Radioprotection 2025, 60( 1), 20 – 27 © Z. You et al., Published by EDP Sciences, 2025 https:// doi. org / 10.1051 / radiopro / 2024037 Available online at: www. radioprotection. org ARTICLE
Analysis and consideration of radiation dose distribution in cardiac catheterization interventions
Z. You 1, a, Y. Liu 2, a, C. Li 1, A. Hu 1, X. Liu 2, W. Li 3, L. Liao 2 and F. Liu 2, 3, 4,*
1 School of Medicine, Jinhua University of Vocational Technology, 321000 Jinhua City, Zhejiang Province, People’ s Republic of China. 2 School of Nursing, University of South China, 421001 Hengyang City, Hunan Province, People’ s Republic of China. 3 Cardiac Interventional Imaging Center, the First Affiliated Hospital, Hengyang Medical School, University of South China, 421001
Hengyang City, Hunan Province, People’ s Republic of China. 4 PhD Degree Program, Faculty of Nursing, Chiang Mai University, 50000 Chiang Mai, Thailand.
Received: 15 April 2024 / Accepted: 12 August 2024
Abstract – Objective: To assess the variations in radiation dose at different areas in the operation room of cardiac catheterization laboratory during cardiac catheterization interventions. Methods: To simulate the conventional operation in cardiac catheterization interventions, perform angiography on standard manikins, the radiation dose was collected from 22 areas in the operation room of cardiac catheterization laboratory under 8 projection angles, and each area was repeated 5 times, and the collected data was analyzed by oneway ANOVA and independent sample t-test. Results: Analysis of the radiation dose in 22 areas under 8 projection angles revealed that the lowest radiation dose was found in the area at the end of the operating table in the cardiac catheterization room( p < 0.05), and the highest radiation dose was found in the area on the left and right sides of the X-ray tube( p < 0.05); the radiation dose in the area on the right side of the X-ray tube of the DSA machine was greater than that in the conventional standing area of the first operator( p < 0.05), and the radiation dose in the conventional standing area of the second operator was greater than that in the conventional standing area of the first operator( p < 0.05); the radiation dose in the standing area of the first operator was highest in the cephalic position( CRA 30 °)( p < 0.05), and the radiation dose in the standing area of the second operator was highest in the left anterior oblique position( LAO 45 °)( p < 0.05); in the angle of RAO projection, the radiation dose in the right area of the X-ray tube was greater than that in the left area of the X-ray tube( p < 0.05), and the result was reversed at the projection angle of the LAO. Conclusion: The radiation dose during cardiac catheterization interventions is lowest in the area at the end of the operating table, which can be used as a standing area for nurses and as an area for the placement of surgical equipment and supplies. At the same time, it is necessary to pay attention to the radiation dose to the second operator and to further improve the radiation protection measures for the second operator, and additional measures are needed to minimize the radiation dose to the operators in the cephalic position( CRA 30 °) and in the left anterior oblique position( LAO 45 °). Keywords: Cardiac catheterization intervention / radiation dose / occupational disease / radiation protection
1 Introduction
Fluoroscopic guidance techniques in cardiac catheterization interventions require the use of X-rays, which can produce a certain amount of radiation( Behan et al., 2010). Due to the particularity of this kind of interventional procedure, the operator and nurse need to be exposed to radiation throughout
* Corresponding author: wind1022 @ 163. com a Ze You and Yaqing Liu are joint first authors. the process( Monzen et al., 2017). Currently, these professionals are the highest dose-exposed group of radiologists( Zhang et al., 2011). With the increasing number of cardiac catheterization interventions in China, there’ s a corresponding rise in radiation doses received by these individuals, leading to emerging radiation-related occupational health concerns( Rajaraman et al., 2016; Uwineza et al., 2019; Ma et al., 2021). Emphasizing radiation protection has become crucial in cardiac catheterization interventions( Liu et al., 2018). The scattering and invisibility of radiation and the dynamic angles of the digital subtraction angiography( DSA) machine during
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