Pediatric Cardiology

, Volume 30, Issue 4, pp 409–413 | Cite as

Staff Radiation Doses in Interventional Cardiology: Correlation With Patient Exposure

  • Eliseo VanoEmail author
  • Carlos Ubeda
  • Fernando Leyton
  • Patricia Miranda
  • Luciano Gonzalez
Original Article


In pediatric interventional cardiology, cardiologists need to stay closer to the patient than during adult catheterization, and the use of biplane systems increases the scatter radiation. Occupational radiation risk is rather high, and estimation of lens doses becomes necessary. Deriving factors for assessing these doses from the patient doses displayed in catheterization laboratories can help in preserving staff radiation safety. A biplane X-ray system and polymethylmethacrylate plates of 4 to 20 cm to simulate pediatric patients have been used. Patient entrance dose rates, dose-area product, and doses to the eyes of the cardiologists for the typical operation modes have been measured. Correlations between patient and staff doses have been obtained. Scatter dose rates increase by a factor of 92 from low fluoroscopy to cine acquisition when phantom thickness increases from 4 to 20 cm. Scatter doses increase linearly with dose-area product for all the thicknesses. Administration of 1 Gy·cm2 to the patient involves 7 μSv to the eyes of the cardiologist (without extra protection). In conclusion, the experimental correlation factors found between phantom and scatter doses allow a fairly good estimation of staff doses from the dosimetric patient data.


Interventional cardiology Radiation risk Staff doses 



The current work has been carried out as part of the Strengthening Radiological Protection of Patients and in Medical Exposures program (TSA3), RLA/9/057 of the International Atomic Energy Agency. Dr E. Vano acknowledges the support of the Spanish Department of Education and Science (grant FIS2006-08186). The authors also acknowledge Dr. P. Doggenweiler and Dr. M. E. Salinas for her helpful suggestions in the final revision of the manuscript.


  1. 1.
    Camm AJ, Reid J, Raphael M et al (1993) Radiation hazards to the cardiologist: a report of a subcommittee of the British Cardiac Society. Br Heart J 70:489–496CrossRefGoogle Scholar
  2. 2.
    Campbell RM, Strieper MJ, Frias PA et al (2005) Quantifying and minimizing radiation exposure during pediatric cardiac catheterization. Pediatr Cardiol 26:29–33PubMedCrossRefGoogle Scholar
  3. 3.
    Foti C, Padovani R, Trianni A et al (2008) Staff dosimetry in interventional cardiology: survey on methods and level of exposure. Radiat Prot Dosim 129:100–103CrossRefGoogle Scholar
  4. 4.
    Haskal ZJ (2004) Interventional radiology carries occupational risk for cataracts. RSNA News 14:5–6. Retrieved 2 May 2008 at Google Scholar
  5. 5.
    International Commission on Radiological Protection. ICRP Publication 103 (2007) Recommendations of the ICRP. Ann ICRP 37:1–332Google Scholar
  6. 6.
    International Commission on Radiological Units and Measurements (2005) Patient dosimetry for X-rays used in medical imaging. ICRU Report 74. J ICRU 5:1–113Google Scholar
  7. 7.
    Kim KP, Miller DL, Balter S et al (2008) Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys 94:211–227PubMedCrossRefGoogle Scholar
  8. 8.
    Kuon E (2008) Radiation exposure in invasive cardiology. Heart 94:667–674PubMedCrossRefGoogle Scholar
  9. 9.
    Li LB, Kai M, Takano K et al (1995) Occupational exposure in pediatric cardiac catheterization. Health Phys 69:261–264PubMedCrossRefGoogle Scholar
  10. 10.
    Martinez LC, Vano E, Gutierrez F et al (2007) Patient doses from fluoroscopically guided cardiac procedures in pediatrics. Phys Med Biol 52:4749–4759PubMedCrossRefGoogle Scholar
  11. 11.
    Rassow J, Schmaltz AA, Hentrich F et al (2000) Effective doses to patients from pediatric cardiac catheterization. Br J Radiol 73:172–183PubMedGoogle Scholar
  12. 12.
    Schultz FW, Geleijns J, Spoelstra FM et al (2003) Monte Carlo calculations for assessment of radiation dose to patients with congenital heart defects and to staff during cardiac catheterizations. Br J Radiol 76:638–647PubMedCrossRefGoogle Scholar
  13. 13.
    Tsapaki V, Kottou S, Vano E et al (2005) Correlation of patient and staff doses in interventional cardiology. Radiat Prot Dosim 117:26–29CrossRefGoogle Scholar
  14. 14.
    Vano E (2003) Radiation exposure to cardiologists: how it could be reduced. Heart 89:1123–1124PubMedCrossRefGoogle Scholar
  15. 15.
    Vano E, Gonzalez L, Beneytez F et al (1998) Lens injuries induced by occupational exposure in nonoptimized interventional radiology laboratories. Br J Radiol 71:728–733PubMedGoogle Scholar
  16. 16.
    Vano E, Gonzalez L, Guibelalde E et al (1998) Radiation exposure to medical staff in interventional and cardiac radiology. Br J Radiol 71:954–960PubMedGoogle Scholar
  17. 17.
    Vano E, Gonzalez L, Fernandez JM et al (2006) Influence of patient thickness and operation modes on occupational and patient radiation doses in interventional cardiology. Radiat Prot Dosim 111:297–304Google Scholar
  18. 18.
    Vano E, Gonzalez L, Fernandez JM et al (2006) Occupational radiation doses in interventional cardiology: a 15-year follow-up. Br J Radiol 79:383–388PubMedCrossRefGoogle Scholar
  19. 19.
    Vano E, Gonzalez L, Fernandez JM et al (2008) Radiation exposure to the lens in interventional suites: caution is warranted. Radiology 248:945–953PubMedCrossRefGoogle Scholar
  20. 20.
    Worgul BW, Kundiyev YI, Sergiyenko NM et al (2007) Cataracts among Chernobyl cleanup workers: implications regarding permissible eye exposures. Radiat Res 167:233–243PubMedCrossRefGoogle Scholar
  21. 21.
    Wu JR, Huang TY, Wu DK et al (1991) Radiation exposure of pediatric patients and physicians during cardiac catheterization and balloon pulmonary valvuloplasty. Am J Cardiol 68:221–225PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Eliseo Vano
    • 1
    Email author
  • Carlos Ubeda
    • 2
  • Fernando Leyton
    • 3
  • Patricia Miranda
    • 4
  • Luciano Gonzalez
    • 5
  1. 1.Radiology DepartmentComplutense University and San Carlos HospitalMadridSpain
  2. 2.Clinical Sciences Department, Faculty of the Science of Health Tarapaca UniversityAricaChile
  3. 3.Public Health Institute of ChileSantiagoChile
  4. 4.Hemodynamic Lab, Cardiovascular ServiceLuis Calvo Mackenna Children’s HospitalSantiagoChile
  5. 5.Radiology DepartmentComplutense UniversityMadridSpain

Personalised recommendations