Radiology Staff Research Articles

EP.FRI.178 Audit of rejected radiological referrals at Ninewells Hospital, Dundee: Reasons and outcomes

Abstract Background Rejected radiology requests in emergency-settings can be time-consuming for clinical and radiological staff; and can delay or even affect patient management plans and outcomes. Inappropriate or duplicate radiological requests additionally can be resource-wasting (according to data from Fairfield Independent Hospital, BUPA, St. Helen’s) - the approximate costs / scan are £160 for Ultrasound, £450-£675 for CT, £350- £525 for MRI. Methods Results Commonest reasons for rejection: Conclusions

The Use of Lean Six Sigma for Improving Availability of and Access to Emergency Department Data to Facilitate Patient Flow.

The aim of this study was to redesign an emergency department [ED] data management system to improve the availability of, and access to, data to facilitate patient flow. A pre-/post-intervention design was employed using Lean Six Sigma methodology with a focus on the voice of the customer, Gemba, and 5S to identify areas for improvement in ED data management processes and to inform solutions for improved ED patient flow processes. A multidisciplinary ED team includes medical consultants and registrars, nurses, patient service staff, radiology staff, as well as information technology and hospital management staff. Lean Six Sigma [LSS] diagnostic tools identified areas for improvement in the current process for data availability and access. A set of improvements were implemented to redesign the pathway for data collection in the ED to improve data availability and access. We achieved a reduction in the time taken to access ED patient flow data from a mean of 9 min per patient pre-intervention to immediate post-intervention. This enabled faster decision-making by the ED team related to patient assessment and treatment and informed improvements in patient flow. Optimizing patient flow through a hospital’s ED is a complex task involving collaboration and participation from multiple disciplines. Through the use of LSS methodology, we improved the availability of, and fast access to, accurate, current information regarding ED patient flow. This allows ED and hospital management teams to identify and rapidly respond to actions impacting patient flow.

Tomografía computarizada coronaria en urgencias: importancia de la experiencia del radiólogo

IntroductionIncorporating coronary computed tomography angiography (CTA) in the hospital workup for suspected acute coronary syndrome requires appropriate skills for interpreting this imaging test. Radiologists’ skills can affect the interobserver agreement in evaluating these studies. ObjectiveTo determine the interobserver agreement according to radiologists’ experience in the interpretation of coronary CTA studies done in patients who present at the emergency department with acute chest pain and low-to-intermediate probability of acute coronary syndrome. Materials and methodsWe studied the interobserver agreement in the urgent evaluation of coronary CTA studies in which CAD-RADS was used to register the findings. We created pairs of observers among a total of 8 assessors (4 attending radiologists and 4 radiology residents). We used the kappa coefficient to estimate the overall concordance and the concordance between subgroups according to their experience. ResultsThe agreement was substantial between experienced radiologists and residents (k = 0.627; 95%CI: 0.436 – 0.826) as well as between all the pairs of observers (k=0.661; 95%CI: 0.506 – 0.823) for all the CAD-RADS together. The degree of agreement within the group of experienced radiologists was greater than that within the group of residents in all the analyses. The agreement was excellent for the overall CAD-RADS (k=0.950; 95% CI: 0.896 – 1) and for CAD-RADS ≥ 4 (k=1); the agreement was lower for CAD-RADS ≥ 3 (k = 0.754; 95% CI: 0.246 – 1.255). The agreement for the residents for these categories was k= 0.623, k=0.596, and k=0.473, respectively. ConclusionThe agreement among attending radiologists regarding the assessment of urgent coronary CTA studies is excellent. The agreement is lower when residents are paired with attending radiologists. These findings should be taken into consideration when implementing coronary CTA in emergency departments and in the organization of radiological staff for interpreting and reporting this imaging test.

Endovascular Repair of a Mycotic Aortic Aneurysm Infected With Bacillus Calmette-Guérin After Treatment of Bladder Cancer

Bacillus Calmette-Guérin (BCG) is an attenuated form of Mycobacterium bovis used for intravesical therapy for bladder carcinoma. Disseminated infection is uncommon. Aortic involvement with aneurysmal degeneration is even rarer, with <30 cases reported. Prior reports documented aggressive open surgical repair. We have detailed a case of mycotic aortic pseudoaneurysm and para-aortic abscess from disseminated BCG treated with endovascular repair and percutaneous drainage. A 73-year-old man was found to have an infrarenal mycotic aortic pseudoaneurysm with para-aortic and iliopsoas abscess on computed tomography after complaining of persistent abdominal pain. His history was noTable for recurrent in situ bladder carcinoma treated with two sessions of intravesical BCG. He eventually underwent cystoprostatectomy with an ileal conduit and cecectomy. His postoperative course was complicated by bowel perforation requiring a diverting ileostomy and reversal—all performed several months before the current episode. Fine needle aspiration was positive for acid fast bacilli, raising concerns for BCG infection. Antibiotics were started, and he was offered surgical repair. Given the hostile abdomen, we decided to proceed with EVAR. With the patient under general anesthesia, a rifampin-soaked 22 × 94-mm thoracic endograft (Medtronic, Dublin, Ireland) was deployed across the pseudoaneurysm. This case was performed before the company recall of their device. The procedure was performed with a single access site, using an 18F Gore sheath (W.L. Gore & Associates, Flagstaff, Ariz) with a buddied pigtail catheter. A completion aortogram revealed an excellent seal. The procedure was well-tolerated, and the patient discharged on the second postoperative day after retroperitoneal drain placement by the radiology staff. He was seen in follow-up at 1 month, at which time his drain was removed and a computed tomography scan demonstrated resolution of his pseudoaneurysm and abscess. Aortic infection from disseminated BCG is a rare clinical entity. The few reported cases have mostly included open surgical repair. We have described the case of a patient treated with an endograft who had had clinical and radiologic resolution at short-term follow-up. The long-term prognosis has not yet been determined. However, our patient's favorable early outcome shows promise for the technique.

A Pilot Program of Virtual Ergonomics Consults for Radiology Staff Working From Home.

In March 2020, social distancing measures and other safety concerns related to the coronavirus disease 2019 (COVID-19) pandemic meant that all possible personnel and radiologists in the Department of Radiology at our institution who could work from home needed to do so on short notice. Although most radiologists already had a home workstation, most were not individually ergonomically optimized. Previously, nonradiologist staff did not have the ability to work from home and scrambled to adapt. Consequently, many traded their multimonitor workstations, task chairs, and desks for laptops on sofas and kitchen tables.

Awareness and Compliance of COVID-19 Imaging and Guidelines among Radiology Staff

Awareness and Compliance of COVID-19 Imaging and Guidelines among Radiology Staff

Incidence of clinical fractures: A 7-year follow-up study in institutionalized adults with epilepsy and intellectual disability

PurposeTo determine the incidence of clinical fractures over seven years of follow-up, in adults with epilepsy and intellectual disability, residing in a long-stay care facility. MethodsIn 2009, all institutionalized adult patients (n = 261) were invited to undergo a Dual-energy X-ray Absorptiometry (DXA) measurement and a Vertebral Fracture Assessment (VFA). Participants were followed over seven years or until date of discharge (in case of moving from the care facility) or date of death. The patients’ medical files were screened for radiology reports and staff notes, to identify clinical fractures. Fracture incidence rates (IR) were determined and compared for subgroups, by calculating incidence rate ratios. Hazard ratios were calculated to identify factors associated with fracture risk, using Cox Proportional Hazards analyses. ResultsA total of 205 patients (124 male, 60.5%) aged between 18 and 88 years (median 48, IQR 34–60) were enrolled. At baseline, 92 patients (44.9%) were diagnosed with osteopenia and 65 (31.7%) with osteoporosis. Between 2009 and 2016, 30 patients (14.6%) deceased and 3 patients (1.5%) left the care facility. During follow-up, 156 clinical fractures were reported in 82 patients (40.0%). Thirty-eight patients (18.5%) had at least one major osteoporotic fracture. Overall, the IR was 11.6 fractures per 100 person-years. Fracture risk was significantly lower in patients who were wheelchair dependent than in patients who were able to walk (p<.001). ConclusionThis study demonstrated that 40% of institutionalized adults with epilepsy and intellectual disability had at least one clinical fracture during seven years of follow-up, despite adequate anti-osteoporosis treatment.

Occupational radiation exposure to the lens of the eye in interventional radiology

Cataract formation is a tissue reaction effected by radiation exposure. The purpose of this study was to evaluate the occupational exposure to the lens of the eye of interventional radiologists (IR's) and interventional radiology staff, with and without lead glasses. Ethical approval was provided by the hospital research and ethics committee. A prospective cohort study was performed over 1 year, doses recorded, lifetime dose (estimated at working 5 days in angiography, for 30 years) was estimated and dose compared to current guidelines. Thermoluminescent dosimeters (TLDs; Landauer, Glenwood, USA) Hp(3) were placed on both the exterior and interior side of the personal lead glasses worn by three interventional radiologists and two radiographers. They were monitored during all procedures performed within 1 year. Lead glasses (AttenuTech® Microlite® , Florida, USA) with specifications were 0.75 mm lead equivalent front shield, and Side shield 0.3 mm Pb equivalent. A control TLD was placed in the storage location of the lead glasses when not in use. Yearly dose was measured and lifetime dose was calculated from the data obtained. Calculation of dose received per day(s) spent performing procedures for both annual and lifetime exposure was performed. In addition a record of occurrence of splashes on glasses was made after each case. Eye doses without protection were double the recommended limits for both annual and lifetime dose. For interventional radiologists working between 3 and 4 or more days in the lab per week, annual dose thresholds would be exceeded (20 mSv/year averaged over 5 years, no more than 50 mSv in 1 year). If interventional radiologists worked between 3 and 4 or more days in the lab, lifetime dose thresholds would be exceeded (500 mSv lifetime dose). Lead glasses reduced radiation exposure by an average of 79%. If lead glasses were worn no interventional radiologists would exceed annual or lifetime dose thresholds to the eyes even if working 5 days per week as the primary operator. Radiographers would not exceed annual or lifetime dose thresholds even without lead glasses. Splash incidents occurred for all interventional radiologists and one radiographer. The use of lead glasses even in this small study resulted in a decreased dose of radiation to the lens of the eye. Regular use of radiation protection eyewear will reduce eye dose for primary proceduralists to well below yearly and lifetime thresholds.

Attitude and barriers of teamwork in intensive care unit from the perspective of nurses in COVID-19 pandemic

Background and Aim: Front-line medical teams are experiencing unprecedented stressors as a result of the COVID-19 pandemic. In the face of these pressures, teamwork has become both more important and more challenging. During the crisis, people trying to work together who may not have done so under 'normal' conditions. Therefore, this study will be conducted to investigate the attitudes and barriers to teamwork from the perspective of intensive care unit nurses in the COVID-19 pandemic. Methods: In this descriptive-analytical study from October 2020 to January 2021, 97 nurses working in intensive care units were selected according to the inclusion criteria. The data collection tool was a standard questionnaire to assess the attitude towards teamwork and assessment of barriers to teamwork, which was completed by the participants after validity and reliability. Data were analyzed using descriptive statistics and independent t-test in SPSS software version 25. Results: The mean score of nurses' attitude to teamwork was 127.82 ± 10.4. The amount of barriers in the workplace for optimal teamwork was reported by 54 (55.67%) high, 32 (32.3%) low and 11 (11.34%) unimpeded. Most barriers to teamwork were reported with nursing managers, organization managers, consulting physicians and therapists and the least barriers were reported with radiology staff and nurses. Conclusion: The performance of nursing managers and the weakness of intra-group relationships are the most important barriers to teamwork in the pandemic situation. In order to provide quality teamwork in the pandemic situation, job descriptions and plans should be provided by the managers of the organization and nurses should receive adequate training in this field. © 2021 Baqiyatallah University of Medical Sciences. All rights reserved.

Impact of 24/7 Onsite Emergency Radiology Staff Coverage on Emergency Department Workflow.

Assess the impact of 24/7/365 emergency trauma radiology (ETR) coverage on Emergency Department (ED) patient flow in an urban, quaternary-care teaching hospital. Patient ED visit and imaging information were extracted from the hospital patient care information system for 2008 to 2018. An interrupted time-series approach with a comparison group was used to study the impact of 24/7/365 ETR on average monthly ED length of stay (ED-LOS) and Emergency Physician to disposition time (EP-DISP). Linear regression models were fit with abrupt and permanent interrupts for 24/7/365 ETR, a coefficient for comparison series and a SARIMA error term; subgroup analyses were performed by patient arrival time, imaging type and chief complaint. During the study period, there were 949,029 ED visits and 739,796 diagnostic tests. Following implementation of 24/7/365 coverage, we found a significant decrease in EP-DISP time for patients requiring only radiographs (-29 min;95%CI:-52,-6) and a significant increase in EP-DISP time for major trauma patients (46 min;95%CI:13,79). No significant change in patient throughput was observed during evening hours for any patient subgroup. For overnight patients, there was a reduction in EP-DISP for patients with symptoms consistent with stroke (-78 min;95%CI:-131,-24) and for high acuity patients who required imaging (-33 min;95%CI:-57,-10). Changes in ED-LOS followed a similar pattern. At our institution, 24/7/365 in-house ETR staff radiology coverage was associated with improved ED flow for patients requiring only radiographs and for overnight stroke and high acuity patients. Major trauma patients spent more time in the ED, perhaps reflecting the required multidisciplinary management.

Clinical Validation Is the Key to Adopting AI in Clinical Practice.

Clinical Validation Is the Key to Adopting AI in Clinical Practice.

Increasing Use Of Cardiac Ct Merits Formal Training Guidelines For Nursing Staff

Introduction: Computed Tomography Coronary Angiography (CTCA) is increasingly used in Cardiology for the investigation and management of coronary artery disease. It is a multidisciplinary practice that involves nursing, radiography, cardiology and radiology staff. However training guidelines from the conjoint committee for the recognition of training in CTCA only applies to medical staff. Traditionally nursing staff are trained in an apprenticeship style approach- we set out to device a formal syllabus for training of CTCA nursing staff.

Diagnostic accuracy and inter-observer reliability of the O-RADS scoring system among staff radiologists in a North American academic clinical setting.

The objective of this study is to evaluate the diagnostic accuracy, interobserver variability, and common lexicon pitfalls of the ACR O-RADS scoring system among staff radiologists without prior experience to O-RADS. After independent review of the ACR O-RADS publications and 30 training cases, three fellowship-trained, board-certified staff radiologists scored 50 pelvic ultrasound exams using the O-RADS system. The diagnostic accuracy and area under receiver operating characteristic were analyzed for each reader. Overall agreement and pair-wise agreement between readers were also analyzed. Excellent specificities (92 to 100%), NPVs (92 to 100%), and variable sensitivities (72 to 100%), PPVs (66 to 100%) were observed. Considering O-RADS 4 and O-RADS 5 as predictors of malignancy, individual reader AUC values range from 0.94 to 0.98 (p < 0.001). Overall inter-reader agreement for all 3 readers was "very good," k = 0.82 (0.73 to 0.90, 95% CI, p < 0.001). Pair-wise agreement between readers were also "very good," k = 0.86-0.92. 14 out of 150 lesions were misclassified, with the most common error being down-scoring of a solid lesion with irregular outer contours. Even without specific training, experienced ultrasound readers can achieve excellent diagnostic performance and high inter-reader reliability with self-directed review of guidelines and cases. The study highlights the effectiveness of ACR O-RADS as a stratification tool for radiologists and supports its continued use in practice.

The effectiveness of collaborative teaching in an introductory online radiology session for master of nursing students

AimThe study aimed to evaluate the effectiveness of the collaborative teaching of a multi- disciplinary team on the introductory online radiology session for the Master of Nursing students. BackgroundThe teaching method for basic radiology reading for the Master of Nursing program was delivered via a 4-hour didactic face-to-face lesson and was ineffective as evidenced by the students' feedback and evaluation. Therefore, a multi-disciplinary team consisting of nursing, medical and radiology staff developed a 4-week online radiology session to enhance knowledge, attitudes and confidence of the Master of Nursing students in interpreting basic chest radiographs, abdominal radiographs and computed tomographic brain scans. MethodsA quasi-experimental study design using pre-test and post-test was adopted. The effectiveness of the online radiology session was evaluated on the students' knowledge, attitudes, and confidence. Forty Master of Nursing program students completed the pre-test and post-test questionnaires (response rate 74%) and responded to the open-ended questions in the post-test. IBM-SPSS was used to analyse the quantitative data and quantifying qualitative data technique was used to analyse the qualitative data. ResultsThe participants demonstrated an improvement in knowledge and confidence mean scores of the post-test compared to pre-test. There was improved self-rated proficiency in reading and interpreting a film radiograph but no difference in the way they perceived the importance of radiological investigations vis-à-vis the physical examination and routine laboratory testing. Quantifying quantitative data technique showed that majority of participants appreciated the learning process as it could be done at their own pace and the lectures could be replayed again. However, participants hoped for improved interaction with the tutor during learning and the use of real-life cases in the scenarios. ConclusionCollaborative teaching using an online radiology session shows promise over a traditional didactic method of teaching but requires further refinement in terms of participant interaction and the use of case examples.

Creating Solutions for Meeting the Challenges of Maintaining a Healthy Work Practice: Our Experience at a County Hospital

Creating Solutions for Meeting the Challenges of Maintaining a Healthy Work Practice: Our Experience at a County Hospital

Development of evidence-based clinical pathways for an outpatient oncology acute care clinic.

e18676 Background: Oncology patients frequently experience acute physical symptoms related to cancer and its treatment. Management of symptoms is best accomplished using evidence-based clinical care. When implementing an advanced practice provider (APP)-led oncology acute care clinic, evidence-based clinical pathways were developed to ensure standardization among treating providers. Methods: The top ten emergency department admitting diagnoses for oncology patients identified by the Centers for Medicare and Medicaid Services provided the foundation for development of the clinical pathways. Relevant primary literature, National Comprehensive Cancer Center Network guidelines, and American Society of Clinical Oncology guidelines were reviewed for development of outpatient oncology acute care clinical pathways. The information was cross-referenced with institutional data to confirm applicability to the patient population. A multidisciplinary team including nursing, pharmacy, laboratory services, radiology, information technology, and administrative staff reviewed the workflow to ensure best processes. The pathways were reviewed by oncologists, APPs and pharmacists before finalization. Results: Nine evidence-based clinical pathways were developed by August 1, 2020. From August to December 2020, 165 patient visits took place in the outpatient oncology acute care clinic. Gastrointestinal manifestations (25%), hypovolemia/weakness (25%), and infections (17%) were the most frequently encountered symptoms. Evidence-based clinical pathways were followed for patients with a chief complaint with an associated algorithm (N=124). Conclusions: Implementation of clinical pathways facilitate best practice standardization when ordering labs, tests, and medications while enhancing the acceptance of the new service. The pathways will be reviewed and updated by a multidisciplinary team every 3 months to ensure current evidence-based practices. Semi-annual pathway audits have been implemented to evaluate utilization and optimize patient outcomes, as well as determine areas of improvement and growth. Areas of opportunity identified during the first pathway audit included creating pathways for cardiac disorders, mouth disorders, and infections unrelated to neutropenia. Additionally, order set integration to automate the clinical pathway process in the electronic medical record is in progress.[Table: see text]

Audiovisual Content for a Radiology Fellowship Selection Process During the COVID-19 Pandemic: Pilot Web-Based Questionnaire Study.

BackgroundTraditional radiology fellowships are usually 1- or 2-year clinical training programs in a specific area after completion of a 4-year residency program.ObjectiveThis study aimed to investigate the experience of fellowship applicants in answering radiology questions in an audiovisual format using their own smartphones after answering radiology questions in a traditional printed text format as part of the application process during the COVID-19 pandemic. We hypothesized that fellowship applicants would find that recorded audiovisual radiology content adds value to the conventional selection process, may increase engagement by using their own smartphone device, and facilitate the understanding of imaging findings of radiology-based questions, while maintaining social distancing.MethodsOne senior staff radiologist of each subspecialty prepared 4 audiovisual radiology questions for each subspecialty. We conducted a survey using web-based questionnaires for 123 fellowship applications for musculoskeletal (n=39), internal medicine (n=61), and neuroradiology (n=23) programs to evaluate the experience of using audiovisual radiology content as a substitute for the conventional text evaluation.ResultsMost of the applicants (n=122, 99%) answered positively (with responses of agree or strongly agree) that images in digital forms are of superior quality to those printed on paper. In total, 101 (82%) applicants agreed with the statement that the presentation of cases in audiovisual format facilitates the understanding of the findings. Furthermore, 81 (65%) candidates agreed or strongly agreed that answering digital forms is more practical than conventional paper forms.ConclusionsThe use of audiovisual content as part of the selection process for radiology fellowships is a new approach to evaluate the potential to enhance the applicants experience during this process. This technology also allows for the evaluation of candidates without the need for in-person interaction. Further studies could streamline these methods to minimize work redundancy with traditional text assessments or even evaluate the acceptance of using only audiovisual content on smartphones.

Evaluation of stress and anxiety caused by the coronavirus disease 2019 (COVID-19) pandemic in pediatric radiology.

BackgroundWork-related stress and burnout were documented to be high among pediatric radiologists prior to the coronavirus disease 2019 (COVID-19) pandemic. New challenges arose from the COVID-19 pandemic, potentially introducing new stressors and anxieties.ObjectiveTo evaluate potential sources of stress and anxiety for pediatric radiology faculty during the early phase of the COVID-19 pandemic.Materials and methodsWe conducted a survey of attending physician members of the Society for Pediatric Radiology in North America from April 27, 2020, to May 22, 2020. The response rate was 21% (251/1,206). Survey questions included demographic information and questions regarding working remotely, personal protective equipment, redeployment, personal wellness, wellness resources and financial concerns. A psychometrician reviewed the questions to ensure minimal risk of misinterpretation.ResultsMedian age of respondents was 48 years (range 33–70 years) with median number of years in practice of 14 (range 1–45 years). Fifty-three percent of respondents were women and 46% were men. Because of an increase in remote work, 69% of respondents endorsed feeling more isolated from a lack of regular interaction with colleagues. Fifty-three percent of respondents indicated that it is challenging to work remotely while overseeing home schooling for children. In comparison to men, women reported overall higher work-related stress and anxiety (P=0.02), higher feelings of guilt from radiology staff (i.e. technologists and nurses) being more exposed to COVID-19 (P=0.02) and higher levels of stress providing for dependents (P=0.04). Most respondents thought that departmental leadership was effective and respondents were not concerned about meeting financial obligations or job loss.ConclusionThe early phase of the COVID-19 pandemic caused additional stress and anxiety for pediatric radiology faculty and disproportionally affected women. Given the continuously evolving state of the COVID-19 pandemic, these results could aid in planning and implementation of future strategies to combat burnout in radiology. Specific attention should be directed to different stressors experienced by female versus male radiologists, especially in regard to dependent care.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00247-021-05088-7.

PERSONAL DOSIMETRY USING MONTE-CARLO SIMULATIONS FOR OCCUPATIONAL DOSE MONITORING IN INTERVENTIONAL RADIOLOGY: THE RESULTS OF A PROOF OF CONCEPT IN A CLINICAL SETTING.

Exposure levels to staff in interventional radiology (IR) may be significant and appropriate assessment of radiation doses is needed. Issues regarding measurements using physical dosemeters in the clinical environment still exist. The objective of this work was to explore the prerequisites for assessing staff radiation dose, based on simulations only.Personal dose equivalent, Hp(10), was assessed using simulations based on Monte Carlo methods. The position of the operator was defined using a 3D motion tracking system. X-ray system exposure parameters were extracted from the x-ray equipment. The methodology was investigated and the simulations compared to measurements during IR procedures.The results indicate that the differences between simulated and measured staff radiation doses, in terms of the personal dose equivalent quantity Hp(10), are in the order of 30–70 %. The results are promising but some issues remain to be solved, e.g. an automated tracking of movable parts such as the ceiling-mounted protection shield.

ASSESSMENT OF WHOLE BODY, SKIN AND EYE LENS DOSES OF THE INTERVENTIONAL RADIOLOGISTS AT SELECTED HOSPITALS IN IRAN.

High radiation doses to the body may lead to the stochastic/deterministic effects of ionizing radiation on the critical organs as well as causing the cataract in eye lens of the clinical staff in interventional radiology. In this study, the received doses of the eyes, skin and whole body of 38 clinical staff including physicians, residents, nurses and radiotechnologists in cardiac angiography departments in three selected hospitals were assessed using personal dosemeters during two bimonthly dosimetry periods. Moreover, the correlation coefficients among the measured dose components including eye lens dose, skin dose and whole body dose equivalent in both area of under and over their lead-apron were calculated for all these occupational groups. The results show that the occupational annual dose values of the clinical staff are below the annual dose limits recommended by International Commission on Radiation Protection. Furthermore, among the measured dose components, the highest correlation coefficient value was obtained between the eye lens dose and personal dose equivalent measured over the lead apron for all the occupational groups.