Radiation dose to procedural personnel and patients from an X-ray volume imaging system

Paul, Jijo; Mbalisike, Emmanuel C.; Vogl, Thomas J.
December 2013
European Radiology;Dec2013, Vol. 23 Issue 12, p3262
Academic Journal
Objective: To evaluate the radiation dose received by procedural personnel and patients from an X-ray volume imaging (XVI) system during interventional procedures. Methods: Forty patients were examined using catheter angiography (group A), digital subtraction angiography (group B) and cone-beam CT (CBCT, group C). Doses to procedural personnel (using thermo-luminescent dosimeters, TLDs) and patients were estimated. Image quality and lesion delineation were assessed using objective and subjective methods. Shapiro–Wilk, two-sided Student’s t and Wilcoxon matched-pairs tests were used to test statistical significance. Results: Doses (milligrays) measured in the hands and left knee of the interventionist were higher than those in an assistant physician ( P < 0.05). Doses (dose–area product and skin entry dose) were lower in group A and higher in C compared with other groups; moreover, comparison among the groups were significant (all P = 0.0001). Subjective and objective lesion delineation showed significant results (all P < 0.05) among the tumour types considered. Image quality estimation showed the opposite results for objective and subjective analysis. Conclusion: More doses were obtained for hands of the procedural personnel compared to other anatomical regions measured. Catheter angiography showed lower dose compared with other imaging groups examined. Lesion delineation was clearly possible using CBCT. Objective and subjective analysis showed the opposite results regarding image quality because of higher noise levels and artefacts. Key Points: • Interventional radiological procedures inevitably impart relatively high radiation doses• Little is known about the doses imparted by cone-beam CT (CBCT)-guided procedures.• During interventional radiological procedures the hands of personnel receive high doses.• Catheter angiography delivered lower doses compared with CBCT and digital subtraction angiography (DSA).• Nevertheless the use of CBCT to delineate lesions is advantageous for patients.


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