Effects of Real-Time Dosimetry on Staff Radiation Exposure in the Cardiac Catheterization Laboratory.

OBJECTIVES: Radiation protection is essential for staff of cardiac catheterization laboratories in order to prevent long-term radiation- associated injury and disease. Instant feedback about the actual received dose may help operators to optimize the use of existing shielding devices. Therefore, the current study was designed to investigate whether routine use of real-time dosimetry may be able to reduce staff radiation exposure.

METHODS AND RESULTS: Over a period of 72 days, operators and assisting nurses were equipped with RaySafe i3 real-time dosimeters (Unfors RaySafe AB), but had no access to the dosimetry results during the first half of the study. This was followed by a second period that allowed operators to modify their behavior according to the dosimetry results. Compared with the first phase, the knowledge of real-time dosimetry results led to a uniform reduction in radiation exposure of all team members by approximately 60%, independent of the chosen vascular access. There were no significant changes in fluoroscopy time, dose-area product, or patient characteristics.

CONCLUSIONS: Real-time dosimetry effectively reduced staff radiation exposure in the cardiac catheterization laboratory. This change was caused by optimized use of existing shielding equipment since no modifications of the general procedural approach or patient characteristics had occurred.