Radiation exposure is affected by C-arm fluoroscopy device positioning during percutaneous renal puncture. Our aim was to compare the exposure of surgeon's lens, hand and chest with a fluoroscopy protocol replicated in different C-arm positions.
A standardized fluoroscopy protocol was created using water-equivalent solid phantoms to replicate a surgeon and patient. 111 mGy radiation (360 s) was applied in standard fluoroscopy mode (91 kVp, 2.7 mA/mAs). Dosimeters were placed on lens, chest and hand of surgeon and patient phantom models. 7 different C-arm positions were created: 0°, mediolateral (ML) +90°, ML -90°, ML +30°, ML -15°, craniocaudal (CC) +30°, CC +15°. Measurements were evaluated separately for different positions.
The highest radiation exposure was measured on patient dosimeter (2.97 mSv). The highest exposure on surgeon was recorded on finger dosimeter in all C-arm positions; highest dose was recorded in ML +90° position (2.88 mSv). In finger dosimeters, lowest exposure was recorded in 0° position (0.51 mSv). The lowest exposure of all positions was measured in chest dosimeter in ML -90° position (0.24 mSv).
In positions where X-ray generator of the C-arm was facing towards the surgeon, radiation exposure measured in all dosimeters was higher compared to positions where the generator was facing away. The hand radiation exposure in all positions was higher than chest and lens. Special care must be taken to avoid facing the X-ray generator tube and hands should be as well-protected as chest and eyes with special protective gear.
Investigative and clinical urology. 2023 Sep [Epub]
Tarik Emre Sener, Yiloren Tanidir, Serap Ketenci, Umut Kutukoglu, Dogancan Dorucu, Huseyin Cayir, Amelia Pietropaolo, Esteban Emiliani, Bhaskar Somani
Department of Urology, Marmara University, School of Medicine, Istanbul, Türkiye., Department of Radiation Oncology, Unit of Radiation Health, Marmara University Pendik Training and Research Hospital, Istanbul, Türkiye., Department of Radiology, Unit of Radiation Health, Marmara University Pendik Training and Research Hospital, Istanbul, Türkiye., Young Academic Urologists, Endourology and Urolithiasis Working Party, European Association of Urology, Arnhem, Netherlands., Department of Urology, NHS Foundation Trust, Southampton University Hospital, Southampton, UK.