Recording interventionalists' occupational dose by clinical procedure: a novel approach to radiation safety

The number of fluoroscopy-guided interventional procedures has increased in recent years due to their significant patient benefits. However, occupational radiation risks for interventionalists remain among the highest in medical practices. Electronic personal dosimeters can measure occupational doses for individual procedures, enabling immediate optimisation actions. An information system that effectively aggregates these records proves to be a powerful tool for this optimisation. Furthermore, implementing alerts to identify abnormal occupational doses is a practical method to improve radiation protection for interventionists.

Electronic dosimeters were linked with the X-ray system to record both the occupational and patient doses on a per-procedure basis. The information, stored in a central database, is used to compute dose indicators and trigger alerts that warn operators about specific areas requiring optimisation.

The results from the first 9 months of 2024 were analysed, covering 3 interventional cardiology rooms and 2 interventional radiology rooms, with 19 interventionalists (8 cardiologists and 11 radiologists) performing a total of 3373 procedures. The initial alerts were configured on the basis of regulatory dose limits and the third quartile of occupational dose per procedure, as well as the ratio of occupational dose to kerma area product per procedure and the ratio between occupational dose and the C-arm measured dose.

These alerts, along with personal dose data and other dosimetry information, are accessible to interventionalists and medical physics experts. This information system provides detailed, structured occupational dose data necessary to implement targeted optimisation measures.