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Radiation risks for the radiologist performing transjugular intrahepatic portosystemic shunt (TIPS)

Department of Radiology, Charité Campus Virchow-Klinikum, University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany

The aim of this study is to evaluate the radiation dose to the interventional radiologist in transjugular intrahepatic portosystemic shunt (TIPS) concerning the risk of cancer and deterministic radiation effects and the relation to recommended dose limits. In 18 TIPS interventions radiation doses were measured with thermoluminescence dosemeters (TLD) fixed at the eyebrow, thyroid and hand of the radiologist without special lead shielding of these body parts and at the chest, abdomen and testes under the lead apron. The doses of the eye lens, thyroid gland and hand were assumed to be equal to the corresponding surface doses. The dose at the abdomen under the lead apron was used as an estimation of the ovarian dose. Effective dose equivalent was estimated by Webster's method. The estimated effective dose equivalent was 0.087 mSv and the effective dose 0.110 mSv. The risk of fatal cancer was of 10^–6 and the risk of severe genetic defect of 10^–7 for one single intervention. The maximum permissible number of TIPS interventions was 181, otherwise the dose limit for effective dose would be exceeded. When the radiologist performed more than 372 TIPS procedures per year for many years, the dose to the lens of the eye could exceed the threshold for cataract. If the interventionist performs a large number of TIPS procedures in a year, the risk of fatal cancer and developing cataracts becomes relatively high.