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. 2024 Aug 13;14(16):1763.
doi: 10.3390/diagnostics14161763.

Real-Time Dosimetry in Endourology: Tracking Staff Radiation Risks

Susanne Deininger  1 , Olaf Nairz  2 , Anna Maria Dieplinger  3 , Christian Deininger  4   5 , Lukas Lusuardi  1 , Christian Ramesmayer  1 , Julia Peters  1 , David Oswald  1 , Maximilian Pallauf  1 , Sophina Bauer  1 , Mathias Christoph Brandt  6 , Peter Törzsök  1   7
Affiliations

Real-Time Dosimetry in Endourology: Tracking Staff Radiation Risks

Susanne Deininger et al. Diagnostics (Basel). .

Abstract

Background: To retrospectively investigate scatter radiation (SCR) exposure among staff in the endourology operating theatre.

Methods: During surgeries under fluoroscopic guidance, five professional groups (urological surgeon [US], surgical nurse [SN], assistant surgical nurse [ASN], anaesthetist [A], and anaesthesia care [AC]) wore real-time dosimeters (Philips DoseAware System) on their head and chest over lead aprons between July 2023 and February 2024. The SCR data were analysed and correlated with procedural and patient factors.

Results: In total, 249 procedures were performed, including 86 retrograde intrarenal surgeries and 10 percutaneous nephrolithotomies. Median SCR exposure was 38.81, 17.20, 7.71, 11.58, 0.63, 0.23, 0.12, and 0.15 Microsievert (µSv) for US chest (USC), US head (USH), SN chest (SNC), SN head (SNH), A chest (AC), AC chest (ACC), ASN chest (ASNC), and ASN head (ASNH), respectively. There was a significant correlation between DAP and SCR doses detected by USC, USH, SNC, SNH, AC, and ACC dosimeters (p < 0.05). The median chest-to-eye conversion factor (CECF) was 2.11 for the US and 0.71 for the SN.

Conclusions: This study, using real-time dosimetry, is among the first to assess staff occupational SCR exposure in endourology. It highlights a substantial SCR exposure, indicating an occupational health hazard that warrants further investigation.

Keywords: RIRS; X-ray; endourology; eye lens; lead apron; radiation protection; staff; stone removal.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Method of wearing of the real-time dosimeters on the head (between the eyes on the forehead attached to a headband or the surgical cap) and chest (on the left chest above the X-ray apron).
Figure 2
Figure 2
Illustration of the positioning of the radiation protective shield “OT81001” (MAVIG GmbH, Munich, Germany) in the area between patient and urological surgeon (right) and surgical nurse (left).
Figure 3
Figure 3
The positions of the urological surgeon (US) and surgical nurse (SN) in relation to the surgical table, X-ray tube, and to each other in the percutaneous nephrolithotomy (PCNL) (a) and lithotomy position (b).
Figure 4
Figure 4
Median dose area product (DAP) in Centigray (cGy)·cm2 according to type of surgeries performed (ESWL = extracorporeal shock wave lithotripsy, PCNL = percutaneous nephrolithotomy, RIRS = retrograde intrarenal surgery).
Figure 5
Figure 5
Median absolute values of individual real-time dosimeters in Microsievert (µSv) for urological surgeon chest (USC) and head (USH) and for surgical nurse chest (SNC) and head (SNH), stratified according to type of surgery performed (ESWL = extracorporeal shock wave lithotripsy, PCNL = percutaneous nephrolithotomy, RIRS = retrograde intrarenal surgery. Comment: Measurement for USH/Memokath™ removed due to implausibly low recording).
Figure 6
Figure 6
Correlation of individual real-time dosimeters’ values in µSievert (µSv) with dose area product (DAP) in centigray (cGy)·cm2.
Figure 6
Figure 6
Correlation of individual real-time dosimeters’ values in µSievert (µSv) with dose area product (DAP) in centigray (cGy)·cm2.
Figure 7
Figure 7
Dosimeter measurements with use of additional lead shield for the dosimeters urological surgeon chest (USC) and head (USH) and surgical nurse chest (SNC) and head (SNH), in Microsievert (µSv)/Centigray (cGy)·cm².
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