Occupational radiation doses to operators performing cardiac catheterization procedures

Area of Science:

• Cardiology
• Radiology
• Occupational Health

Background:

• Cardiac catheterization procedures, guided by fluoroscopy, are vital for reducing patient morbidity and mortality.
• These procedures necessitate radiation exposure for both patients and healthcare professionals, particularly physicians (operators).

Purpose of the Study:

• To systematically summarize operator radiation doses from fluoroscopically-guided cardiovascular procedures.
• To identify key factors influencing operator radiation dose.
• To assess temporal trends in operator radiation doses.

Main Methods:

• A comprehensive literature search of English-language articles from the 1970s to the present was conducted using PubMed.
• Reported radiation doses, measurement methods, equipment, and protective measures were abstracted.
• Effective doses to operators were calculated for comparative analysis.

Main Results:

• Effective doses varied significantly across procedures: diagnostic catheterizations (0.02-38.0 μSv), percutaneous coronary interventions (0.17-31.2 μSv), ablations (0.24-9.6 μSv), and pacemaker/ICD implantations (0.29-17.4 μSv).
• Radiation doses were generally higher on the operator's left side.
• Modest dose reductions were observed for diagnostic catheterizations and ablations due to technological improvements, but not for percutaneous coronary interventions, likely due to increased procedure complexity.

Conclusions:

• Significant variations in operator radiation doses necessitate optimizing procedure protocols and protective strategies.
• Standardization of dosimetric methods is crucial for accurate comparison and effective radiation protection of medical radiation workers.