Standardization of Occupational Dose to Patient DAP Enables Reliable Assessment of Radiation-Protection Devices in Invasive Cardiology

Abstract PURPOSE: With the aim of assessing the effectiveness of radiation-protection devices in invasive cardiology, the goal of this study was to validate relative parameters for operator occupational exposure, standardized to the patient's primary dose. MATERIAL AND METHODS: One of these parameters was the local dose, measured in air at the operator's position per dose area product (DAP), applied to a male anthropomorphic Alderson-Rando phantom for simulation of coronary angiography. The second parameter was personal occupational dose to the operator per DAP, measured by thermoluminescence dosimeter stripes during 121 procedures in routine clinical work. RESULTS: The local and personal doses per unit DAP - using typical 0.5-mm lead overcouch and undercouch protection - were comparable (left eye 180 vs. 360, thyroid 260 vs. 260, left shoulder 280 vs. 150, chest 400 vs. 500, hands 400 vs. 550, waist 900 vs. 400 nSv/Gy × cm 2 ). The results, however, were far lower than typically reported values. Our findings therefore disclose a typically inadequate use or acceptance by individual operators of available table-attached lead protection devices, and of ceiling-attached lead-glass screens. The additional use of individual 1.0-mm lead-equivalent garments reduced local doses to levels between 1 ... 10 %. CONCLUSIONS: DAP-standardized dose parameters - determined experimentally (phantom measurements), or in routine clinical work - are not appreciably influenced by the equipment age and type, or by the image-intensifier entrance dose rate of the respective catheterization system. They are consequently best suited for obtaining eloquent comparisons of various radiation-protection devices, and for reliable estimation of local scatter radiation exposure by simple documentation of intervention DAP.