A Study of Radiation Exposure and the Effects of Real-Time Dosimetry System on Staff Safety in Neurointerventional Procedures.

Abstract

Background and purposeNeurointerventional procedures expose both patients and medical personnel to high radiation, raising concerns about long-term health risks. This study investigated whether real-time radiation monitoring systems reduce occupational radiation doses and improve radiation protection behaviors among staff.Materials and methodsWe conducted a retrospective and prospective cohort study at Prince of Songkla University Minimally Invasive Surgical-Interventional Radiology Center between October 2023 and July 2024. The study included 167 patients undergoing cerebral angiograms and 26 medical personnel (interventional neuroradiologists, nurses, and radiologic technologists). Patient radiation metrics (air kerma, dose-area product, and fluoroscopy time) were collected via Radimetrics software. Personnel doses were measured using optically stimulated luminescence dosimeters, with real-time personal dose meters (RaySafe i3) implemented from January 2024, providing immediate feedback during procedures.ResultsPatients received a median dose-area product of 32.25 Gy·cm² and air kerma of 129.19 mGy, with a mean fluoroscopy time of 2.7 minutes; all values remained below Thai national standards. Among personnel, interventional neuroradiologists demonstrated significant dose reduction following real-time monitoring implementation. Personal dose equivalent Hp(10) decreased from 1.628 mSv in 2023 to 0.335 mSv in 2024, representing a 79.4% reduction (P = .01). Hp(0.07) and Hp(3) values decreased by 15.7% and 16.1%, respectively (P = .01). Real-time monitoring increased personnel awareness of radiation dose levels in the angiography suite from 42.9% to 85.7%, with protective equipment utilization and optimal positioning practices also improving substantially.ConclusionsImplementation of real-time personal radiation dosimeters significantly reduced occupational radiation exposure during neurointerventional procedures, particularly for interventional neuroradiologists. This reduction was achieved through enhanced staff awareness and improved radiation protection behaviors without compromising patient care quality.