Occupational radiation dose to the eye lens of physicians from departments of interventional radiology

Radiation exposure in augmented fluoroscopic bronchoscopy procedures: a comprehensive analysis for patients and physicians

Cancer is a major health challenge and causes millions of deaths worldwide each year, and the incidence of lung cancer has increased. Augmented fluoroscopic bronchoscopy (AFB) procedures, which combine bronchoscopy and fluoroscopy, are crucial for diagnosing and treating lung cancer. However, fluoroscopy exposes patients and physicians to radiation, and therefore, the procedure requires careful monitoring. The National Council on Radiation Protection and Measurement and the International Commission on Radiological Protection have emphasised the importance of monitoring patient doses and ensuring occupational radiation safety. The present study evaluated radiation doses during AFB procedures, focusing on patient skin doses, the effective dose, and the personal dose equivalent to the eye lens for physicians. Skin doses were measured using thermoluminescent dosimeters. Peak skin doses were observed on the sides of the patients' arms, particularly on the side closest to the x-ray tube. Differences in the procedures and experience of physicians between the two hospitals involved in this study were investigated. AFB procedures were conducted more efficiently at Hospital A than at Hospital B, resulting in lower effective doses. Cone-beam computed tomography (CT) contributes significantly to patient effective doses because it has higher radiographic parameters. Despite their higher radiographic parameters, AFB procedures resulted in smaller skin doses than did image-guided interventional and CT fluoroscopy procedures. The effective doses differed between the two hospitals of this study due to workflow differences, with cone-beam CT playing a dominant role. No significant differences in left and right eyeHp(3) values were observed between the hospitals. For both hospitals, theHp(3) values were below the recommended limits, indicating that radiation monitoring may not be required for AFB procedures. This study provides insights into radiation exposure during AFB procedures, concerning radiation dosimetry, and safety for patients and physicians.

Current status of eye-lens dosimetry in Canada

For occupational exposures in planned exposure situations International Commission on Radiological Protection (ICRP) publication 118 recommends an equivalent dose limit for the lens of the eye of 20 mSv yr^-1averaged over five years with no single year exceeding 50 mSv. This constitutes a reduction from the previous limit of 150 mSv yr^-1. The Canadian nuclear regulator, the Canadian Nuclear Safety Commission, responded to the ICRP recommendation by initiating amendments to theRadiation Protection Regulationsthrough a discussion paper which was published for comment by interested stakeholders in 2013. The revised equivalent dose limit of 50 mSv in a one-year dosimetry period for nuclear energy workers came into effect in January 2021. This paper presents the outcome of discussions with Canadian stakeholders in diverse fields of radiological work which focused on the implementation of the reduced occupational equivalent dose limit for the lens of the eye in their respective workplaces. These exchanges highlighted the existing practices for monitoring doses to the lens of the eye and identified current technological gaps. The exchanges also identified that, in many cases, the lens of the eye dose is anticipated to be well within the new dose limit despite some of the gaps in technology. The paper also presents the monitoring and eye-lens dose assessment solutions that are available based on different methods for eye-lens monitoring; presented together with criteria for their use.