study designing, standardization of readings with more real time accuracy can make this method more reliable and is a low cost means to monitor short periods of radiation exposure for radiation workers.

Does radiation exposure during pediatric supracondylar humeral fracture surgery change according to the C-arm position? A comparison of two different techniques

IntroductionIn the surgical treatment of supracondylar humeral fractures (SHF), the surgeon has to stand right next to the fluoroscopy device, so it is very important to know how to use it in the most appropriate way to reduce radiation exposure. The aim of this study was to investigate the effect of using C-arm in uniplanar (inverted) and biplanar (standard-horizontal) configurations on (1) the radiation exposure to the surgeon, and (2) surgical time and fluoroscopy exposure time. Material and methodsThis prospective randomised study was conducted on 20 patients who underwent fluoroscopy during closed reduction and percutaneous pinning for a SHF. In the first configuration, the C-arm was inverted and the image intensifier was used as a surgical table. In the second configuration, the C-arm was used biplanar. The operations were performed by 5 surgeons, with each surgeon using each method only twice. During the operation, to find a value closed to direct radiation exposure measurement was made by attaching a dosimeter to the wrist and scatter radiation exposure was measured by attaching a dosimeter to the neck and waist of the surgeons. The operation time and fluoroscopy exposure time were determined. ResultsThe duration of operations performed with the biplanar C-arm position and the fluoroscopy exposure time in operations performed with the uniplanar method were found to be statistically significantly longer (p = 0.001). The measurements on the dosimeter worn on the neck of surgeons were found to be statistically significantly higher while using the uniplanar C-arm configuration (p = 0.001). There was no statistically significant difference between the dosimeter measurements on the wrists and waists of the surgeons and the C-arm configurations (p = 0.820; p = 0.185). ConclusionsAlthough the use of biplanar C-arm has no effect on radiation exposure to the surgeon's wrist, the most important advantages are that the neck area is exposed to less radiation and it shortens the fluoroscopy time so the use of a biplanar C-arm can be recommended. Level of evidenceLevel II

Paper-Based Vertical Flow Immunoassay for the Point-of-Care Multiplex Detection of Radiation Dosimetry Genes

In a nuclear or radiological incident, first responders must quickly and accurately measure radiation exposure among civilians as medical countermeasures are radiation dose-dependent and time-sensitive. Although several approaches have been explored to measure absorbed radiation dose, there is an important need to develop point-of-care (POC) bioassay devices that can be used immediately to triage thousands of individuals potentially exposed to radiation. Here we present a proof-of-concept study showing the use of a paper-based vertical flow immunoassay (VFI) to detect radiation dosimetry genes. Using labeled primers during amplification and a multiplex membrane, our results showed that the nucleic acid VFI can simultaneously detect two biodosimetry genes, CDKN1A and DDB2, as well as one housekeeping gene MRPS5. The assay demonstrated good linearity and precision with an inter- and intra-assay coefficient of variance <20% and <10%, respectively. Moreover, the assay showed its ability to discriminate non-irradiated controls (0 Gy) from irradiated samples (1 + 2 Gy) with an overall sensitivity of 62.5% and specificity of 100% (AUC = 0.8672, 95% CI: 0.723–1.000; p = 0.004). Interestingly, the gene combination also showed a dose-dependent response for 0, 1, and 2 Gy, similar to data obtained by real-time PCR benchmark. These preliminary results suggest that a VFI platform can be used to detect simultaneously multiple genes that can be then quantified, thus offering a new approach for a POC biodosimetry assay that could be rapidly deployed on-site to test a large population and help triage and medical management after radiological event.

Patients’ Radiation Exposure During Endovascular Abdominal Aortic Aneurysm Repair

To investigate associations between patient characteristics, intraprocedural complexity factors, and radiation exposure to patients during endovascular abdominal aortic aneurysm repair (EVAR). Elective standard EVAR procedures between January 2015 and December 2020 were retrospectively analyzed. Patient characteristics and intraprocedural data (i.e., type of device, endograft configuration, additional procedures, and contralateral gate cannulation time [CGCT]) were collected. Dose area product (DAP) and fluoroscopy time were considered as measurements of radiation exposure. Furthermore, effective dose (ED) and doses to internal organs were calculated using PCXMC 2.0 software. Descriptive statistics, univariable, and multivariable linear regression were applied to investigate predictors of increased radiation exposure. The 99 patients were mostly male (90.9%) with a mean age of 74±7years. EVAR indications were most frequently abdominal aortic aneurysm (93.9%), penetrating aortic ulceration (2.0%), focal dissection (2.0%), or subacute rupture of infrarenal abdominal aortic aneurysm (2.0%). Median fluoroscopy time was 19.6minutes (interquartile range [IQR], 14.1-29.4) and median DAP was 86,311 mGycm2 (IQR, 60,160-130,385). Median ED was 23.2 mSv (IQR, 17.0-34.8) for 93 patients (93.9%). DAP and ED were positively correlated with body mass index (BMI) and CGCT. Kidneys, small intestine, active bone marrow, colon, and stomach were the organs that received the highest equivalent doses during EVAR. Higher DAP and ED values were observed using the Excluder endograft, other bi- and tri-modular endografts, and EVAR with ≥2 additional procedures. Multivariable linear regression analysis revealed that BMI, ≥2 additional procedures during EVAR, and CGCT were independent positive predictors of DAP and ED levels after accounting for endograft type. Patient-related and procedure-related factors such as BMI, ≥2 additional procedures during EVAR, and CGCT resulted predictors of radiation exposure for patients undergoing EVAR, as quantified by higher DAP and ED levels. The main intraprocedural factor that increased radiation exposure was CGCT. These data can be of importance for better managing radiation exposure during EVAR.

Occupational radiation exposure to the lens of the eyes and its protection during endoscopic retrograde cholangiopancreatography

This study aimed to examine occupational radiation exposure to the lens of the eyes during endoscopic retrograde cholangiopancreatography (ERCP). In this multicenter, prospective, observational cohort study, we collected data regarding occupational radiation exposure to the lens of the eyes during ERCP. We measured radiation exposure of patients and examined its correlation with occupational exposure. In dosimetrically-measured ERCPs (n = 631), the median air kerma at the patient entrance reference point, air kerma-area product, and fluoroscopy time were 49.6 mGy, 13.5 Gycm2, and 10.9 min, respectively. The median estimated annual radiation dose to the lens of the eyes was 3.7, 2.2, and 2.4 mSv for operators, assistants, and nurses, respectively. Glass badge over lead aprons and eye dosimeter results were similar in operators but differed in assistants and nurses. A strong correlation was shown between eye dosimeter measurements and patients' radiation exposure. The shielding rates of the lead glasses were 44.6%, 66.3%, and 51.7% for operators, assistants, and nurses, respectively. This study revealed the actual occupational exposure dose for the lens of the eyes during ERCP and the efficacy of lead glass. Values of radiation exposure to patients can help estimate exposure to the lens of the eyes of medical staff.

179 Measuring Real Time Radiation Exposure to Spine-Focused Neurosurgeons

INTRODUCTION: C-arm fluoroscopy and O-arm navigation are vital tools in modern spine surgeries, but their repeated usage can endanger spine surgeons. While a surgeon’s chest and abdomen are protected by lead aprons, the eyes and extremities generally receive less protection. METHODS: This prospective cohort study includes 65 consecutive spine surgeries performed by a single spine-focused neurosurgeon over a 9-month period. Radiation exposure to the primary surgeon was measured through dosimeters worn over the lead apron, under the lead apron, on surgical loupes, and as a ring on the dominant hand. Differences were assessed with rigorous statistical testing and radiation exposure per surgical case was extrapolated. RESULTS: During the study, the measured radiation exposure over the apron, 176 mrem, was significantly greater than that under the apron, 8 mrem (p = .0020), demonstrating shielding’s protective effect. The surgeon’s dominant hand was exposed to 329 mrem while the eyes were exposed to 152.5 mrem of radiation. Compared to the surgeon’s protected abdominal area, the hands (p = .0002) and eyes (p=.0002) received significantly greater exposure. Calculated exposure per case was 2.8 mrem for the eyes and 5.1 mrem for the hands. It was determined that a spine-focused neurosurgeon operating 400 cases annually will incur a radiation exposure of 60,750 mrem to the hands and 33,900 mrem to the eyes over a 30-year career. CONCLUSIONS: Our study found that spine surgeons encounter significantly more radiation exposure to the eyes and the extremities compared to protected body regions. Lifetime exposure exceeds the annual limits set by the International Commission on Radiological Protection for the extremities (50,000 mrem/yr) and the eyes (15,000 mrem/yr), calling for increased awareness about the dangerous levels of radiation exposure that a spine surgeon incurs over one’s career.

Radiation exposure to staff during fluoroscopic endoscopic procedures.

Fluoroscopically guided procedures utilize ionizing radiation to assist in the diagnosis and treatment of the patient. The use of ionizing radiation is not without risk to the operator and other staff members present during endoscopic procedures. This study simulates radiation exposure during endoscopic retrograde cholangiopancreatography procedures under different shielded conditions and provides practical radiation safety recommendations, through easy-to-use visual guides. We obtained radiation exposure measurements at varying locations with different shielding setups surrounding a mobile C-arm fluoroscopic unit while imaging a patient equivalent phantom at different heights. Heat maps were generated for the various conditions to provide visual guides for radiation protection. Different heat maps detailing various shielding methods have been generated to assist in determining the dose rate at varying locations surrounding the patient. The use of appropriate radiation protection could decrease the staff dose by up to 98%. Although minor per procedure, the magnitude of radiation exposure will accumulate over the staff's working life. As such, it is recommended that precautions be taken during fluoroscopically guided endoscopy procedures to ensure radiation is kept as low as reasonably achievable.

Body Surface Radiation Exposure in Interventional Echocardiographers During Structural Heart Disease Procedures

BackgroundThe distribution of radiation exposure on the body surface of interventional echocardiographers during structural heart disease (SHD) procedures is unclear. ObjectivesThis study estimated and visualized radiation exposure on the body surface of interventional echocardiographers performing transesophageal echocardiography by computer simulations and real-life measurements of radiation exposure during SHD procedures. MethodsA Monte Carlo simulation was performed to clarify the absorbed dose distribution of radiation on the body surface of interventional echocardiographers. The real-life radiation exposure was measured during 79 consecutive procedures (44 transcatheter edge-to-edge repairs of the mitral valve and 35 transcatheter aortic valve replacements [TAVRs]). ResultsThe simulation demonstrated high-dose exposure areas (>20 μGy/h) in the right half of the body, especially the waist and lower body, in all fluoroscopic directions caused by scattered radiation from the bottom edge of the patient bed. High-dose exposure occurred when obtaining posterior-anterior and cusp-overlap views. The real-life exposure measurements were consistent with the simulation estimates: interventional echocardiographers were more exposed to radiation at their waist in transcatheter edge-to-edge repair than in TAVR procedures (median 0.334 μSv/mGy vs 0.053 μSv/mGy; P < 0.001) and in TAVR with self-expanding valves than in those with balloon-expandable valves (median 0.067 μSv/mGy vs 0.039 μSv/mGy; P < 0.01) when the posterior-anterior or the right anterior oblique angle fluoroscopic directions were used. ConclusionsDuring SHD procedures, the right waist and lower body of interventional echocardiographers were exposed to high radiation doses. Exposure dose varied between different C-arm projections. Interventional echocardiographers, especially young women, should be educated regarding radiation exposure during these procedures. (The development of radiation protection shield for catheter-based treatment of structural heart disease [for echocardiologists and anesthesiologists]; UMIN000046478)