Patient and staff dosimetry in vertebroplasty

Abstract

Study design: Eleven vertebroplasty operations were studied in terms of radiation dose.

Objective: Doses to patients and staff associated with vertebroplasty were measured. Occupational doses were compared with the annual dose limits, and the effectiveness of the used radiation protection means was estimated. Patient dose was estimated by means of both surface and effective dose, and the radiation-induced risk was evaluated.

Summary of background data: Vertebroplasty is a recent minimally invasive technique for the restoration of vertebral body fractures. It involves fluoroscopic exposure, and so, it demands dose measurements for both patient and staff exposed to radiation.

Methods: Thermoluminescent dosimeters (TLDs) were placed on the medical personnel and the effective dose was derived. Slow films were placed to patients' skin to measure entrance surface dose. Furthermore, a Rando phantom loaded with TLDs was irradiated under conditions simulating vertebroplasty, in order to estimate effective dose to the patient.

Results: Mean fluoroscopy time was 27.7 minutes. Patient's mean skin dose was 688 mGy, while effective dose was calculated to be 34.45 mGy. It was estimated that the primary operator can perform about 150 vertebroplasty operations annually without exceeding the annual dose constraints, whereas occupational dose can be reduced by 76% using mobile shielding.

Conclusions: Measures have to be taken to reduce patient's skin dose, which, in extreme cases, may be close to deterministic effects threshold. The highest dose rates, recorded during the procedure, were found for primary operator's hands and chest when no shielding was used.