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Cranial radiation exposure during cerebral catheter angiography
  1. Muhammad Omar Chohan1,
  2. Daniel Sandoval2,
  3. Andrew Buchan3,
  4. Cristina Murray-Krezan4,
  5. Christopher L Taylor1,2
  1. 1Department of Neurosurgery, University of New Mexico Hospital, Albuquerque, New Mexico, USA
  2. 2Department of Radiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
  3. 3Department of Safety and Risk Services, University of New Mexico, Albuquerque, New Mexico, USA
  4. 4Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
  1. Correspondence to Dr M O Chohan, Department of Neurosurgery, MSC 10-5615, 1 University of New Mexico, Albuquerque, NM 87131, USA; mchohan{at}salud.unm.edu

Abstract

Background Radiation exposure to patients and personnel remains a major concern in the practice of interventional radiology, with minimal literature available on exposure to the forehead and cranium.

Objective In this study, we measured cranial radiation exposure to the patient, operating interventional neuroradiologist, and circulating nurse during neuroangiographic procedures. We also report the effectiveness of wearing a 0.5 mm lead equivalent cap as protection against radiation scatter.

Design 24 consecutive adult interventional neuroradiology procedures (six interventional, 18 diagnostic) were prospectively studied for cranial radiation exposures in the patient and personnel. Data were collected using electronic detectors and thermoluminescent dosimeters.

Results Mean fluoroscopy time for diagnostic and interventional procedures was 8.48 (SD 2.79) min and 26.80 (SD 6.57) min, respectively. Mean radiation exposure to the operator's head was 0.08 mSv, as measured on the outside of the 0.5 mm lead equivalent protective headgear. This amounts to around 150 mSv/year, far exceeding the current deterministic threshold for the lens of the eye (ie, 20 mSv/year) in high volume centers performing up to five procedures a day. When compared with doses measured on the inside of the protective skullcap, there was a statistically significant reduction in the amount of radiation received by the operator's skull.

Conclusions Our study suggests that a modern neurointerventional suite is safe when equipped with proper protective shields and personal gear. However, cranial exposure is not completely eliminated with existing protective devices and the addition of a protective skullcap eliminates this exposure to both the operator and support staff.

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