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A study of the distribution of dose across the hands of interventional radiologists and cardiologists

Health Physics, Department of Clinical Physics and Bio-Engineering, West House, Gartnavel Royal Hospital, Glasgow, UK

View larger version (78K): [in a new window]   Figure 1. Positions of thermoluminescent dosemeters (TLDs) used for monitoring (a) the dorsum and (b) the palmer aspects of the hands. The X marks the position of the TLD that was used as the denominator when deriving ratios for doses to different parts of the hands.

View larger version (45K): [in a new window]   Figure 2. Diagram showing the positions where the hands are located relative to the patient for various points of entry for the different groups of procedures studied, (a) interventional radiology with femoral, internal jugular vein (IJV) and percutaneous access and (b) percutaneous transluminal coronary angiography (PTCA) with radial and femoral access. Contours relate to dose rate distributions measured on one unit and are given in µGy min–1.

View larger version (21K): [in a new window]   Figure 3. Numbers of procedures where the mean doses to the most exposed hand lay in different dose ranges for each category of procedure. In 62 procedures the mean doses to the hand were below 0.02 mSv and these have been excluded (percutaneous transluminal coronary angiography (PTCA) 2, femoral 36, internal jugular vein (IJV) 12, percutaneous 12).

View larger version (24K): [in a new window]   Figure 4. Distribution of dose across the hands for interventional radiology procedures with femoral (cross-hatched) and internal jugular vein (IJV) (black) access. All doses are normalized with respect to that to the centre of the back of the hand (Figure 2). Error bars indicate ±1 standard deviation. TLD, thermoluminescent dosemeter.

View larger version (14K): [in a new window]   Figure 5. Distribution of dose across the hands for interventional radiology procedures with percutaneous access. All doses are normalized with respect to that to the centre of the back of the hand (Figure 2). Error bars indicate ±1 standard deviation. TLD, thermoluminescent dosemeter.

View larger version (12K): [in a new window]   Figure 6. Distribution of dose across the dorsum aspect of the hands for cardiology percutaneous transluminal coronary angiography (PTCA) procedures. All doses are normalized with respect to that to the centre of the back of the hand. Error bars indicate ±1 standard deviation. TLD, thermoluminescent dosemeter.

View larger version (18K): [in a new window]   Figure 7. Hand positions and configurations used for performing (a) the advancing/retracting and prodding actions and (b) the twisting action required for interventional radiology and cardiology procedures with femoral access.

View larger version (22K): [in a new window]   Figure 8. Hand positions and configurations used for performing percutaneous procedures in which the hand is required to be close to the X-ray beam.

View larger version (19K): [in a new window]   Figure 9. Hand positions and configurations used for performing (a) the advancing/retracting and (b) the twisting actions required for interventional radiology internal jugular vein (IJV) procedures.