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The power to manage 
exposure in your hands

Too often achieving ALARA in interventional procedures is treated as an experiment of trial and error. Furthermore, feedback and analysis on radiation exposure over time can take months to track and evaluate, leaving staff potentially exposed to higher than necessary radiation levels in the meantime.

 

With DoseWise Portal, used in concert with DoseAware Xtend, you can protect staff from unnecessary scatter radiation. The platform provides real-time feedback to staff and management to quantitatively track, record, analyze and demonstrate the impact of your efforts—putting radiation exposure in your control to improve staff safety.

What can be controlled?
 

The patient and table are the largest source of scatter radiation (staff dose). Staff dose is expressed in millisieverts (mSv) is determined from measurements of external ionizing radiation on various types of human tissue. All occupational limits are expressed in mSv with 20mSv per year, being the maximum for medical personnel in EU and 50 mSv per year in the US.

 

You and your staff can take control of radiation exposure by managing the effects of:

  • Shielding
  • Distance
  • Fluoro settings
  • Angulation
  • Field of view (FOV)
  • Collimation
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Real-time feedback with DoseAware Xtend*
 

DoseAware Xtend is a real-time radiation exposure feedback solution designed to monitor and record staff radiation exposure during an interventional procedure. Following the exam, all dose data associated with the procedure is exported to DoseWise Portal for quantitative analysis and reporting.
Each staff member wears a personal dose meter
A reference personal dose meter is positioned on the C-Arm.
Then displayed in the DoseAware user interface which is integrated into the FlexVision monitor
Measurements are transmitted to a dosimetry hub mounted on the ceiling
Export of staff dose information to the DoseWise Portal

Take control now

With DoseAware implemented and personal dose meters on each staff member, you are in control. Each step you take to minimize scatter radiation can be visually demonstrated (in real-time) and numerically recorded.

Shielding

Logically, lead protection has a large impact on scatter reduction. Be sure to consider eyewear too.

Distance

Like shielding, increasing distance from the patient can greatly reduce exposure to scatter radiation. Move away from the source when you can.

Fluoro settings

Maintain proper fluoroscopy parameter settings with respect to the size of the patient. This may help improve image quality at low dose.

Angulation (tube position)

Stand on the “detector” side of the equipment when using fluoro. Radiation bounces off the patient entry point and reflects into the staff. This “scatter radiation” is much less on the detector side as the patient effectively shields staff from some radiation.

Field of view (FOV)

If you zoom in to a smaller FOV the amount of scatter radiation is moderately reduced. Patient dose does increase a bit.

Collimation

One of the best and easiest ways to reduce scatter radiation is to collimate. It simply produces less scatter for your staff and helps the patient too.

Optimizing angulation

In this test, a phantom is positioned on the table and a personal dose meter is attached to the lead interventionalist. Angulation is affected by the position of the C-Arm in relation to the position of the staff member. The best place to stand when the C-Arm is in a lateral position is on the detector side, opposite the X-ray tube.

Standing next to C-Arm in Anterior/Posterior position

Scatter radiation coming from the Anterior/Posterior (AP) position is much less than in the lateral because in the lateral position you are almost in the field of view. Radiation comes out of the tube like a flashlight, a cone beam that will extend sometimes more than the detector surface and strike the operator. Like in billiards, radiation loses its energy when it interacts (scattered), so less dose in the AP position after it strikes the table and patient.

Standing next to C-Arm in lateral position

Conversely, the interventionalist is in the red when remaining in place during rotation. The exposure (in mSv/h) increases significantly — to nearly the same as the unprotected reference personal dose meter.

Discovering trends

 

Considered together, these actions taken by your staff can make a difference. Over time, dose trends can be identified and best practices established or anomalies corrected.

DoseAware knows when a patient is on the table and synchronizes start dose — then automatically exports to DoseWise Portal at the end of the procedure. DoseWise Portal receives data for each procedure and every staff member (up to eight) involved in that procedure. By gaining easy access to detailed dose performance through reports and analytics, you can establish a strong institution-wide dose management program.

There are many opportunities to optimize your exposure to scatter radiation

Influence AK ref point

Effect on staff dose

Involves staff behavior
Lead protection
no (0)

large (++)
    yes
Take distance
no (0)

large (++)
    yes
Fluoro I, II, III
yes (+)

minimal (-)
    yes
Tube position/angulation
large (++)

large (++)
    yes
Adjust FOV
minimal (+)

moderate (+)
    yes
Collimation
no (0)

moderate (+)
    yes

Enable dose management across your organization
 

DoseWise Portal is a vendor-agnostic, web-based solution that collects, measures, analyzes, and reports patient & staff radiation exposure, assisting you to take control of quality of care, efficiency, and patient/staff safety.
View product

Make a conscious choice

 

Before you even begin an interventional procedure it is important to choose the right application setting on the angio system. This determines, in large part, the X-ray dose to the patient and has an impact on scatter radiation. Choose carefully.

Angio system radiation levels by application

low

medium

high
Neuro

1
3
7
R/min
Peripheral

1
3
7
R/min
Abdominal

1
3
7
R/min
Vascular

1
3
7
R/min
EP

0.5
1
2
R/min
Cardio

2.5
5
9
R/min

More dose management articles and insights

  • Building a safety culture

    Building a safety culture

    Learn how important it is to share attitudes, values, goals and practices regarding radiation safety across all imaging departments.

    Read the article

  • Understanding DAP and AK

    Understanding DAP and AK

    The difference between Dose Area Product (DAP) total radiation dose exposure measurement and Air Kerma (AK) radiation dose measurement at a point on a patient’s skin.

    Read the article

  • Understanding DAP and AK

    Understanding DAP and AK

    The difference between Dose Area Product (DAP) total radiation dose exposure measurement and Air Kerma (AK) radiation dose measurement at a point on a patient’s skin.

    Read the article

View all articles
*The Personal Dose Meters (PDM) used by DoseAware Xtend do not replace the TLD as a legal dose meter.